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re: "The sensitivity

(SE) and specificity (SP) for dermatomal pattern of pain are low for all nerve root levels"

This raises a LOT of question....

When they say ...."Doc....it hurts RIGHT THERE ----->>>

(pointing) we don't need to pay much attention to

that complaint as part of the anatomical/physiological/clinical picture?

Just how was this 'radicular nerve pain' actually assessed in objective

terms? And as I understand it...."pain" itself is entirely subjective

and not measurable outside a PET scanner.

Did the assessment have other components establishing clinical status,

or was assessment entirely reliant on those pain drawing and

descriptions.

If 2/3rd of the time pain patterns

are unrelated to expected anatomical pathways....how can we assume what

we're doing had the desired

effect? What role does the exam have if there are no 'significant'

findings, coupled with 2/3 error rate in relation of pain response to

those nifty little NMS signs we all had to learn?

J. Pedersen DC

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