Audit of patients of the pain clinic of the University Hospital of Heraklion with neuropathic pain during the period 2019–2020

Introduction: Neuropathic pain is caused by a lesion or disease of the somatosensory system and affects 7–10% of the population [1–3]. The aim of this study was the analysis of patients referred with neuropathic pain to the University Hospital of Heraklion pain clinic (2019–2020) in terms of characteristics, underlying disease, treatment and response to treatment.

Methods: Patients diagnosed with neuropathic pain (Pain Detect questionnaire) were recruited. Pain intensity was assessed using NAS. Data were in the form of qualitative or quantitative variables and were expressed as frequencies and % frequencies. The x2 test was used to detect statistically significant differences in percentages or correlations between the categorical variables. Statistical analysis was performed using IBM SPSS Statistics 26.0 (IBM Corp., Chicago, IL, USA). Acceptance limit was set to α = 0.05.

Results: 120 patients (age 64.0 ± 15.1 years, men 55.8%, cancer history 50%) were included. Merely neuropathic pain occurred in 43.3% of patients. Patients were allocated into two groups: benign pain group —with herpes zoster (23%) and spine diseases (14%) as the most frequent causes—and malignant pain group (mainly due to gynaecological, breast or lung cancer). The groups did not differ in the main symptoms—burning (46.7%), allodynia (23.3%), hyperalgesia (28.3%)—nor in the pain location (most often in lower extremities and pelvis). Both groups experienced sleep disorders—poorer sleep quality in malignant pain (36.7% vs 16.7%)—and poor psychological state (33.9% in benign, 28.8% in malignant pain). NSAIDs use was more common in benign (58.3% vs 15.9%, p < 0.001), while antidepressants more common in malignant pain (61.7% vs 28.3%, p < 0.001). Both groups reported reduction in VAScore >30% following initial treatment and a corresponding reduction in further modification.

Conclusions: Most patients with neuropathic pain were >50 years old, reported a burning sensation and experienced effects on quality of life (quality of sleep, psychological state).

[1] International Association For The Study Of Pain. IASP Pain Terminology: https://www.iasp-pain.org/resources/terminology/#pain (Accessed: 10 July 2021).

[2] Torrance N, Smith BH, Bennett MI, Lee AJ. The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey. The Journal of Pain. 2005; 7: 281–289.

[3] Bouhassira D, Lantéri-Minet M, Attal N, Laurent B, Touboul C. Prevalence of chronic pain with neuropathic characteristics in the general population. Pain. 2008; 136: 380–387.