Overview: Two alternative hypotheses have been proposed for unexplained low back pain: psychosocial contributing factors and musculoskeletal dysfunction (MSD). This article outlines how pain drawings have been analyzed, with commentary on usefulness in understanding MSD. In experimental settings selective provocation is used together with pain drawings to study how irritation results in pain being experienced at different locations.
Method: Qualitative literature review.
Summary: Pain drawing analysis (PDA) is one of many forms of assessment used in interpreting low back pain clinically. PDA can be grouped into three main methods: rating, area, and pattern. Rating drawings for the likelihood of underlying psychologic disorders (nonanatomic) has failed to be replicated for back pain sufferers. Its value in studying MSD is limited. Assessing drawings for area (or extent) provides descriptive data on location (site) and may indicate one component of severity as compared to intensity. PDA may be unresponsive to treatment because a small number of large anatomic regions may overestimate affected areas. Preliminary data with more accurate area assessment show significant time variation in drawing low back pain. Pattern analysis of pain drawings gained from a clinical setting may show correspondence with the pain drawings generated from selected provocation applied in an experimental setting.