Advertisement

Current Pain and Headache Reports

, Volume 16, Issue 3, pp 191–198 | Cite as

Epidemiology of Neuropathic Pain and Its Impact on Quality of Life

  • Blair H. SmithEmail author
  • Nicola Torrance
Neuropathic Pain (R Raja, Section editor)

Abstract

Epidemiology is an important clinical tool in designing and evaluating management and prevention strategies, and is particularly relevant to neuropathic pain. However, there is a relative lack of accurate information available. In one sense, neuropathic pain describes a symptom or a mechanism, rather than a specific disease; on the other hand, there are sufficient similarities in the effects and response to treatment between different causes to make it worthwhile to consider neuropathic pain as a distinct condition. However, there are important specific disease-based factors that need to be considered separately. Estimates of prevalence that are based on specific causes of neuropathic pain tend to be lower (1–2%) than those that are based on reports of the classic symptoms (6–8%), and further methodological research is needed. All neuropathic pain is associated with poor general health, comparable with other severe chronic diseases. The importance of newly proposed risk factors, including genetic factors, still needs to be assessed at a population level.

Keywords

Neuropathic pain Epidemiology Prevalence Incidence Chronic pain Screening tools Neuropathy Diabetic neuropathy Postherpetic neuralgia 

Notes

Disclosures

Dr. Blair H. Smith has received a grant from Pfizer; has received honoraria from Eli Lilly; has received payment for the development of educational presentations from Grünenthal; and has received travel expense compensation from Grünenthal and Eli Lilly. Dr. Nicola Torrance received a grant from Pfizer.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Last JM. A dictionary of epidemiology. 3rd ed. Oxford: Oxford University Press; 1995.Google Scholar
  2. 2.
    Treede RD, Jensen TS, Campbell JN, et al. Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology. 2008;70:1630–5.PubMedCrossRefGoogle Scholar
  3. 3.
    •• Jensen TS, Baron R, Haanpaa M, et al. A new definition of neuropathic pain. Pain. 2011;152:2204–5. This article clarifies and discusses the new IASP definition of neuropathic pain.PubMedCrossRefGoogle Scholar
  4. 4.
    Merskey H, Bogduk N. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. Seattle: IASP press; 1994.Google Scholar
  5. 5.
    Haanpaa ML, Backonja MM, Bennett MI, et al. Assessment of neuropathic pain in primary care. Am J Med. 2009;122:S13–21.PubMedCrossRefGoogle Scholar
  6. 6.
    •• Haanpaa M, Attal N, Backonja M, et al. NeuPSIG guidelines on neuropathic pain assessment. Pain. 2011;152:14–27. This article provides a wide-ranging, in-depth review of all aspects of neuropathic pain assessment based on current evidence.PubMedCrossRefGoogle Scholar
  7. 7.
    Bennett MI, Smith BH, Torrance N, Lee AJ. Can pain be more or less neuropathic? Comparison of symptom assessment tools with ratings of certainty by clinicians. Pain. 2006;122:289–94.PubMedCrossRefGoogle Scholar
  8. 8.
    Sindrup SH, Jensen TS. Efficacy of pharmacological treatments of neuropathic pain: an update and effect related to mechanism of drug action. Pain. 1999;83:389–400.PubMedCrossRefGoogle Scholar
  9. 9.
    Hansson PT, Dickenson AH. Pharmacological treatment of peripheral neuropathic pain conditions based on shared commonalities despite multiple etiologies. Pain. 2005;113:251–4.PubMedCrossRefGoogle Scholar
  10. 10.
    Daniel HC, Narewska J, Serpell M, et al. Comparison of psychological and physical function in neuropathic pain and nociceptive pain: implications for cognitive behavioral pain management programs. Eur J Pain. 2008;12:731–41.PubMedCrossRefGoogle Scholar
