Neuropathic pain feature in cancer-induced bone pain: does it matter? a prospective observational study
Nantthasorn Zinboonyahgoon, Choopong Luansritisakul
Abstract
Background: Cancer-induced bone pain (CIBP) is considered to have both nociceptive and neuropathic components.However, the prevalence, risk factors, and impact of the neuropathic components are yet poorly understood.Methods: We estimate the prevalence of neuropathic pain (NP) features in patients with CIBP at a tertiary care pain clinic setting using the Douleur Neuropathique 4 questionnaire and evaluate their associated factors and their impact after 4 weeks of treatment using the Brief Pain Inventory questionnaire and the Edmonton Symptom Assessment System.Results: A total of 133 patients were recruited.The estimated prevalence of NP was 30.8% (95% confidence interval: 23.6%-39.1%).Initially, the patients with NP had significantly higher average pain scores (6.00 vs. 5.05, P = 0.006), higher total interference scores (5.84 vs. 4.89, P = 0.033), and symptom distress scores (35.88 vs. 26.52,P = 0.002).After 4 weeks of treatment, patients in both groups reported significantly decreased pain intensity and improved quality of life.However, the patients with NP still reported significantly higher average pain (4.61 vs. 3.58, P = 0.048), trending toward higher total interference scores (3.52 vs. 2.99, P = 0.426), and symptom distress scores (23.30 vs. 20.77,P = 0.524).From multivariate analysis, the independent risk factors for NP were younger age, pain in the extremities, and higher average pain scores.Conclusions: NP are common in patients with CIBP.These conditions negatively affect pain intensity and the patient's quality of life before and after treatment.