Sensory Perception in Lumbosacral Radiculopathy with Radicular Pain: Feasibility Study of Multimodal Bedside-Suitable Somatosensory Testing

Alfredas Vaitkus, Jūratė Šipylaitė, Alfredas Vaitkus, Jūratė Šipylaitė

Abstract

Background: Somatosensory testing could be useful in stratifying pain patients and improving pain treatment guidelines. Bedside-suitable techniques are searched for application in daily clinical practice. This study aimed to characterize chronic unilateral lumbosacral radiculopathy (LSR) patients with radicular pain using multimodal bedside-suitable somatosensory testing.

Materials and methods: We evaluated 50 chronic unilateral LSR patients with radicular pain (LSR group) and 24 controls (Control group). Sensory testing was performed using a battery of bedside sensory tests (10g monofilament, 200-400 mN brush, Lindblom rollers with controlled 25°C and 40°C temperature, and 40g neurological pin and investigator's finger pressure). Participants had to rate their sensory perceptions on both legs at multiple test points within L3 to S2 dermatomes. Characteristics of the testing process and sensory disturbances were analyzed.

Results: LSR group showed sensory disturbances in 82% of patients. The Control group showed no sensory disturbances. Sensory testing took longer (p < 0.001) in the LSR group (29.3 ± 6.5 minutes per patient) than in the Control group (20.5 ± 5.2). Nine sensory phenotypes were detected in the LSR group according to individual sensory disturbances within 5 superficial tests.

Conclusions: The applied multimodal bedside-suitable somatosensory testing battery is suitable for sensory evaluation and characterization of LSR patients. Grouping of allied sensory phenotypes revealed some tendencies in pain intensity characteristics.

Keywords: back pain; bedside testing; lumbosacral radiculopathy; sensory phenotyping; sensory testing.

Conflict of interest statement

Nothing to declare.

Copyright © 2021 Alfredas Vaitkus, Jūratė Šipylaitė.

Figures

Figure 1.
Figure 1.
Flowchart for the inclusion of study participants into the LSR group.
Figure 2.
Figure 2.
Nerve root impairment according to diagnosis in the LSR group (n = 50).
Figure 3.
Figure 3.
Proportions of patients with sensory disturbances detected at different modalities in the LSR group (n = 50).
Figure 4.
Figure 4.
Low back (A) and leg (B) pain intensities differed between groups of sensory phenotypes.Pain intensities are presented as means in points on NRS 0-10. Differences between groups are insignificant. NRS – numeric rating scale.

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