  11. 11.
    • Baron R, Tolle TR, Gockel U, et al. A cross-sectional cohort survey in 2100 patients with painful diabetic neuropathy and postherpetic neuralgia: differences in demographic data and sensory symptoms. Pain. 2009;146:34–40. This article identifies five distinct subtypes of neuropathic pain, based on symptoms and sensory profiles. It is not clear yet whether these have implications for management and response to treatment.PubMedCrossRefGoogle Scholar
  12. 12.
    Fields HL, Rowbotham M, Baron R. Postherpetic neuralgia: irritable nociceptors and deafferentation. Neuro Dis. 1998;5:209–27.CrossRefGoogle Scholar
  13. 13.
    Gremeau-Richard C, Dubray C, Aublet-Cuvelier B, et al. Effect of lingual nerve block on burning mouth syndrome (stomatodynia): a randomized crossover trial. Pain. 2010;149:27–32.PubMedCrossRefGoogle Scholar
  14. 14.
    Scholz J, Woolf CJ. Can we conquer pain? Nat Neurosci. 2002;5:S1062–7.CrossRefGoogle Scholar
  15. 15.
    Kieburtz K, Simpson D, Yiannoutsos C, et al. A randomized trial of amitriptyline and mexiletine for painful neuropathy in HIV infection. Neurology. 1998;51:1682–8.PubMedGoogle Scholar
  16. 16.
    Shlay JC, Chaloner K, Max MB, et al. Acupuncture and amitriptyline for pain due to HIV-related peripheral neuropathy: a randomized controlled trial. JAMA. 1998;280:1590–5.PubMedCrossRefGoogle Scholar
  17. 17.
    Hahn K, Arendt G, Braun JS, et al. A placebo-controlled trial of gabapentin for painful HIV-associated sensory neuropathies. J Neurol. 2004;251:1260–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Abrams DI, Jay CA, Shade SB, et al. Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology. 2007;68:515–21.PubMedCrossRefGoogle Scholar
  19. 19.
    Ellis RJ, Toperoff W, Vaida F, et al. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. Neuropsychopharmacology. 2009;34:672–80.PubMedCrossRefGoogle Scholar
  20. 20.
    Bowsher D. Neurogenic pain syndromes and their management. Br Med Bull. 1991;47:644–66.PubMedGoogle Scholar
  21. 21.
    Bennett GJ. Neuropathic pain: an overview. In: Borsook D, editor. Molecular biology of pain. Seattle: IASP Press; 1997. p. 109–13.Google Scholar
  22. 22.
    Dworkin RH. An overview of neuropathic pain: syndromes, symptoms, signs, and several mechanisms. Clin J Pain. 2002;18:343–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Wild S, Roglic G, Green A, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047–53.PubMedCrossRefGoogle Scholar
  24. 24.
    Bowsher D. The lifetime occurrence of Herpes zoster and prevalence of post-herpetic neuralgia: a retrospective survey in an elderly population. Eur J Pain. 1999;3:335–42.PubMedCrossRefGoogle Scholar
  25. 25.
    Davies M, Brophy S, Williams R, Taylor A. The prevalence, severity, and impact of painful diabetic peripheral neuropathy in type 2 diabetes. Diabetes Care. 2006;29:1518–22.PubMedCrossRefGoogle Scholar
  26. 26.
    Choo PW, Galil K, Donahue JG, et al. Risk factors for postherpetic neuralgia. Arch Intern Med. 1997;157:1217–24.PubMedCrossRefGoogle Scholar
  27. 27.
    Freynhagen R, Baron R, Gockel U, Tolle TR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin. 2006;22:1911–20.PubMedCrossRefGoogle Scholar
  28. 28.
    Bennett MI, Attal N, Backonja MM, et al. Using screening tools to identify neuropathic pain. Pain. 2007;127:199–203.PubMedCrossRefGoogle Scholar
  29. 29.
    Torrance N, Smith BH, Bennett MI, Lee AJ. The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey. J Pain. 2006;7:281–9.PubMedCrossRefGoogle Scholar
  30. 30.
