Peripheral neuropathic pain—a multidimensional burden for patients

Abstract

The present study was undertaken to assess the health-related quality of life (HRQoL) and burden of illness due to pain and its treatment for patients with peripheral neuropathic pain (PNP). It is the first step in finding reliable instruments/targets to evaluate treatment outcome in this patient population. Study population consisted of 126 patients suffering from neuropathic pain due to a peripheral nerve or root lesion, recruited from two multidisciplinary pain clinics. HRQoL was examined using Short Form 36 (SF-36) Health Survey and Nottingham Health Profile (NHP). Pain intensity in four categories (at rest and evoked by movement, touch and cold) was rated on a visual analogue scale (VAS). Degree of discomfort from pain and 25 symptoms related to pain and side-effects was also assessed. Reduction in workload due to pain was recorded, as was the pain relief from previous and current treatments and the reasons for discontinuing previous treatments. All dimensions in SF-36 and NHP were significantly impaired. SF-36 was a valid instrument for describing the impact of pain on the HRQoL of patients with PNP. NHP had a lower reliability but has other advantages that might be of importance. Many patients experienced poor pain relief from ongoing pain treatments. Most previous treatments were discontinued owing to lack of efficacy and/or severe side-effects. Many patients experienced a high intensity of at least one type of pain; median VAS for the highest pain intensity score of each patient (any type of pain) was 74/100. Besides pain, patients were most bothered by difficulty in sleeping, lack of energy, drowsiness, difficulty in concentrating and dry mouth. Employment status was reduced owing to pain in 52% of the patients. The intense pain, other troublesome symptoms, limited efficacy and tolerability of available treatments, together with the impaired health and reduced work status, amount to a substantial burden for patients with PNP.

The Prevalence, Predictors, and Consequences of Peripheral Sensory Neuropathy in Older Patients

“…This has been documented by others, [45][46][47] although we were unable to confirm the association with falls that others have observed. 10 -14,32,48 This supports our contention that peripheral neuropathy in the elderly is not trivial.…”

Burrowing as a non‐reflex behavioural readout for analgesic action in a rat model of sub‐chronic knee joint inflammation

“…Neuropathic pain is known to be significantly impacted by co-morbidities such as anxiety and depression (Meyer-Rosberg et al, 2001;Smith et al, 2007;Daniel et al, 2008), which may contribute to the usefulness of the OF readout in animal models of chronic pain. Under specific conditions with low light and a large arena, pain-induced changes in OF behaviour (predator-avoidance behaviour) have been demonstrated and were reversed by analgesics, which have been proven to be a useful measure of non-evoked pain in rat models of neuropathy (Hasnie et al, 2007;Wallace et al, 2008).…”

Biomedical and Psychosocial Factors Associated with Disability After Peripheral Nerve Injury

“…The present study showed that patients with peripheral nerve injury had high levels of cold sensitivity and disability and that disability was predicted by pain and cold sensitivity. Many studies have demonstrated persistent cold sensitivity and substantial pain following hand trauma 65,66,68,71,76,79 . Cold sensitivity remains a challenge following peripheral nerve injury, particularly for patients who reside in cold environments.…”