Characteristics of patients with neuropathic pain syndromes screened by the painDETECT questionnaire and diagnosed by physician exam

Abstract

BackgroundThe aim of this study was to identify the clinical characteristics, treatment usage, and health outcomes of US adults diagnosed with neuropathic pain (NeP) by experienced physicians.MethodsAdults with scores exceeding the threshold for probable NeP (painDETECT ≥19) and diagnosed with NeP by a qualified physician completed a questionnaire that included comorbid conditions, pain symptoms and experiences, medication use, health status (3-level EuroQol 5 Dimensions (EQ-5D-3L]: health utilities index and visual analog scale), pain severity and interference with functioning (Brief Pain Inventory), and work and activity impairment (Work Productivity and Activity Impairment questionnaire). Descriptive analyses were performed for each NeP subtype.ResultsParticipants (n=295) were predominantly female (64.4%), middle-aged (53.9%), and white (51.5%). Chronic low back pain was the most frequently diagnosed major NeP syndrome (n=166), followed by diabetic peripheral neuropathy (n=58), post-trauma neuropathy (n=47), post-surgical neuropathy (n=28), and central NeP (n=23). An additional 45 participants were diagnosed, but did not meet the criteria for the aforementioned subtypes. Participants could be diagnosed with multiple subtypes. Across each NeP subtype, patients reported high rates of comorbid disease, including arthritis (range: 39.1%–64.3%) and high blood pressure (range: 26.1%–69.0%), as well as symptomology that included numbness (range: 68.1%–91.4%) and changes in muscular strength (range: 24.1%–65.2%). The majority of patients reported back pain (range: 77.8%–95.7%) and arthritis/joint pain (range: 68.1%–78.6%). The most commonly reported types of NeP pain medication were non-steroidal anti-inflammatory drugs (range: 43.1%–70.2%), weak opioids (range: 22.2%–39.3%), and strong opioids (range: 8.7%–28.6%). All six NeP groups generally reported similar levels of dysfunction on all self-report measures. The most notable finding was that the EuroQol-5D-3L health utilities index scores for each of the six groups were lower than the US norms by a clinically important amount.ConclusionThese exploratory findings indicate that patients with NeP across different etiologies are medically complex and experience impaired function across multiple domains.

High-Dose Spinal Cord Stimulation Reduces Long-Term Pain Medication Use in Patients With Failed Back Surgery Syndrome Who Obtained at Least 50% Pain Intensity and Medication Reduction During a Trial Period: A Registry-Based Cohort Study

“…In this study, a significant reduction in subscores of MQS in new patients was only found in the opioid and anti‐neuropathic agent subcategories, the two main pillars of pain medication treatment for neuropathic pain (36). Interestingly, although the subscores did not decrease significantly, the number of patients using NSAIDs and benzodiazepines reduced significantly after 12 months of HD‐SCS.…”

Quantitative sensory profiles of upper extremity chemotherapy induced peripheral neuropathy: Are there differences in sensory profiles for neuropathic versus nociceptive pain?

“…From the regression model, the DASH score showed statistically significant differences between the groups in that the neuropathic group demonstrated impaired upper limb function (P = 0.002). More important, the DASH score mean of 35 (31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46) in the nonneuropathic group versus 51 (41-67) in the neuropathic group met the minimum clinical important difference in change scores, indicating that these groups are not only statistically but also clinically different. 18 Due to the heavily skewed distribution of pain scores, the 11-point NPRS was analyzed based on percentages of those experiencing pain (NPRS 1 or higher) versus no pain.…”

“…Neuropathic pain symptoms correlate with higher medical comorbidities, higher reported pain intensity, and greater disability burden than other causes of pain. [31][32][33] This often results in poorer prognosis, and studies have identified higher levels of depression and disability. 34,35 Pain catastrophizing and pain acceptance are important in treatment outcomes, and a multidisciplinary focus has been suggested for this population.…”

Neuropathic-like pain in psoriatic arthritis: evidence of abnormal pain processing

“…Painful diabetic neuropathy has been shown to affect 1/3 of community-based diabetics in a large English population, with having type 2 diabetes being one of the factors of patients with diabetes in whom painful diabetic neuropathy was more prevalent [42]. Diabetic peripheral neuropathy is one of a number of causes of neuropathic pain, which can be detected as probable neuropathic pain using the PainDetect score (44 ) (other causes of neuropathic pain include chronic lower back pain, post-surgical neuropathy, post trauma neuropathy, HIV, trigeminal neuralgia, post-herpetic neuralgia [13, 43]). A previous study found an increased prevalence of diabetes in patients with PsA compared with non-PsA patients and suggested that PsA may have an association with diabetes in females, in particular [44].…”