This LANSS scale for neuropathic pain questionnaire calculator assesses the underlying mechanisms that cause a certain pain scale and what signs the patient experiences. Below the form you can find a description of all the items in the Leeds assessment scale as well as the score interpretation.
How does the LANSS scale for neuropathic pain questionnaire calculator work?
This is a health tool adapted from the Leeds Assessment of Neuropathic Symptoms Scale and signs 2001 study by Bennet.
It comprises of a 7 item questionnaire that aims to discern which nerves involved with carrying pain signals have been impaired and which are properly functioning.
The first five questions address pain sensations that the patient has been experiencing during the past week. The evaluator asks about different characteristics of the pain and the patient needs to confirm or infirm each of them.
■ The first item concerns unpleasant sensations that feel strange such as pricking, tingling or the so called pins and needles.
■ The second item focuses on the aspect of the skin in the area corresponding to the pain. Is the skin appearance mottled, red or pinkish?
■ The third item evaluates whether the skin in the painful areas is abnormally sensitive to touch and the patient experiences unpleasant sensations while stroking the skin or pain while wearing tight clothing items.
■ The fourth item refers to the pain timing, whether it is sudden or bursting at certain moment, even when the body is in repose. For instance, the patient is asked whether they experience electric shocks, jumping or bursting sensations in the painful areas or limbs.
■ The fifth item evaluates skin temperature in the painful areas and whether the patient has experienced any abnormal changes or burning sensations.
The second part of the LANSS score is composed of two physical exams in which pain and skin sensitivity is compared to contralateral or adjacent non painful areas. This is a mean of evaluating the presence of allodynia and that of an altered pin-prick threshold.
Allodynia is defined as the experience of pain from non painful stimulation, usually caused by light touch.
■ The exam for allodynia consists in stroking a piece of cotton wool across the chosen non painful area and then across the described painful area. The exam is positive if the non painful area has a normal response while pain is experienced in the painful area.
■ The altered pin-prick threshold (PPT) is determined by using a 23 gauge needle placed on a 2ml syringe barrel that is placed on both the non painful area and the painful one. The response is then compared. Usually, for a positive test, in the non painful area the patient feels a sharp pin prick but in the painful areas either no response or a blunt one is experienced (characteristic for raised PPT) or a very painful sensation (lowered PPT).
Discerning the type of pain is essential in establishing the right pain management treatment and the scale can also be used to monitor pain response in time.
Neuropathic pain guidelines
This is a type of chronic pain in which the nerve fibers are damaged or injured or there are certain mechanisms that have rendered them dysfunctional. The impaired nerves send incorrect pain signals in different areas of the body.
The most common causes include different types of injuries, amputation, multiple sclerosis, back problems, chemotherapy or diabetes.
Symptoms experienced are different types of pain in varying degrees. Diagnostics are usually put after a physical and sensory exam as well as blood tests and other specific laboratory tests depending on the area of pain and suspected cause.
Treatment management comprises of non steroidal anti inflammatory drugs up until strong painkillers like opioids. Pain specialists also recommend electrical stimulation therapies, massage therapy or acupuncture, techniques that are proved to have some alleviating effects.
Score interpretation
The bed side questionnaire focuses on the neuropathic mechanisms behind pain while translating medical information into easily understandable clues for the patients to describe their status.
The scoring system is simple with each of the 7 items being awarded a weighted number of points. Only the positive answers are given points while the negative answers are classed as naught.
Scores range from 0 to 24, with scores below 12 carrying a lower chance of pain being caused by neuropathic mechanisms while scores above 12 are most likely characterizing neuropathic pain.
The LANSS scale for neuropathic pain questionnaire calculator analyses sensory dysfunction. The original study focused on 60 chronic pain patients with nociceptive and neuropathic pain
The subsequent validation focuses on the discriminating capabilities of the scale on 40 patients. There are also a modified version and a self report scale available for sensory examinations.
In terms of sensitivity and accuracy, the scale is said to accurately identify and class into the appropriate neuropathic pain category 84% of cases.
References
1) Bennett M. (2001) The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs. Pain; 92(1-2):147-57.
2) Bennett MI, Smith BH, Torrance N, Potter J. (2005) The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. J Pain; 6(3):149-58.
3) Weingarten TN et al. (2007) Validation of the S-LANSS in the community setting. Pain; 132(1-2):189-94.
4) Backonja MM. (2002) Need for differential assessment tools of neuropathic pain and the deficits of LANSS pain scale. Pain; 98(1-2):229-30; author reply 230-1.
14 Jan, 2016