Elsevier

The Journal of Pain

Volume 8, Issue 2, February 2007, Pages 118-126
The Journal of Pain

Original report
Symptom Profiles Differ in Patients With Neuropathic Versus Non-neuropathic Pain

https://doi.org/10.1016/j.jpain.2006.06.005Get rights and content
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Abstract

The distinction between neuropathic and non-neuropathic pain reflects partially distinct mechanisms and patterns of treatment response. It was therefore hypothesized that patients with neuropathic and non-neuropathic pain have different profiles of symptoms and signs. To test this hypothesis, pain intensity, unpleasantness, quality, and spatial characteristics were examined in 618 patients with 1 of 3 peripheral neuropathic pain conditions (painful diabetic peripheral neuropathy, painful idiopathic sensory polyneuropathy, or postherpetic neuralgia), osteoarthritis pain, or low back pain. These assessments were conducted before treatment had begun in clinical trials of lidocaine patch 5% administered alone or with stable dosages of other analgesics. Patients with osteoarthritis pain and low back pain did not differ in their profile of pain quality and spatial characteristics and were combined to form a group of patients with non-neuropathic pain. In univariate analyses, patients with peripheral neuropathic pain reported significantly more intense hot, cold, sensitive, itchy, and surface pain and significantly less intense dull and deep pain than patients with non-neuropathic pain. In a multivariate analysis, the overall pattern of pain quality and spatial characteristics differed significantly between patients with neuropathic and non-neuropathic pain. In addition, specific pain quality and spatial characteristics improved the discrimination of patients with neuropathic and non-neuropathic pain in a logistic regression model that adjusted for demographic covariates and overall pain intensity and unpleasantness.

Perspective

The results indicate that the distinction between neuropathic and non-neuropathic pain is reflected in different profiles of pain quality and spatial characteristics and suggest that the assessment of patterns of pain symptoms might contribute to the identification of distinct pathophysiologic mechanisms and the development of mechanism-based treatment approaches.

Key words

Neuropathic pain
symptoms
pain quality
non-neuropathic pain
low back pain
osteoarthritis pain

Cited by (0)

Supported by a grant from Endo Pharmaceuticals to the University of Rochester Office of Professional Education. RHD has received research support, consulting fees, or honoraria in the past year from Allergan, Astellas Pharma, Biomedical Development Corporation, Cephalon, Dov Pharmaceuticals, Eli Lilly & Co, Endo Pharmaceuticals, EpiCept Corporation, Fralex Therapeutics, NeurogesX (also stock options), Novartis Pharmaceuticals, Organon, Pfizer, UCB Pharma, US Food and Drug Administration, US National Institutes of Health, Wyeth, and Yamanouchi Europe. MPJ has received research support or consulting fees in the past year from Depomed, Endo Pharmaceuticals, Fralex Therapeutics (also stock options), and Pfizer. ARG is an employee of and holds stock options in Endo Pharmaceuticals.