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Prevalence, Characteristics and Clinical Course of Neuropathic Pain in Primary Care Patients Consulting with Low Back-related Leg Pain.

Dunn

Prevalence, Characteristics and Clinical Course of Neuropathic Pain in Primary Care Patients Consulting with Low Back-related Leg Pain. Thumbnail


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Abstract

OBJECTIVES: Little is known about the epidemiology of neuropathic pain in primary care patients consulting with low back-related leg pain. We aimed to describe prevalence, characteristics and clinical course of low back-related leg pain patients with and without neuropathic pain, consulting with their family doctor in the UK. METHODS: This was a prospective cohort study. Data were collected using a standardised baseline clinical examination and self-report questionnaires at baseline, 4, 12 and 36-months. We identified cases of neuropathic pain using three definitions: two based on clinical diagnosis (sciatica, with and without evidence of nerve root compression on MRI), one on the self-report version of Leeds Assessment for Neurological Symptoms and Signs (S-LANSS). Differences between patients with and without neuropathic pain were analysed comparing each definition. Clinical course (mean pain intensity measured as the highest of leg or back pain intensity: mean of three Numerical Rating Scales, each 0-10) was investigated using linear mixed models over 36-months. RESULTS: Prevalence of neuropathic pain varied from 48% to 74% according to definition used. At baseline, patients with neuropathic pain had more severe leg pain intensity, lower pain self-efficacy, more patients had sensory loss than those without. Distinct profiles were apparent depending on neuropathic pain definition. Mean pain intensity reduced after 4-months (6.1 to 3.9 (sciatica)), most rapidly in cases defined by clinical diagnosis. DISCUSSION: This research provides new information on the clinical course of neuropathic pain and a better understanding of neuropathic pain in low back-related leg pain patients consulting in primary care.

Acceptance Date Jul 28, 2020
Publication Date Nov 1, 2020
Journal Clinical Journal of Pain
Print ISSN 0749-8047
Publisher Lippincott, Williams & Wilkins
DOI https://doi.org/10.1097/AJP.0000000000000879
Keywords pain, neuropathic pain, primary care, patients, back pain, leg pain
Publisher URL https://journals.lww.com/clinicalpain/Abstract/2020/11000/Prevalence,_Characteristics,_and_Clinical_Course.1.aspx

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