Instituut voor Neuropathische Pijn
English articles Post-stroke shoulder pain and DN4
| Post-stroke shoulder pain and DN4 |
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Classifying post-stroke shoulder pain: Can the DN4 be helpful? Under this titel the dutch investigators Roosink and collegaues from the Biomedical Signals & Systems, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, The Netherlands analysed the usefulness of the DN 4 scale in post stroke pain. The shoulderpain after a stroke has both neuropathic as well as nociceptive elements combined.
The authors point out that the etiology of post-stroke shoulder pain (PSSP) may involve both nociceptive and neuropathic mechanisms. Due to its nature no gold standard is present for PSSP diagnosis. In their study the authors used the DN4 to categorize PSSP patients and compared symptoms and signs suggestive of either nociceptive or neuropathic pain. Pain was also assessed using a numeric rating scale and the McGill pain questionnaire. Sensory functions were assessed using clinical examination and quantitative sensory testing (QST). Patients classified as DN4 positives reported constant pain, higher pain intensity, a higher impact of pain on daily living, more frequent loss of cold sensation, reduced QST thresholds at the unaffected side and increased QST thresholds at the affected side. They conclude that PSSP prognosis and treatment should not be solely based on the DN4, but DN4 can give an idea about the severity of the pain. [1] Jan M. Keppel Hesselink, MD, PhD, june 2010 Referenties[1]: Roosink M, van Dongen RT, Renzenbrink GJ, Ijzerman MJ. | Classifying post-stroke shoulder pain: can the DN4 be helpful? | Eur J Pain. | 2011 Jan;15(1):99-102. Epub 2010 Jun 14. |