Abstract
Background
Differential diagnosis of low back pain (LBP) is challenging; guidance may come from patients' history cues and physical examination. The literature conveys that applying pressure on peripheral branches of compromised lumbar nerves (e.g., at the buttock) may induce subjective responses and thus reveal lumbar radicular pain (LRP). We proposed the Buttock Applied Strain (BUAS-test) for LBP differential diagnosis. Clinical improvement of LRP, diagnosed with the BUAS-test and congruently treated, may bring further support to this test diagnostic ability.
Methods
Among 580 LRP patients who, upon first visit (V1), tested positive on the BUAS-test (with/without positive Lasegue Test, LT), the effect of gabapentin prescription on painDETECT (PD) questionnaire and Brief Pain Inventory (BPI) outcomes was quantified in the follow-up visit (V2). This study hypothesized that, at V2, >50% of the sample would present a negative PD outcome, significant (t-test), and ⩾2 points V2-V1 differences for the BPI-items score. We used multinomial logistic regression (MLR) and χ2 analyses to evaluate the dependence on the PD-V2 outcomes on independent socio-demographic variables.
Results
Of the sample, >75% reported a negative PD-V2 outcome. V2-V1 differences of BPI-items score were significant and >2 points. PD-V2 outcomes showed significant associations with LT-V1 and PD-V1, respectively, but not with gender, age group or pain site. MLR showed a significant relationship between LT-V1 and PD-V2 outcomes.
Conclusion
Among patients, who tested positive on the BUAS-test and treated with gabapentin, the study’s hypothesis was confirmed. These results add evidence for BUAS-test ability to conferm potential LRP. The co-presence of both positive BUAS-test and LT suggests a severer LRP condition. Further prospective research, in different settings, is imperative.
References
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