The epidemiology of neuropathic pain: an analysis of prevalence and associated factors in UK Biobank

Abstract

Previous epidemiological studies of neuropathic pain have reported a range of prevalences and factors associated with the disorder. This study aimed to verify these characteristics in a large UK cohort. A cross sectional analysis was conducted of 148,828 UK Biobank participants who completed a detailed questionnaire on chronic pain. The Douleur Neuropathique en Quatre Questions (DN4) was used to distinguish between neuropathic pain (NeuP) and non-neuropathic pain (Non-NeuP) in participants with pain of at least 3 months duration. Participants were also identified with less than 3 months pain or without pain (NoCP). Binomial and multinomial regression were used to identify factors associated with NeuP compared to Non-NeuP and NoCP respectively. Chronic pain was present in 76,095 participants (51.1%). The overall prevalence of NeuP was 9.2% (13,744/148,828. NeuP was significantly associated with worse health-related quality of life, having a manual or personal service type occupation and younger age compared to NoCP. As expected NeuP was associated with diabetes and neuropathy, but also other pains (pelvic, post-surgical and migraine) and musculoskeletal disorders (rheumatoid arthritis, osteoarthritis and fibromyalgia). Additionally, NeuP was associated with pain in the limbs and greater pain intensity and higher BMI compared to Non-NeuP. Female gender was associated with NeuP when compared to NoCP, whilst male gender was associated with NeuP when compared to Non-NeuP. This is the largest epidemiological study of neuropathic pain to date. The results confirm that the disorder is common in the general population and is associated with a higher health impact than non-neuropathic pain.