I work in a pain clinic and we use the Neuropathic Pain Scale (NPS) as part of the intake testing. We are specifically looking for any evidence that the patients’ pain is coming from the nervous system. What do other groups use? Is the NPS the best choice?

As you have probably discovered, nerve pain (also known as neuropathic pain) can be difficult to diagnose and measure. For some time now, neuroscientists have been working on finding easy and simple ways to identify and quantify neuropathic pain. So far, they have come up with several screening tools in the form of questionnaires.

These include the Leeds Assessment of Neuropathic Symptoms (LANSS), the Neuropathic Pain Questionnaire (NPQ), the Douleur Neuropathique en 4 Questions, DN4, ID-Pain, and painDETECT. Each one measures type of sensations experienced by patients. Most are self-administered (the patient fills out the form). A few are clinician-administered (the examiner asks the questions and completes the form).

The Neuropathic Pain Scale is one of the most commonly used tools to assess pain quality (intensity, frequency, duration). But it doesn’t cover all the symptoms patients with neuropathic pain might report.

A second tool called the Neuropathic Pain Symptom Inventory (NPSI) was developed to help overcome the limitations of the Neuropathic Pain Scale (NPS). Both the NPSI and the NPS are self-report (the patient fills out the form). The Neuropathic Pain Symptom Inventory assesses a wider range of possible neuropathic pain types and has been tested in more than 25 large international multicenter trials.

Right now, it doesn’t seem as though there is a one-test-fits-all for screening neuropathic pain. But these screening tools represent a step in the right direction for at least recognizing what’s going on in the patient’s body. They provide a piece of the diagnostic puzzle but the information gained must be used in context of the whole patient.