LANSS Scale For Neuropathic Pain

Checks the pain related symptoms the patient experiences to get the underlying mechanisms.

You can read more about the scale and the underlying mechanism in the text below the tool.


The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale consists of 7 items that are aimed at discerning the cause of the pain the patient is suffering from.

At the same time it can offer useful information to the assessor as to which nerves are not functioning properly anymore.

The first 5 questions refer to sensations of pain experienced during the past week. Characteristics of pain are evoked and the patient is asked to confirm or infirm them.

The other 2 questions use the results from two physical tests in which pain and skin sensitivity is compared to contralateral or adjacent non painful areas.


Each of the 7 questions is awarded a number of points, depending on the pain associated signs the patient is experiencing:

■ Scores below 12: less likelihood of neuropathic pain mechanism;

■ Scores of 12 and above: high likelihood of neuropathic pain mechanism.

The original study consisted of a cohort of 60 chronic pain patients suffering from nociceptive and neuropathic pain, the validation study involved cohort of 40 subjects.

The scale sensitivity and accuracy was found to be 84%.


1

Does the pain produce unpleasant sensations such as tingling, pricking or pins and needles?

2

Is there a different skin aspect in the painful areas, i.e. skin redder than usual or appearing mottled?

3

Does stroking the skin in the painful area or wearing tight clothing items produce unpleasant sensations?

4

Do you experience any sensations like electric shocks, bursting or jumping corresponding to painful episodes, i.e. unexplained bursts of pain?

5

Do you experience burning sensations in the painful areas or a sudden temperature change?

6

Result to stroking the non painful area and the described painful area with cotton wool:

7

Result to touching (pinprick) both areas with a 23 gauge needle:

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LANSS pain scale

The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale evaluates sensory dysfunction and whether the pain is caused by neuropathic mechanisms or not.

The following table introduces the scale, the answers choices and the number of points awarded to each answer:

LANSS item Answer choices (points)
1. Does the pain produce unpleasant sensations such as tingling, pricking or pins and needles? Yes (5)
No (0)
2. Is there a different skin aspect in the painful areas, i.e. skin redder than usual or appearing mottled? Yes (5)
No (0)
3. Does stroking the skin in the painful area or wearing tight clothing items produce unpleasant sensations? Yes (3)
No (0)
4. Do you experience any sensations like electric shocks, bursting or jumping corresponding to painful episodes, i.e. unexplained bursts of pain? Yes (2)
No (0)
5. Do you experience burning sensations in the painful areas or a sudden temperature change? Yes (1)
No (0)
6. Result to stroking the non painful area and the described painful area with cotton wool: Allodynia in painful area (5)
Normal sensations in both areas (0)
7. Result to touching (pinprick) both areas with a 23 gauge needle: Altered PPT in the painful area (3)
Equal sensations in both areas (0)

Whilst the first 5 questions relate to pain signs experienced lately, the last 2 questions require two small functioning tests, one for non-painful stimulation (allodynia) and the other for the altered pin-prick threshold.

The allodynia test consists in the stroking of a piece of cotton wool across a non-painful area and then across the described painful area.

A positive result means that pain is experienced in the painful area.

The altered pin-prick threshold (PPT) is determined with the help of a 23-gauge needle placed on a 2 ml syringe barrel that is placed on the non-painful area and the painful one.

A positive result is when the patient feels a sharp pin prick in the non-painful area and either no response, a blunt one or a very painful sensation is experienced in the painful areas.

 

LANSS interpretation

As a bedside questionnaire, LANSS was aimed at offering a quick interpretation of the medical information it collects.

Each of the 7 items is awarded a number of points, depending on the answer choice.

In general, answers like no or that signal normal function are awarded 0 points and those that signal a pain related symptom or sign are awarded a number of points varying from 1 to 5, depending on the severity of the particular sign.

The final score ranges from 0 to 24. The interpretation is that patient with scores below 12 are less likely to carry a neuropathic cause for their pain whilst in the case of patients scoring 12 or more, there is a higher chance for the underlying mechanism to be neuropathic.

 

About the study

The original study was conducted in 2001 by Dr Bennett and tested 60 chronic pain patients with nociceptive and neuropathic pain in order to determine a way to discriminate between the patient’s neuropathic and non-neuropathic pain mechanisms.

The LANSS Pain Scale is based on sensory description and bedside examination of sensory dysfunction.

The derived pain scale was then validated on a group of 40 patients and showed inter-rater agreement and 84% sensitivity in identifying neuropathic pain.

 

Neuropathic pain

NP is a type of chronic pain characterized by the occurrence of damage or injury that ends up turning the nerve fibers dysfunctional. Such nerves send incorrect pain signals from different areas of the body.

Some of the causes that may lead to neuropathic pain include a variety of injuries, amputation, back problems, multiple sclerosis, diabetes or chemotherapy.

Diagnosis is put after physical and sensory examinations and in some cases blood tests and other laboratory tests are run.

Treatment consists of medication from non steroidal anti inflammatory drugs to strong painkillers such as opioids. Alternative treatments include electrical stimulation therapy, acupuncture or massage therapy.

 

Original study

Bennett M. The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs. Pain. 2001; 92(1-2):147-57.

Other references

1. Bennett MI, Smith BH, Torrance N, Potter J. The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. J Pain. 2005; 6(3):149-58.

2. Backonja MM. Need for differential assessment tools of neuropathic pain and the deficits of LANSS pain scale. Pain. 2002; 98(1-2):229-30; author reply 230-1.


App Version: 1.0.1

Coded By: MDApp

Specialty: Pain Management

System: Nervous

Objective: Evaluation

Type: Scale

No. Of Items: 7

Year Of Study: 2001

Abbreviation: LANSS

Article By: Denise Nedea

Published On: March 15, 2017 · 03:50 PM

Last Checked: March 15, 2017

Next Review: March 9, 2018