During a sensory nerve function assessment, which test should be omitted if pain sensation is normal?

During a sensory nerve function assessment, which test should be omitted if pain sensation is normal?

• A. Temperature.
• B. Vibration.
• C. Pain.
• D. Light touch.

Answer: (A)

When you assess sensory nerve function, you check several modalities that travel along different nerve fibers: pain uses small, rapid fibers; temperature also travels on small fibers; light touch and vibration use larger, myelinated fibers; proprioception involves even larger pathways. If pain sensation is normal, the nociceptive pathway is functioning, which often means the small-fiber pathways are intact as well. In that situation, testing temperature adds little new information and can be omitted to keep the exam efficient, since abnormal temperature would be unlikely when pain is normal. If later findings or symptoms suggest small-fiber involvement, temperature testing can be added then. The other tests—light touch and vibration—still provide valuable information about different fiber pathways that could be affected independently of pain.

When you assess sensory nerve function, you check several modalities that travel along different nerve fibers: pain uses small, rapid fibers; temperature also travels on small fibers; light touch and vibration use larger, myelinated fibers; proprioception involves even larger pathways. If pain sensation is normal, the nociceptive pathway is functioning, which often means the small-fiber pathways are intact as well. In that situation, testing temperature adds little new information and can be omitted to keep the exam efficient, since abnormal temperature would be unlikely when pain is normal. If later findings or symptoms suggest small-fiber involvement, temperature testing can be added then. The other tests—light touch and vibration—still provide valuable information about different fiber pathways that could be affected independently of pain.