Skip to main content

Advertisement

Log in

Prevalence and associations of neuropathic pain in a cohort of multi-ethnic Asian low back pain patients

  • Observational Research
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

The prevalence of neuropathic low back pain differs in different ethnic populations. The aims of the study are to determine its frequency and associations in a multi-ethnic cohort of Asian low back pain patients. This was a cross-sectional study of low back patients seen at the University of Malaya Medical Centre, Kuala Lumpur, Malaysia. Neuropathic low back pain patients were identified using the painDETECT questionnaire and compared with non-neuropathic (unclear or nociceptive) low back pain patients, in terms of socio-demographic and clinical factors, pain severity (numerical pain rating scale, NPRS), disability (Roland Morris Disability Questionnaire, RMDQ), as well as anxiety and depression (Hospital Anxiety and Depression Scale, HADS). Of 210 patients, 26 (12.4%) have neuropathic low back pain. Neuropathic pain is associated with non-Chinese ethnicity, higher body mass index and pain radiation below the knee. Patients with neuropathic pain have significantly higher NPRS and RMDQ scores, and there are more subjects with anxiety on HADS. However, there are no differences between the groups in age, gender, pain duration or underlying diagnosis of low back pain. The prevalence of neuropathic low back pain in a multi-ethnic Malaysian cohort is lower than previously reported in other populations with possible differences between ethnic groups. It is associated with greater pain severity, disability and anxiety.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F et al (2012) A systematic review of the global prevalence of low back pain. Arthritis Rheum 64(6):2028–2037

    Article  PubMed  Google Scholar 

  2. Veerapen K, Wigley RD, Valkenburg H (2007) Musculoskeletal pain in Malaysia: a COPCORD survey. J Rheumatol 34(1):207–213

    PubMed  Google Scholar 

  3. Baron R, Binder A, Attal N, Casale R, Dickenson AH, Treede RD (2016) Neuropathic low back pain in clinical practice. Eur J Pain 20(6):861–873

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Freynhagen R, Baron R (2009) The evaluation of neuropathic components in low back pain. Curr Pain Headache Rep 13(3):185–190

    Article  PubMed  Google Scholar 

  5. Treede RD, Jensen TS, Campbell JN, Cruccu G, Dostrovsky JO, Griffin JW et al (2008) Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology 70(18):1630–1635

    Article  CAS  PubMed  Google Scholar 

  6. Schmidt CO, Schweikert B, Wenig CM, Schmidt U, Gockel U, Freynhagen R et al (2009) Modelling the prevalence and cost of back pain with neuropathic components in the general population. Eur J Pain 13(10):1030–1035

    Article  PubMed  Google Scholar 

  7. Freynhagen R, Baron R, Gockel U, Tolle TR (2006) painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin 22(10):1911–1920

    Article  PubMed  Google Scholar 

  8. Haanpaa M, Attal N, Backonja M, Baron R, Bennett M, Bouhassira D et al (2011) NeuPSIG guidelines on neuropathic pain assessment. Pain 152(1):14–27

    Article  PubMed  Google Scholar 

  9. Beith ID, Kemp A, Kenyon J, Prout M, Chestnut TJ (2011) Identifying neuropathic back and leg pain: a cross-sectional study. Pain 152(7):1511–1516

    Article  PubMed  Google Scholar 

  10. Hiyama A, Watanabe M, Katoh H, Sato M, Sakai D, Mochida J (2015) Evaluation of quality of life and neuropathic pain in patients with low back pain using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire. Eur Spine J 24(3):503–512

    Article  PubMed  Google Scholar 

  11. Kaki AM, El-Yaski AZ, Youseif E (2005) Identifying neuropathic pain among patients with chronic low-back pain: use of the Leeds Assessment of Neuropathic Symptoms and Signs pain scale. Reg Anesth Pain Med 30(5):422–428

    PubMed  Google Scholar 

  12. Morso L, Kent PM, Albert HB (2011) Are self-reported pain characteristics, classified using the PainDETECT questionnaire, predictive of outcome in people with low back pain and associated leg pain? Clin J Pain 27(6):535–541

