Sensory

Note: The purpose of "pinprick" testing for pain sensation is to assess the integrity of non-myelinated pain fibers and their input as part of the
spinothalamic pathway (separate from dorsal column functions). Only stimuli that assess pain, rather than light touch, are useful. Two methods in common practice are (a) a clean (new) safety pin, discarded after use, or (b) a broken tongue depressor or broken wooden swab stick, if a decent point for a "pinprick" is obtained, and discarded after use.  An essential message to convey to the patient is that the object being used is disposable and has not been used before and will not be used again.  Sometimes, the tongue depressor option works better in this regard, as the patient can see it being unwrapped from its sterile packaging, and then can see it being thrown away at the end of the exam. It is also a bit less anxiety-provoking for the patient than being approached with a sharpened metal object. If a safety pin is used,  it should be disposed of in the sharps container in full view of the patient. (Some "multi-function" neurologic exam tools have on-board
devices included for testing pinprick; these are not acceptable at any time.)