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Neuropathic pain in the general population: A systematic review of epidemiological studies

van Hecke, O.a,*; Austin, Sophie K.b; Khan, Rafi A.c; Smith, B. H.a; Torrance, N.a

doi: 10.1016/j.pain.2013.11.013
Comprehensive review

Summary This systematic review includes epidemiological studies of neuropathic pain within the general population. There is a wide range of incidence and prevalence rates.

ABSTRACT Most patients with neuropathic pain symptoms present and are managed in primary care, with only a minority being referred for specialist clinical assessment and diagnoses. Previous reviews have focused mainly on specific neuropathic pain conditions based in specialist settings. This is the first systematic review of epidemiological studies of neuropathic pain in the general population. Electronic databases were searched from January 1966 to December 2012, and studies were included where the main focus was on neuropathic pain prevalence and/or incidence, either as part of a specific neuropathic pain-related condition or as a global entity in the general population. We excluded studies in which data were extracted from pain or other specialist clinics or focusing on specific population subgroups. Twenty-one articles were identified and underwent quality assessment and data extraction. Included studies differed in 3 main ways: method of data retrieval, case ascertainment tool used, and presentation of prevalence/incidence rates. This heterogeneity precluded any meta-analysis. We categorised comparable incidence and prevalence rates into 2 main subgroups: (1) chronic pain with neuropathic characteristics (range 3–17%), and (2) neuropathic pain associated with a specific condition, including postherpetic neuralgia (3.9–42.0/100,000 person–years [PY]), trigeminal neuralgia (12.6–28.9/100,000 PY), painful diabetic peripheral neuropathy (15.3–72.3/100,000 PY), glossopharyngeal neuralgia (0.2–0.4/100,000 PY). These differences highlight the importance of a standardised approach for identifying neuropathic pain in future epidemiological studies. A best estimate of population prevalence of pain with neuropathic characteristics is likely to lie between 6.9% and 10%.

a Medical Research Institute, University of Dundee, UK

b Foundation Year, Livingston Hospital, NHS Lothian, Livingston, UK

c Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee, UK

* Corresponding author. Address: Mackenzie Building, Ninewells Hospital and Medical School, Kirsty Semple Way, Dundee DD2 4BF, UK. Tel.: +44 (1382) 383 930; fax: +44 (1382) 383 802.

E-mail address: o.vanhecke@dundee.ac.uk

Article history:

Received 21 August 2013

Received in revised form 29 October 2013

Accepted 19 November 2013

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

© 2014 International Association for the Study of Pain
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