Tools for Assessing Neuropathic Pain

[IF 12.601] According to the latest definition, the term neuropathic pain refers to pain arising as a direct consequence of a lesion or disease affecting the somatosensory system. When physicians and researchers use the term assessment of neuropathic pain, they may be referring to two distinct types of assessment: (1) assessing pain intensity and quality and possibly their treatmentinduced changes, and (2) diagnosing neuropathic (as opposed to non-neuropathic) pain. Pain is a complex experience that depends strongly on cognitive, emotional, and educational influences. Hence the pressing need for tools that can measure pain objectively. We distinguish four different levels of ‘‘objectivity’’: (1) laboratory tests that use quantitative tools and measure an objective response; (2) quantitative sensory testing, a measure that despite using quantitative, graded stimuli inevitably relies on the patient’s evaluation; (3) bedside examination, which relies on the physician’s experience and the patient’s ability and willingness to collaborate; and (4) pain questionnaires, tools that depend entirely on the patient. We review each of these in turn, drawing in part on our previous work in this field.