    Article  PubMed  Google Scholar 

  13. Orita S, Yamashita T, Ohtori S, Yonenobu K, Kawakami M, Taguchi T et al (2016) Prevalence and location of neuropathic pain in lumbar spinal disorders: analysis of 1804 consecutive patients with primary lower back pain. Spine 41(15):1224–1231

    Article  PubMed  Google Scholar 

  14. Ouedraogo DD, Nonguierma V, Napon C, Kabre A, Tieno H, Guira O et al (2012) Prevalence of neuropathic pain among Black African patients suffering from common low back pain. Rheumatol Int 32(7):2149–2153

    Article  PubMed  Google Scholar 

  15. Yamashita T, Takahashi K, Yonenobu K, Kikuchi S (2014) Prevalence of neuropathic pain in cases with chronic pain related to spinal disorders. J Orthop Sci 19(1):15–21

    Article  PubMed  Google Scholar 

  16. Matsubayashi Y, Takeshita K, Sumitani M, Oshima Y, Tonosu J, Kato S et al (2013) Validity and reliability of the Japanese version of the painDETECT questionnaire: a multicenter observational study. PLoS One 8(9):e68013

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Campbell CM, Edwards RR (2012) Ethnic differences in pain and pain management. Pain Manag 2(3):219–230

    Article  PubMed  PubMed Central  Google Scholar 

  18. Chou R (2010) Low back pain (chronic). BMJ Clin Evid 2010:1116

    PubMed  PubMed Central  Google Scholar 

  19. Roland M, Fairbank J (2000) The roland-morris disability questionnaire and the oswestry disability questionnaire. Spine 25(24):3115–3124

    Article  CAS  PubMed  Google Scholar 

  20. Snaith RP (2003) The hospital anxiety and depression scale. Health Qual Life Outcomes 1:29

    Article  PubMed  PubMed Central  Google Scholar 

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

    Article  PubMed  Google Scholar 

  22. Torrance N, Smith BH, Bennett MI, Lee AJ (2006) The epidemiology of chronic pain of predominantly neuropathic origin. Results from a general population survey. J Pain 7(4):281–289

    Article  PubMed  Google Scholar 

  23. Enthoven WT, Scheele J, Bierma-Zeinstra SM, Bueving HJ, Bohnen AM, Peul WC et al (2013) Back complaints in older adults: prevalence of neuropathic pain and its characteristics. Pain Med 14(11):1664–1672

    Article  PubMed  Google Scholar 

  24. Attal N, Perrot S, Fermanian J, Bouhassira D (2011) The neuropathic components of chronic low back pain: a prospective multicenter study using the DN4 Questionnaire. J Pain 12(10):1080–1087

    Article  PubMed  Google Scholar 

  25. Hiyama A, Watanabe M, Katoh H, Sato M, Sakai D, Mochida J (2016) Effect of depression and neuropathic pain using questionnaires on quality of life in patients with low back pain; cross-sectional retrospective study. Eur Spine J 25(9):2750–2760

    Article  PubMed  Google Scholar 

  26. Gormsen L, Rosenberg R, Bach FW, Jensen TS (2010) Depression, anxiety, health-related quality of life and pain in patients with chronic fibromyalgia and neuropathic pain. Eur J Pain 14(2):127e1–127e8

    Article  Google Scholar 

  27. Smith BH, Torrance N, Bennett MI, Lee AJ (2007) Health and quality of life associated with chronic pain of predominantly neuropathic origin in the community. Clin J Pain 23(2):143–149

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Khean-Jin Goh.

Ethics declarations

Conflict of interest

All the authors declare that they have no conflicts of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kew, Y., Tan, CY., Ng, CJ. et al. Prevalence and associations of neuropathic pain in a cohort of multi-ethnic Asian low back pain patients. Rheumatol Int 37, 633–639 (2017). https://doi.org/10.1007/s00296-016-3633-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-016-3633-x

Keywords

Navigation