IS THE SYMPTOM OF NIGHT PAIN IMPORTANT IN THE DIAGNOSIS OF SERIOUS SPINAL PATHOLOGY IN A BACK PAIN TRIAGE CLINIC?

I. Harding; E. Davies; E. Buchanan; J. Fairbank

doi:10.1302/0301-620X.87BSUPP_III.0870239

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IS THE SYMPTOM OF NIGHT PAIN IMPORTANT IN THE DIAGNOSIS OF SERIOUS SPINAL PATHOLOGY IN A BACK PAIN TRIAGE CLINIC?

I. Harding
E. Davies
E. Buchanan
J. Fairbank

IS THE SYMPTOM OF NIGHT PAIN IMPORTANT IN THE DIAGNOSIS OF SERIOUS SPINAL PATHOLOGY IN A BACK PAIN TRIAGE CLINIC?

Harding I, Davies E, Buchanan E, Fairbank J. IS THE SYMPTOM OF NIGHT PAIN IMPORTANT IN THE DIAGNOSIS OF SERIOUS SPINAL PATHOLOGY IN A BACK PAIN TRIAGE CLINIC?. Orthop Procs. 2005;87-B(SUPP_III):239-239. doi:10.1302/0301-620X.87BSUPP_III.0870239

Harding, I., et al. “IS THE SYMPTOM OF NIGHT PAIN IMPORTANT IN THE DIAGNOSIS OF SERIOUS SPINAL PATHOLOGY IN A BACK PAIN TRIAGE CLINIC?.” Orthopaedic Proceedings, vol. 87-B, no. SUPP_III, 2005, pp. 239-239., https://doi.org/10.1302/0301-620X.87BSUPP_III.0870239

Harding, I., Davies, E., Buchanan, E., & Fairbank, J. (2005). IS THE SYMPTOM OF NIGHT PAIN IMPORTANT IN THE DIAGNOSIS OF SERIOUS SPINAL PATHOLOGY IN A BACK PAIN TRIAGE CLINIC?. Orthopaedic Proceedings, 87-B(SUPP_III), 239-239. https://doi.org/10.1302/0301-620X.87BSUPP_III.0870239

Harding, I., Davies, E., Buchanan, E. and Fairbank, J. (2005) “IS THE SYMPTOM OF NIGHT PAIN IMPORTANT IN THE DIAGNOSIS OF SERIOUS SPINAL PATHOLOGY IN A BACK PAIN TRIAGE CLINIC?.” Orthopaedic Proceedings, 87-B(SUPP_III), pp. 239-239. Available at: https://doi.org/10.1302/0301-620X.87BSUPP_III.0870239

Harding, I., E. Davies, E. Buchanan, and J. Fairbank. “IS THE SYMPTOM OF NIGHT PAIN IMPORTANT IN THE DIAGNOSIS OF SERIOUS SPINAL PATHOLOGY IN A BACK PAIN TRIAGE CLINIC?.” Orthopaedic Proceedings 87-B, no. SUPP_III (2005): 239-239. https://doi.org/10.1302/0301-620X.87BSUPP_III.0870239

Harding I, Davies E, Buchanan E, Fairbank J. IS THE SYMPTOM OF NIGHT PAIN IMPORTANT IN THE DIAGNOSIS OF SERIOUS SPINAL PATHOLOGY IN A BACK PAIN TRIAGE CLINIC?. Orthop Procs. 2005 Sep 1;87-B(SUPP_III):239-239. https://doi.org/10.1302/0301-620X.87BSUPP_III.0870239

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Abstract

Study Design: Prospective cohort study

Objective: To assess the ‘red flag’ symptom of night pain as an indicator for serious disease in patients attending a back pain triage clinic (BPTC).

Summary of Background Data: Although common in patients with known serious pathology, the prevalence of night pain in this population is not known.

Methods: 482 consecutive patients attending BPTC were assessed (including history of frequency and duration of night pain). Clinical examination was performed and demographic data obtained. MRI was performed if indicated according to local guidelines.

Outcome measures: Oswestry (ODI), Visual Analogue Scales (for pain, distress and coping) and Hospital Anxiety Depression (HAD) patient based outcome scores were obtained. Serious pathology was defined as infection or tumour as per AHCPR Guidelines (1994) which state that these symptoms are associated with severe night time pain.

Results: 213 patients had night pain with 90 having pain every night. No serious pathology was identified. Patients with night pain had 4.95 hours continuous sleep (2–7) and were woken 2.5 times/night (0–6). Patients with pain every night exhibited higher ODI and HAD scores than those that did not.

Conclusions: Although it is a significant and disruptive symptom for patients, these results challenge the sensitivity of the presence of night pain per se as a useful diagnostic indicator for serious spinal pathology in a back pain triage clinic.

These abstracts were prepared by Mr. Brian J C Freeman FRCS (Tr & Orth). Correspondence should be addressed to him at The Centre for Spinal Studies and Surgery, University Hospital, Queens Medical Centre, Nottingham NG7 2UH.