Pain Qualities and Satisfaction with Therapy: A Survey of Subjects with Neuropathic Pain

Abstract

Pain qualities may reflect neurobiological mechanisms and guide therapy. The objective was to assess whether pain qualities were associated with satisfaction with pain relief in subjects with neuropathic pain. Subjects responded to a web survey that included current pain qualities, type of medications, and satisfaction with pain relief. A total of 1,502 subjects, primarily with diabetic neuropathy, completed the survey and were grouped into six clusters based on their pain qualities. Subjects in the Broadest spectrum endorsed all pain types (paroxysmal, throbbing, paresthesias, evoked pain, and numbness). Subjects in the Broad spectrum endorsed all types of pain, but to a lesser degree. Subjects in the Sharp paroxysmal and paresthesias endorsed mainly stabbing-like pain, subjects in the throbbing dull pain endorsed throbbing and pressure, subjects in the numbness endorsed mainly numbness, and subjects in the least affected endorsed few symptoms. The degree of satisfaction in each cluster varied with the type of medication. Two clusters were dissatisfied with antidepressants: subjects with paroxysmal pain and paresthesias (odds ratio [OR] = 0.38; 95% confidence interval [CI], 0.19-0.74) and subjects with the broadest spectrum of symptoms (OR = 0.63; 95% CI, 0.41-0.97). Two clusters were dissatisfied with opioids: subjects with throbbing and dull pain (OR = 0.44; 95% CI, 0.26-0.75) and subjects with numbness (OR = 0.48; 95% CI, 0.23-0.99). Pain qualities may help guide pain therapy and permit individualization of therapy.