PAIN DRAWINGS IN THE ASSESSMENT OF NERVE ROOT COMPRESSION - A COMPARATIVE-STUDY WITH LUMBAR SPINE MAGNETIC-RESONANCE-IMAGING

Study Design. Prospective comparative study of pain drawings with find ings on lumbar spine magnetic resonance imaging. Objectives. To assess the ability of the pain drawing to predict the presence of nerve root compression. Summary of Background Data. Most research work has conce ntrated on the ability of the pain drawing to act as a screening metho d for psychological distress with less work directed at the influence the anatomic abnormality has on the pain drawing. Methods, One hundred thirty-four consecutive outpatients attending for lumbar magnetic res onance imaging in the investigation of back and leg pain completed pai n drawings and psychological testing immediately before the examinatio n. The pain drawing was analyzed by previously reported criteria, and the magnetic resonance imaging was assessed independently for the pres ence of nerve compression by three radiologists. Multivariate stepwise discriminant analysis was used to identify patients with nerve compre ssion on the basis of their pain drawing. Results. Nerve compression w as predicted by numbness in the anterolateral aspect of the foot. Ther e was considerable overlap in the appearances of the pain drawings bet ween patients with and without nerve compression, and the pain drawing correctly classified only 58% Of patients with nerve compression. Con clusions. The pain drawing is not a good predictor of nerve compressio n on magnetic resonance imaging in a group of patients investigated fo r back and leg pain. It should be interpreted with caution and in ligh t of the full clinical picture.