    Bouhassira D, Lanteri-Minet M, Attal N, et al. Prevalence of chronic pain with neuropathic characteristics in the general population. Pain. 2008;136:380–7.PubMedCrossRefGoogle Scholar
  31. 31.
    Smith BH, Torrance N, Bennett MI, Lee AJ. Health and quality of life associated with chronic pain of predominantly neuropathic origin in the community. Clin J Pain. 2007;23:143–9.PubMedCrossRefGoogle Scholar
  32. 32.
    • Attal N, Lanteri-Minet M, Laurent B, et al. The specific disease burden of neuropathic pain: results of a French nationwide survey. Pain. 2011;152:2836–43. This paper is a follow-up to the prevalence study (Bouhassira et al. [30]) and confirms the detrimental impact of neuropathic pain within the general population.PubMedCrossRefGoogle Scholar
  33. 33.
    Tesfaye S, Chaturvedi N, Eaton SE, et al. Vascular risk factors and diabetic neuropathy. NEJM. 2005;352:341–50.PubMedCrossRefGoogle Scholar
  34. 34.
    Jensen TS, Backonja MM, Hernandez Jimenez S, et al. New perspectives on the management of diabetic peripheral neuropathic pain. Diabetes Vasc Dis Res. 2006;3:108–19.CrossRefGoogle Scholar
  35. 35.
    Jung BF, Johnson RW, Griffin DR, Dworkin RH. Risk factors for postherpetic neuralgia in patients with herpes zoster. Neurology. 2004;62:1545–51.PubMedGoogle Scholar
  36. 36.
    Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367:1618–25.PubMedCrossRefGoogle Scholar
  37. 37.
    Dieleman JP, Kerklaan J, Huygen FJ, et al. Incidence rates and treatment of neuropathic pain conditions in the general population. Pain. 2008;137:681–8.PubMedCrossRefGoogle Scholar
  38. 38.
    Hall GC, Caroll, Parry D, et al. Primary care incidence and treatment of four neuropathic pain conditions: a descriptive study, 2002–2005. BMC Fam Pract. 2008;9:26.PubMedCrossRefGoogle Scholar
  39. 39.
    Smith BH, Torrance N. Epidemiology of neuropathic pain. Pain Manage. 2011;1:87–96.CrossRefGoogle Scholar
  40. 40.
    Bennett MI, Smith BH, Torrance N, Potter J. The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. J Pain. 2005;6:149–58.PubMedCrossRefGoogle Scholar
  41. 41.
    Bouhassira D, Atta N, Alchaar H, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114:29–36.PubMedCrossRefGoogle Scholar
  42. 42.
    Gustorff B, Dorner T, Likar R, et al. Prevalence of self-reported neuropathic pain and impact on quality of life: a prospective representative survey. Acta Anaesthesiol Scand. 2008;52:132–6.PubMedCrossRefGoogle Scholar
  43. 43.
    Yawn BP, Wollan PC, Weingarten TN, et al. The prevalence of neuropathic pain: clinical evaluation compared with screening tools in a community population. Pain Med. 2009;10:586–93.PubMedCrossRefGoogle Scholar
  44. 44.
    Toth C, Lander J, Wiebe S. The prevalence and impact of chronic pain with neuropathic pain symptoms in the general population. Pain Med. 2009;10:918–29.PubMedCrossRefGoogle Scholar
  45. 45.
    Opstelten W, Mauritz JW, de Wit NJ, et al. Herpes zoster and postherpetic neuralgia: incidence and risk indicators using a general practice research database. Fam Pract. 2002;19:471–5.PubMedCrossRefGoogle Scholar
  46. 46.
    Yawn BP, Saddier P, Wollan PC, et al. A population-based study of the incidence and complication rates of herpes before zoster vaccine introduction. Mayo Clin Proc. 2007;82:1341–9.PubMedCrossRefGoogle Scholar
  47. 47.
    Gauthier A, Breuer J, Carrington D, et al. Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom. Epidemiol Infect. 2009;137:38–47.PubMedCrossRefGoogle Scholar
  48. 48.
    Cebrian-Cuenca AM, Diez-Domingo J, San-Martin-Rodriguez M, et al. Epidemiology and cost of herpes zoster and postherpetic neuralgia among patients treated in primary care centres in the Valencian community of Spain. BMC Infect Dis. 2011;11:302.PubMedCrossRefGoogle Scholar
