The Epidemiology of Chronic Pain of Predominantly Neuropathic Origin. Results From a General Population Survey

Department of General Practice and Primary Care, University of Aberdeen, Scotland.
Journal of Pain (Impact Factor: 4.01). 05/2006; 7(4):281-9. DOI: 10.1016/j.jpain.2005.11.008
Source: PubMed


Progress in the understanding of chronic pain with neuropathic features has been hindered by a lack of epidemiologic research in the general population. The Leeds Assessment of Neuropathic Symptoms and Signs score (S-LANSS) was recently validated for use in postal surveys, making the identification of pain of predominantly neuropathic origin possible. Six family practices in 3 UK cities (Aberdeen, Leeds, and London) generated a total random sample of 6,000 adults. The mailed questionnaire included demographic items, chronic pain identification, and intensity questions, the S-LANSS, the Level of Expressed Needs questionnaire, and the Neuropathic Pain Scale. With a corrected response rate of 52%, the prevalence of any chronic pain was 48% and the prevalence of pain of predominantly neuropathic origin was 8%. Respondents with this chronic neuropathic pain were significantly more likely to be female, slightly older, no longer married, living in council rented accommodation, unable to work, have no educational qualifications, and be smokers than all other respondents. Multiple logistic regression modeling found that pain of predominantly neuropathic origin was independently associated with older age, gender, employment (being unable to work), and lower educational attainment. Respondents with this pain type also reported significantly greater pain intensity, higher scores on the NPS, higher levels of expressed need, and longer duration of pain. This is the first estimate of the prevalence and distribution of pain of predominantly neuropathic origin in the general population, using a previously validated and reliable data collection instrument. PERSPECTIVE: Chronic pain with neuropathic features appears to be more common in the general population than previously suggested. This type of pain is more severe than other chronic pain but distributed similarly throughout sociodemographic groups.

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Available from: Blair H Smith, Jun 16, 2014
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    • "It has been suggested that neuropathic features in chronic pain may be more prevalent in the general population than previously thought.[11] Estimates for the prevalence of neuropathic pain in the population are 6% to 8%[31]; neuropathic pain is experienced by 16 to 26% of diabetic patients (diabetic neuropathy)[15] and 8% to 19% of patients with herpes zoster virus infection (post-herpetic neuralgia).[30][30] In the present study we ascertained the prevalence of neuropathic pain as part of CWP in TwinsUK (part of the NIHR BRC BioResource). "
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    ABSTRACT: Chronic widespread pain (CWP) has complex aetiology and forms part of the fibromyalgia syndrome. Recent evidence suggests a higher frequency of neuropathic pain features in those with CWP than previously thought. The aim of this study was to determine the prevalence of neuropathic pain features in individuals with CWP, and to estimate the influence of genetic and environmental factors on neuropathic pain in CWP. Validated questionnaires (the London Fibromyalgia Screening Study questionnaire and PainDETECT questionnaire) were used to classify twins as having CWP and neuropathic pain respectively. The prevalence of CWP was 14.7% (n=4324), and of the 1357 twins invited to complete neuropathic pain screening, 15.9% of those having CWP demonstrated features of neuropathic pain. Neuropathic pain was found to be heritable (A = 37%; 95%CIs 23-50%) with unique environmental factors accounting for 63% (95%CI 49-79%) of the variance. Heritability of neuropathic pain and CWP were found to be correlated 0.54 (95%CI 0.42-0.65). Increasing age, raised BMI, female gender and smoking were all risk factors for neuropathic pain (p<0.05), and CWP (p<0.05). High socio-economic status (SES) showed negative correlation with neuropathic pain (p=0.003) and CWP (p=0.001). Bivariate analysis of the two pain traits revealed that the genetic predisposition to neuropathic pain is shared with that for CWP. This is the first study to provide formal heritability estimates for neuropathic pain in CWP. The findings suggest that at least some of the genetic factors underlying the development of neuropathic pain and CWP are the same.
    Pain 06/2015; DOI:10.1097/j.pain.0000000000000277 · 5.21 Impact Factor
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    • "The lack of reliable epidemiological data has hampered progress in understanding the clinical impact of neuropathic pain and associated features. Studies using the S-LANSS (Torrance et al., 2006) and painDETECT (Freynhagen et al., 2006) indicate that standardized tools improve the quality of epidemiological data, and similar ongoing studies using DN4 will report soon. Standardized screening tools for neuropathic pain may also be useful in future trials of new therapies because they might help assess treatment efficacy for a specific symptom, or symptom combination, rather than to a disease entity (Jensen, 2005). "
    Pain 03/2015; · 5.21 Impact Factor
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    • "The British study on the cohort of general practitioner's patients evidenced neuropathic pain in 8.2% of adult patients having significantly higher pain intensity than others [6]. The French study in a randomly selected adult population using the "
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    ABSTRACT: Neuropathic pain still present a major diagnostic and therapeutic challenge despite considerable progress in understanding of its mechanisms and publication of number of studies which assessed the efficacy and safety of drugs used in the symptomatic treatment. In practice, it is diagnosed less frequently than recognised in the epidemiological studies, and many patients do not achieve satisfactory outcomes of treatment. A multidisciplinary team of Polish experts, commissioned by the Polish Association for the Study of Pain and the Polish Neurological Society, has reviewed the literature on neuropathic pain, with special focus on the published international recommendations, and formulated recommendations on neuropathic pain diagnosis and treatment, in accordance with the principles of evidence-based medicine. The paper presents also background information on the neuropathic pain definition, epidemiology, pathomechanism and method of assessment. The diagnosis of neuropathic pain may be established based on medical history and physical examination including special assessment of the somatosensory system. First-line drugs used in pharmacological management of neuropathic pain are: tricyclic antidepressants, serotonin and norepinephrine reuptake inhibitors, gabapentin, pregabalin, opioids and lidocaine patches.
    Neurologia i neurochirurgia polska 11/2014; 48(4). DOI:10.1016/j.pjnns.2014.07.011 · 0.64 Impact Factor
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