[Measurement of clinical pain intensity: quantitative sensory testing]

Abstract

Pain is a private internal event, the degree of which can not be evaluated directly by others. The measurement of the nociceptive pain threshold may apply to the evaluation of the degree of the pain. The instruments using mechanical and electrical stimulation are available for the clinical application. Thermotest allows the testing of quantitative evaluation of thermal thresholds such as heat, cold, and heat and cold pain sensation. A machine for the thermotest using radiant heat and contact heat is available in Japan. There is an instrument using puncturing stimulus and pressure stimulus for a mechanical stimulation. A puncturing stimulus is suitable for the clinical use with a handy instrument such as von Frey filaments and needle type algometry. In clinical practice, the pressure algometry is usually applied over a bony surface or over the muscle. The method seems to be well suited for the evaluation of pain in musculoskeletal disorders. The electrical stimulation test provides a quantitative measure of pain tolerance to a transcutaneous stimulation, neuroselective for large and small myelinated and unmyelinated nerve fibers. There are characteristics including advantages and faults in each method, and the method of measurement corresponding to the purpose and application is important.