Systematic review of prevalence of neuropathic pain in the general population
Neuropathic pain is experienced in parts of the body which otherwise appear normal. It is characterized by features such as numbness, paresthesia, and allodynia and it is generally nonresponsive to standard analgesics to treat chronic pain. It is also associated with longstanding and severe pain and with a burden of disease similar to that of other chronic conditions, including mental health conditions.
According to International Association for the Study of Pain, Neuropathic pain was redefined as Pain caused by a lesion or disease of the somatosensory nervous system and graded as “possible,” “probable,” or “definite,” depending on the extent and results of neurological assessment. Recently a cross-sectional survey was conducted to describe the epidemiology of neuropathic pain in population.
Most studies had been conducted in Europe and the United Kingdom where rates were lower compared to the few reports from other parts of the world. In the America, 9.8% had been reported with clinical examination and 12.4% using self-report in Olmsted County, Minnesota, USA and 10% in Brazil. The only Canadian study, which was conducted in Alberta reported a prevalence of 17.9%, considerably higher than the other parts of the world.
Likely or possible neuropathic pain was defined using a neuropathic pain-related diagnosis and a positive outcome on the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs pain scale (S-LANSS) or the Douleur Neuropathique 4 (DN4) Questions. The prevalence of likely or possible neuropathic pain was 7.7% (S-LANSS) and 11.5% (DN4). Males were twice as likely to report neuropathic pain using the DN4 compared to the S-LANSS (13.6% vs. 6.5%). Less than 10% used a combination of medication and nonmedication therapy. Males who were economically disadvantaged had the highest burden of neuropathic pain.
Prevalence varied by screening tool, indicating more work is needed to develop reliable measures. Better training of primary care practitioners and community based clinical studies might help refine the precision of the estimates.