-Original-

Reliability of PainDETECT for Evaluating Low Back Pain Caused by Cluneal Nerve Entrapment

Chiho Takada¹, Kyongsong Kim², Rinko Kokubo², Minoru Ideguchi², Riku Mihara², Kenta Koketsu² and Yasuo Murai³

¹Medical Student, Nippon Medical School, Tokyo, Japan
²Department of Neurological Surgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
³Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan

Background: Superior/middle cluneal nerve entrapment (CN-E) is an elicitor of low back pain (LBP). The painDETECT questionnaire is used to characterize CN-E symptoms.
Methods: Nineteen consecutive patients with LBP caused by CN-E (superior CN-E = 7; middle CN-E = 12) participated in a Japanese language painDETECT questionnaire survey before surgery. A score of 12 or lower was recorded as 'neuropathic component unlikely', a score of 19 or higher as 'neuropathic pain likely', and scores between 13 and 18 as 'neuropathic pain possible'. LBP severity was recorded on a numerical rating scale, the Roland-Morris Disability Questionnaire, and the EuroQol-5 dimension-5 level.
Results: The mean painDETECT score was 11.8 and did not significantly differ between the superior CN-E and middle CN-E groups. We classified low back pain as unlikely to have a neuropathic component in 13 patients, as likely to have a neuropathic component in 2 patients, and as possibly neuropathic in 4 patients. There was no significant difference in the pain level of patients with scores of ≤12 and ≥13 on painDETECT. All patients reported trigger pain; the positive rate was high for electric shock pain, radiating pain, and pain attacks and low for a burning or tingling sensation, pain elicited by a light touch, and pain caused by cold or hot stimulation.
Conclusion: The painDETECT questionnaire may not reliably identify LBP caused by superior/middle CN-E as neuropathic pain. A diagnosis of LBP due to CN-E must be made carefully because symptoms resemble nociceptive pain.

J Nippon Med Sch 2024; 91: 328-332

Keywords
cluneal nerve entrapment, low back pain, PainDETECT

Correspondence to
Kyongsong Kim, MD, PhD, Department of Neurological Surgery, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
kyongson@nms.ac.jp

Received, October 31, 2023
Accepted, January 10, 2024