Kovacs et al reported models for evaluating neck pain patients seen in routine clinical practice. One model predicts improvement in the arm pain associated with neck pain. The authors are from Hospital Universitario HLA-Moncloa and the Spanish Back Pain Research Network in Madrid.
Patient selection: neck pain with arm pain
Parameters:
(1) 10 cm VAS score for arm pain
(2) 10 cm VAS score for neck pain
(3) clinical diagnosis
(4) disc degeneration on imaging studies
(5) chronic pain (>= 90 days)
(6) treated with NRT (neuro-reflexotherapy)
points for arm pain =
= (0.53714 * (arm score)) + 0.014286
points for neck pain =
= 3.3238 - (0.33143 * (neck score))
Parameter
Finding
Points
clinical diagnosis
disc herniation or protrusion
0.5
spinal stenosis
0
nonspecific
2
disc degeneration on imaging
no
1.4
yes
0
chronic pain
no
2
yes
0
therapy with NRT
no
0
yes
10
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 24.1
• The higher the score the more likely that the arm pain will improve.
X =
= (0.28235 * (score)) - 3.6602
Score
Probability of Improvement
< 2.5
< 5%
2.5 to 23.4
probability of improvement = 1 / (1 + EXP((-1) * X))
> 23.4
> 95%
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