A Portable Wireless Solution for Back Pain Telemonitoring: A 3D-Based, Virtual Reality Approach - Computational Intelligence in Healthcare: Advanced Methodologies - page 420

Fig. 7. A sample Pain Drawing illustrating the use of color as a representation of pain
and stabbing, whereas [32] further explored the use of color as a representation for the
different sensation types being experienced (fig. 7). The results from this study
showed that the ability of color pain drawings to express the pain experienced re-
mained the same as with previous monochrome approaches.
On the other hand though, the usefulness of sensation in diagnosing back pain has
been questioned by many studies, which conclude that pain sensation seems less reli-
able, most likely because it is subjective; however it was also suggested that it could
assist in differentiating certain conditions [45].
Pain drawing scoring techniques
In order for the several pain drawings to be interpreted and further associated with
causes of back pain and treatment suggestions, they first need to be assessed by the
clinician. A very common method of assessing a drawing according to [44], is “at a
glance”, where the clinician usually looks to see if the pain marks or shades follow
dermatome patterns. They further describe dermatomes as “a 'segmental field' of the
skin that is innervated by a spinal nerve”, and which could be used to determine the
level of injuries that might have occurred in the spinal cord, something that makes
them an accurate tool in localizing the source of certain pain types (fig. 8).
In addition to assessing a drawing at “a glance”, several more manual scoring
techniques have been devised that would allow for further interpretation of the pain
descriptions, and which are specifically useful for studies or clinicians who would like
to quantify drawings for further analysis. Generally, these techniques as described in
literature broadly fall into one of four categories, namely Penalty Point System, Visual
Inspection Methods, Body Region Methods, and Grid Methods. It has to be noted here
that the first two methods require subjective interpretation, whilst the last two record
the presence or absence of pain within defined regions [34].