Pain drawing and myelography in sciatic pain.

In order to assess the predictive value of pain drawings of sciatic pain, 81 patients admitted because of symptoms and signs of lumbar disc herniation were asked to chart their pain on a schematic body drawing prior to myelography. There were no differences in sexes, ages, or pain duration between the group of 37 patients with a herniated lumbar disc compared to the 44 patients with a normal myelogram. From the features of the pain drawing alone, it was possible to predict the presence or absence of a herniated disc with a high statistical significance (p less than 0.001). Patients with a disc herniation rarely had pain in the upper trunk or arms (three of 37) compared with the normal group (23 of 44). Only one of nine patients with pain in the groin had disc herniation, and the same was true concerning pain in the iliac crest. Three patients without pain below the knee had no prolapsed disc. The Ransford score was significantly higher in patients with nondiscogenic sciatica, but there was no difference between the groups in the number of types of pain sensation.