Do pain qualities and spatial characteristics make independent contributions to

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J Pain. 2006 Sep;7(9):644-53.

Do pain qualities and spatial characteristics make independent

contributions to interference with physical and emotional functioning?

Jensen MP, Dworkin RH, Gammaitoni AR, Olaleye DO, Oleka N, Galer BS.

Department of Rehabilitation Medicine, University of Washington

School of Medicine, Seattle, Washington.; Multidisciplinary Pain

Center, University of Washington Medical Center, Seattle, Washington.

Although pain is acknowledged to be a multidimensional experience

that can vary in intensity, quality (eg, burning, sensitive), and

spatial characteristics (eg, location on body, perceived depth), its

qualitative and spatial domains continue to be rarely assessed in

pain clinical trials.

One factor that may be contributing to the relatively rare assessment

of pain quality and spatial characteristics is the lack of research

addressing whether knowledge about these aspects of pain contributes

important information beyond that provided by pain intensity alone.

For example, there is no research that has examined whether measures

of pain quality and perceived depth add anything to the understanding

of the impact of pain on function.

In the current study, secondary analyses of pretreatment data from

clinical trials of patients from 3 diagnostic groups (osteoarthritis,

low back pain, and peripheral neuropathy) indicated that measures of

pain quality and perceived depth were significantly associated with

pain interference with functioning, independent of global pain

intensity and unpleasantness.

No single pain descriptor emerged as universally important, however,

although the findings suggest that: 1) sharp, deep, and perhaps

especially sensitive pain may be important in patients with painful

peripheral neuropathy; 2) sharp, sensitive, itchy, deep, and surface

pain may be key pain descriptors important to persons with low back

pain; and 3) perhaps deep pain may be the sole key pain descriptor

important among persons with osteoarthritis.

The findings support the potential utility of including measures of

specific pain qualities and perceived depth in pain clinical trials

and provide an initial empirical basis for determining which pain

descriptors may be most closely linked to patient functioning.

PERSPECTIVE: Specific pain qualities, such as sharp, sensitive, and

itchy pain, and perceived depth of pain appear to play a significant

and unique role in the prediction of pain interference in addition to

global pain intensity and unpleasantness. These findings suggest that

measures of these specific pain domains could play an important role

in understanding the impact of pain on patient functioning.