  49. 49.
    Wu EQ, Borton J, Said G, et al. Estimated prevalence of peripheral neuropathy and associated pain in adults with diabetes in France. Curr Med Res Opin. 2007;23:2035–42.PubMedCrossRefGoogle Scholar
  50. 50.
    Younes M, Bejia I, Aguir Z, et al. Prevalence and risk factors of disk-related sciatica in an urban population in Tunisia. Joint Bone Spine. 2006;73:538–42.PubMedCrossRefGoogle Scholar
  51. 51.
    Jensen MP, Chodroff MJ, Dworkin RH. The impact of neuropathic pain on health-related quality of life: review and implications. Neurology. 2007;68:1178–82.PubMedCrossRefGoogle Scholar
  52. 52.
    Schmader KE. Epidemiology and impact on quality of life of postherpetic neuralgia and painful diabetic neuropathy. Clin J Pain. 2002;18:350–4.PubMedCrossRefGoogle Scholar
  53. 53.
    • Doth AH, Hansson PT, Jensen MP, Taylor RS. The burden of neuropathic pain: a systematic review and meta-analysis of health utilities. Pain. 2010;149:338–44. This paper confirms the hypothesis that patients with neuropathic pain experience low health utilities and, therefore, low HRQoL.PubMedCrossRefGoogle Scholar
  54. 54.
    Finnerup NB, Sindrup SH, Jensen TS. The evidence for pharmacological treatment of neuropathic pain. Pain. 2010;150:573–81.PubMedCrossRefGoogle Scholar
  55. 55.
    Veves A, Backonja M, Malik RA. Painful diabetic neuropathy: epidemiology, natural history, early diagnosis, and treatment options. Pain Med. 2008;9:660–74.PubMedCrossRefGoogle Scholar
  56. 56.
    Oxman MN, Levin MJ, Johnson GR, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. NEJM. 2005;352:2271–84.PubMedCrossRefGoogle Scholar
  57. 57.
    Bouhassira D, Chassany O, Gaillat J, et al. Patient perspective on herpes zoster and its complications: an observational prospective study in patients aged over 50 years in general practice. Pain. 2011;153:342–9.PubMedCrossRefGoogle Scholar
  58. 58.
    Dworkin RH, Gnann JW, Oaklander AL, et al. Diagnosis and assessment of pain associated with herpes zoster and postherpetic neuralgia. J Pain. 2008;9:S37–44.PubMedCrossRefGoogle Scholar
  59. 59.
    Harpaz R, Ortega-Sanchez IR, Seward JF, et al. Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). Morbidity and mortality weekly report. Centers for Disease Control. 2008;57:1–30.Google Scholar
  60. 60.
    O’Connor AB, Schwid SR, Herrmann DN, et al. Pain associated with multiple sclerosis: systematic review and proposed classification. Pain. 2008;137:96–111.PubMedCrossRefGoogle Scholar
  61. 61.
    Barrett AM, Lucero MA, Le T, et al. Epidemiology, public health burden, and treatment of diabetic peripheral neuropathic pain: a review. Pain Med. 2007;8:S50–62.PubMedCrossRefGoogle Scholar
  62. 62.
    Jih JS, Chen YJ, Lin MW, et al. Epidemiological features and costs of herpes zoster in Taiwan: a national study 2000 to 2006. Acta Derm Venereol. 2009;89:612–6.PubMedCrossRefGoogle Scholar
  63. 63.
    Mehra M, Hill K, Nicholl D, Schadrack J: The burden of chronic low back pain with and without a neuropathic component: a healthcare resource use and cost analysis. J Med economics 2011, Dec 5. [Epub ahead of print]Google Scholar
  64. 64.
    Schmidt CO, Schweikert B, Wenig CM, et al. Modelling the prevalence and cost of back pain with neuropathic components in the general population. Eur J Pain. 2009;13:1030–5.PubMedCrossRefGoogle Scholar
  65. 65.
    Dworkin RH, Panarites CJ, Armstrong EP, et al. Healthcare utilization in people with postherpetic neuralgia and painful diabetic peripheral neuropathy. J Am Geriatr Soc. 2011;59:827–36.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.University of Dundee, Medical Research InstituteDundeeUK

Personalised recommendations