Diagnostic utility of patient history, clinical examination, and screening tool data to identify neuropathic pain in low back related leg pain: a systematic review and narrative synthesis

Review written by Dr Sarah Haag info

Key Points

  1. Low back related leg pain commonly has a neuropathic component.
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Neuropathic pain (NP) is particularly common in low back related leg pain (LBLP), but not all LBLP is neuropathic. Being able to identify neuropathic pain can assist in identifying the most effective treatment. NP may be responsible for LBLP, however other pain mechanisms may be present or coexist with neuropathic pain.

Reviews have previously looked at how to classify LBLP (1), however finding examination or classification systems to reliably identify NP have been inadequate to date. This review evaluated the diagnostic utility of patient history, clinical examination, and screening tool data in order to identify NP in adults presenting with LBLP.

Not all low back related leg pain is neuropathic.
There was no single aspect of a patient’s history, screening tool, or physical examination that could alone identify possible neuropathic pain.


The protocol for this systematic review was informed by The Cochrane Handbook for Diagnostic Test Accuracy studies, the Centre for Reviews and Dissemination, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis - Protocols (PRISMA-P) Checklist.

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