Presented at the 2013 AAPM Annual Meeting « Back

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

Soledad Cepeda, MD PhD, scepeda@its.jnj.com¹, Marsha A. Wilcox, EdD ScD², Marsha A. Wilcox, EdD ScD², Bennett Levitan, MD PhD¹, (1) Janssen R&D, Titusville, New Jersey, (2) Janssen Pharmaceutical Research and Development, Acton, Massachusetts

Introduction: Pain qualities may reflect neurobiological mechanisms and guide therapy. Materials and Methods: The objective of this cross-sectional study was to examine the association between neuropathic pain qualities (throbbing, etc.) and satisfaction with pain relief. Subjects with diabetic neuropathy or post-herpetic neuralgia responded to a Web questionnaire that included current pain qualities, type of medications, and satisfaction with pain relief. IRB approval was obtained. Multiple correspondence analysis was used to cluster subjects with similar patterns across the 36 pain qualities. We used principle components and factor analysis to describe clusters. Results: A total of 1,502 subjects completed the questionnaire. We identified 6 clusters based on pain qualities. Broadest spectrum: Subjects endorsed all pain types (paroxysmal, throbbing, paresthesias, evoked pain, and numbness). Broad spectrum: Subjects endorsed all types of pain, but to a lesser degree. Throbbing and deep pain: Subjects endorsed throbbing, pressure. Least affected: Subjects endorsed few symptoms. Paroxysmal and paresthesias/dysesthesias: Subjects endorsed mainly stabbing-like pain. Numbness: Subjects endorsed mainly numbness. The degree of satisfaction in each cluster varied with the type of medication: Subjects with the broadest spectrum of symptoms were more dissatisfied when on antidepressants (odds ratio [OR]=0.63; 95% confidence interval [CI], 0.41-0.97) as were subjects with paroxysmal pain and paresthesias/dysesthesias (OR=0.38; 95% CI, 0.19-0.74). Subjects with throbbing and deep pain were more dissatisfied when on opioids (OR=0.44; 95% CI, 0.26-0.75) as were subjects with primarily numbness (OR=0.48; 95% CI, 0.23-0.99). Conclusion: Pain qualities may help guide the choice of pain therapy and permit individualization of treatment.

Funding: None