Adequate pain drawings obtained from 119 patients who were surgically treated for a low back disorder during 1992 were analysed to evaluatae the possibility of using the pain drawings in the initial diagnosis at first visit, in the assessment of
psychological status of patients, and in the prediction of the treatments results. An initial diagnostic impression was made at a glance over the pain drawing into five categories and the results were compared with the final diagnosis after
surgery. The
penalty score of pain drawings evaluated by Ransford's scoring system were compared with the MMPI scores of 14 patients and with the treatment results of 79 patients who were followed more than one year after surgery.
The initial impressions were five benign back pains, 53 disc herniations, 44 spinal stenosis. Eight significant underlying disorders. And nine psychogenic back pain. The final diagnosis were 59 disc herniations, 42 spinal stenosis. And 18
significant
underlying disorders. Concerning the disc herniation, spinal stenosis, and significant underlying disorder there were statistically significant relationship between the intial impression and the final diagnosis. 84 pain drawings were evaluated as
low
penalty scores of two or less and 35 pain drawings as high penalty scores of three to 12. MMPI scores evaluated for 12 patients with high penalty score revealed more than 70 of hypochondriasis or hysteria scores in nine patients, but in all
patients
with low penalty scores revealed normal MMPI. A satisfactory clinical results of treatment without sinificant pain or disability was obtained in 53(96.4%) of 55 patients with low penalty scores and 18(75%) of 24 patients with high penalty scores.
In conclusions a pain drawing was considered to be useful for the initial diagnostic screening, for the psychological assessment of patients, and for the prediction of treatment results.
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