Chronic Pain: Diagnostic Tests

Medical device diagnostics are based on the exact extent and location of the pain or the underlying condition.

Optional medical device diagnostics – depending on the results of the history, physical examination, and obligatory laboratory parameters – for differential diagnostic clarification

  • X-rays of the spine, ribs, etc. – if bony cause is suspected.
  • Abdominal sonography (ultrasound examination of the abdominal organs) – for abdominal pain (abdominal pain).
  • Computed tomography (CT) – sectional imaging method (X-ray images from different directions with computer-based evaluation), particularly well suited for the depiction of bony injuries.
  • Magnetic resonance imaging (MRI) – computer-assisted cross-sectional imaging procedure (using magnetic fields, i.e. without X-rays); particularly well suited for changes in the spinal cord and brain and for the depiction of soft tissue injuries.
  • Procedure for the diagnosis of neuropathic pain [S2k guideline]:
    • Laser-evoked potentials (LEP): objective neurophysiologic measure for functional examination of the nociceptive system (system for pain perception); in this procedure, stimulation is applied to the periphery on the skin (eg. Hand) irritated and the triggered potentials are derived by means of EEG (electroencephalogram / derivation of brain waves) at the scalp – for the diagnosis of neuropathic pain (no routine diagnostics) [latency delay and / or amplitude reduction in small fiber neuropathy or nerve lesions in the spinal cord].
    • Pain-related evoked potentials (PREP): electrophysiological procedure that uses concentric surface electrodes and stimulation with low currents to stimulate epidermal A-delta fibers and induce a potential derivable via Cz – for the diagnosis of neuropathic pain.
    • Corneal confocal microscopy: noninvasive procedure for quantitative examination of the corneal fibers (cornea of the eye) of the subbasal plexus (between the basement membrane and Bowman’s membrane) – for the diagnosis of neuropathic pain of any cause when conventional electrophysiological methods do not show abnormalities and/or small fiber nerve fiber affection (small fiber neuropathy) is suspected.