PTOTOtherNeuroRehabilitation2022

Characterization of neuropathic component of back pain in patients with osteoporotic vertebral fractures.

Antimo Moretti, Sara Liguori, Marco Paoletta and 4 others

PMID 35599506

WHAT IT FOUND

In patients with osteoporotic vertebral fractures, neuropathic pain features were present in 23.6% of cases.

This prevalence was linked to fracture location rather than number. Therapists should screen for neuropathic symptoms in patients with thoracic or lumbar fractures.

Key findings

01Neuropathic pain was detected in 23.6% of patients using the LANSS scale, compared to only 5.5% using the painDETECT questionnaire.

02Among patients with a single vertebral fracture, neuropathic pain was significantly more prevalent in those with thoracic fractures compared to lumbar fractures.

03Among patients with multiple vertebral fractures, neuropathic pain was significantly more prevalent in those with lumbar fractures.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

Small sample size (72 patients) limits the generalizability of the findings. Cross-sectional design prevents establishing causality between fracture location and neuropathic pain development. Most patients were already receiving anti-osteoporotic therapy, which may have analgesic effects and mask true pain severity. No data were collected on the mean duration of back pain, which is a key factor in central sensitization. Discrepancy between assessment tools (LANSS vs. PD-Q) suggests uncertainty in the true prevalence of neuropathic pain.

Declared interests

The authors report no conflicts of interest.

The easy way to misread this

Do not assume that low reported pain intensity means there is no neuropathic component. The study found that neuropathic features were present in over 20% of patients despite mild pain scores, and the prevalence depended heavily on which screening tool was used.

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