StEP pain-subtype assessment
A structured interview-plus-exam tool (StEP) was developed and validated to separate neuropathic/radicular from non-neuropathic axial low-back pain.
Source
A novel tool for the assessment of pain: validation in low back pain
What they did
Part 1 mapped symptoms/signs across pain subtypes to build StEP; Part 2 applied it in an independent chronic LBP cohort to distinguish radicular vs axial pain, benchmarking against clinical classification.
What they found
Pinprick response was highly sensitive (95%) and specific (93%) for neuropathic vs non-neuropathic pain; combined signs gave strong predictive values for radicular LBP.
The limits
What it doesn't show
StEP is not a standalone imaging replacement and was validated in specialist clinic populations.
Key terms
- StEP
- Standardized Evaluation of Pain structured interview and bedside exam.
- Radicular pain
- Pain from nerve-root involvement, often leg-radiating.
- Axial LBP
- Back-predominant pain without clear radicular pattern.
- Neuropathic pain
- Pain from lesion/disease of the somatosensory system.
- Pinprick testing
- Bedside sensory test that best separated neuropathic from non-neuropathic pain here.
- DN4
- Neuropathic pain screening questionnaire compared with StEP.
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StEP is primarily a:
Common questions
What is StEP?
A standardized symptom interview plus physical tests for pain subtypes.
Who was studied?
Adults with chronic pain ≥3 months and average intensity ≥6/10.
Best single test?
Pinprick: 95% sensitive and 93% specific for neuropathic vs non-neuropathic pain.
Part 2 purpose?
Validate distinguishing radicular vs axial chronic LBP.
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