Health and quality of life associated with chronic pain of predominantly neuropathic origin in the community

Objectives: To assess the health and quality of life associated with chronic pain of predominantly neuropathic origin (POPNO) on health and daily activity in the general population. Methods: The Self-complete Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) questionnaire, recently validated for identifying pain of predominantly neuropathic origin, was sent to 6000 adults identified from general practices in the United Kingdom, along with chronic pain identification and severity questions, the Brief Pain Inventory (BPI), the Neuropathic Pain Scale, and the SF-36 general health questionnaire. Results: With a corrected response rate of 52%, 3 groups of respondents were identified: those without chronic pain (No Chronic Pain group, n = 1537); those with chronic pain who were S-LANSS positive indicating the presence of POPNO (Chronic POPNO group, n = 241); and those with chronic pain who were S-LANSS negative [Chronic Pain (non-POPNO) group, n = 1179]. The chronic POPNO group reported higher pain severity and had significantly poorer scores for all interference items of the BPI than those with chronic pain (non-POPNO). Mean scores from the Neuropathic Pain Scale were also significantly higher for the Chronic POPNO group. There were significant differences between the groups in all domains of the SF-36, with the Chronic POPNO group reporting the worst health. After adjusting for pain severity, age, and sex, the chronic POPNO group was still found to have poorer scores than the other Chronic Pain (non-POPNO) group in all domains of the SF-36 and all interference items in the BPI, indicating poorer health and greater disability. Discussion: This study confirms the importance of identifying neuropathic pain in the community, and the need for multidimensional management strategies that address all aspects of health.