Neuropathic Extremity Pain in Patients With Multiple Sclerosis: Preventive and Personalized Approach

Abstract BackgroundNeuropathic extremity pain is a disabling symptom in patients with multiple sclerosis. The aim of this study is to evaluate the prevalence of neuropathic extremity pain among patients with multiple sclerosis and to assess its effect on quality of life.MethodsThe present cross-sectional study included 180 patients with relapsing-remitting multiple sclerosis. Douleur Neuropathique 4 pain scale and Leeds Assessment of Neuropathic Symptoms and Signs pain scale were used to evaluate neuropathic pain. The effect of neuropathic extremity pain on quality of life was assessed by the 36-Item Short Form Survey. ResultsThe mean age and the mean disease duration were 38.78±9.37 and 8.96±6.93 years, respectively. The prevalence of neuropathic extremity pain was 38.9% in the Leeds Assessment of Neuropathic Symptoms and Signs pain scale and 47.8% in the Douleur Neuropathique 4 pain scale. The presence of neuropathic extremity pain was associated with the higher Expanded Disability Status Scale in the Leeds Assessment of Neuropathic Symptoms and Signs pain scale (p=0.015) and the longer disease duration in the Douleur Neuropathique 4 pain scale (p=0.021). All patients with psychiatric disorders reported neuropathic extremity pain. Lower 36-Item Short Form Survey scores were obtained in patients with neuropathic extremity pain than patients without neuropathic extremity pain in all domains of 36-Item Short Form Survey.ConclusionsThis study suggests that neuropathic extremity pain is a common symptom among patients with multiple sclerosis. Higher disability and longer disease duration are associated with neuropathic extremity pain. The presence of pain and psychiatric disorders are related to the impairment of the quality of life.Relevance of the article for predictive, preventive, and personalized medicine Questioning of pain is often neglected in multiple sclerosis practice. However, identification and treatment of pain has the potential to increase the quality of life in patients with multiple sclerosis. This article emphasizes that revealing the presence of pain might improve clinical outcome in multiple sclerosis patients providing personalized approaches to disease course.