Evaluation of pain in patients with lumbar disc surgery using VAS scale and quantitative sensory testing.

Abstract

BACKGROUND: Pain is interpreted at the cortex level, however, pain signaling stimuli arise at the periphery and are conveyed by nociceptive A delta and C fibers. OBJECTIVES: Evaluation of pain using the VAS scale in pre- and postoperative S1 sciatica patients with regard to thermal thresholds in the corresponding dermatome. MATERIAL AND METHODS: Twenty-six S1 sciatica patients with herniated disc on an MRI, non-responsive to conservative care, were involved in the study. Pain in the affected leg was measured using the VAS scale and thermal thresholds in S1 symptomatic dermatome using Quantitative Sensory Testing (QST). RESULTS: Pain intensity as well as thermal thresholds were increased in sciatica patients compared to controls. Disc surgery resulted in a pronounced lowering of pain in each of the operated patients. From the whole group, 21 subjects were examined postoperatively six months later. In the group with complete clinical recovery, thermal thresholds were within normal limits. In those patients with residual pain disability, normalization of thresholds has not been achieved. CONCLUSIONS: Pain in sciatica patients may be objectively measured by QST.