Commentary on: Neuropathic pain in low back-related leg pain patients: What is the evidence of prevalence, characteristics, and prognosis in primary care? A systematic review of the literature

摘要

This intensively researched paper is a study of nearly3000 patients initially evaluated at primary care centersfor low back pain.[1] Some were diagnosed with acomponent of neuropathic leg pain and another grouphad what the authors consider to be nociceptive referredleg pain. Such patients had non?neuropathic pain in a legin association with low back pain. The authors concludethat there is “some evidence of higher levels of morbidityin low back leg pain patients with neuropathic pain.” Thisis hardly earthshattering. Primary care providers if theyfind evidence of neuropathic leg pain should be awarethat this is more serious than if there is nociceptive legpain. However, there is no overarching statistic that theauthors of this paper present to confirm this conclusion.“More research is needed” is hardly helpful. They statethat there is “some consistent evidence for worse backand leg pain related disability in LBLP (low back legpain) patients with neuropathic pain.” Such conclusionsare consistent with other published evidence, but theauthors sought to confirm this by studying only thosepatients who presented to primary care centers. For astudy that relied heavily on careful collation of scientificstudies, there is a paucity of statistical inclusion in theresults.