Background

The Nottingham Hip Fracture Score (NHFS) is a risk stratifying score that estimates the 30-day and 12-month mortality rates of hip fracture patients. To date, it has only been validated in few centres in the UK. Our study aims to see how our mortality rates compare with those predicted by the NHFS.

Purpose of study: Pain mechanisms underlying the majority of low back and leg pain remain to be elucidated. A recently developed neuropathic pain questionnaire (PainDETECT) was used to assess for the presence of probable neuropathic pain in a group of patients with low back ± leg pain and the effect this has on them.

Method: Patients with low back ± leg pain referred to an Extended Scope Practitioner Physiotherapy clinic who consented to take part completed the PainDETECT questionnaire, and the Roland Morris Disability Questionnaire, and the Fear Avoidance Beliefs Questionnaire. Patients were then grouped by the PainDETECT score into probable neuropathic pain, unlikely neuropathic pain or pain of uncertain underlying mechanism. In patients imaged subsequent to assessment in the clinic (MRI) the PainDETECT scores were compared to evidence of compression of nerve roots.

Results: 17% of patients had probable neuropathic pain, in 47% neuropathic pain unlikely and 36% uncertain. Those with probable neuropathic pain when compared to unlikely neuropathic pain were more disabled (p> .001), scored higher on a visual analogue scale (p=0.013), but were no different on the Fear avoidance scale (p=0.08). Those with neuropathic components to their pain always reported leg pain (93% below knee), whereas 63% of unlikely neuropathic pain patients had leg pain (38% below knee). The relationship between nerve root compression and neuropathic pain score was uncertain.

Conclusion: Patients with a neuropathic component to their back pain report higher levels of pain, more leg pain and are more disabled by their problem.