Incidence rates and treatment of neuropathic pain conditions in the general population ☆

Abstract

Incidence rate estimates of neuropathic pain are scanty and mostly address single types whereas the scope of the disease is wide. We aimed to calculate the incidence rates of neuropathic pain conditions in the Dutch general population and to assess treatment strategies in primary care. The study population included persons registered for at least one year in the Integrated Primary Care Information (IPCI) database between 1996 and 2003. Neuropathic pain was ascertained and classified by systematic review of computerized longitudinal medical records. Incidence rates (IR) were calculated, and the treatment for pain was compared to age and gender matched controls. Among 362,693 persons contributing 1,116,215 person years (PY), we identified 9135 new cases of neuropathic pain (IR: 8.2/1000 PY, 95%CI: 8.0-8.4). Mononeuropathy and carpal tunnel syndrome were the most frequent types with 4.3 and 2.3 cases/1000 PY followed by diabetic peripheral neuropathy and post-herpetic neuralgia at 0.72 and 0.42/1000 PY. Neuropathic pain was 63% more common in women than in men and peaked between the ages 70 and 79. More than 50% of cases received pain medication within 6 months after diagnosis, mostly consisting of NSAIDs or aspirin. Anticonvulsants and tricyclic antidepressants were only used by 4.8 and 4.7% of cases. Neuropathic pain is a rather frequent condition with an annual incidence of almost 1% of the general population and affecting women and middle-aged persons more often. The treatment mostly consisted of regular analgesics suggesting that pharmacological treatment of neuropathic pain is suboptimal.

A prospective cohort study investigating an exposure–response relationship among vibration-exposed male workers with numbness of the hands

“…Presenting their data as US-standardized annual incidence among men, they report an incidence of 125 per 100 000 persons. In a Dutch general population, the incidence rate for CTS was 2.3 cases per 1000 person-years (18).…”

“…There are some studies reporting on incidence of CTS (17)(18)(19). However, comparisons to these incidences may be difficult to interpret.…”

Evidence-based pharmacological management of chronic neuropathic pain

“…[3][4][5] However, the prevalence of neuropathic pain varies with the etiology. Peripheral diabetic neuropathy (PDN) is estimated to affect 20% to 24% of persons with diabetes and the condition is painful in 15% of persons with diabetes.…”

Obwodowa neuropatia wywołana chemioterapią. Część II. Zapobieganie

“…Ból neuropatyczny jest wyjątkowo trudnym do leczenia zespołem, dlatego warunkiem osiągnięcia zmniejszenia dolegliwości jest m.in. trafna diagnoza i wdrożenie właściwego leczenia [1][2][3].Często przyczyną dolegliwości jest uszkodzenie nerwu jako struktury anatomicznej przez ucisk z zewnątrz (rozrost guza, materiał kostny przy złama-niach patologicznych, w rzadkich przypadkach przerzuty do nerwów). Z punktu widzenia neuropatologii w takim przypadku sekwencja zdarzeń jest dwuetapowa.…”

“…Ból neuropatyczny jest wyjątkowo trudnym do leczenia zespołem, dlatego warunkiem osiągnięcia zmniejszenia dolegliwości jest m.in. trafna diagnoza i wdrożenie właściwego leczenia [1][2][3].…”