Is it Neuropathic Pain or Sensory Hypersensitivity?

Different types of pain respond to different medications; so a collaborative team across the United States and United Kingdom looked at how the Chronic Pain Questionnaire (CPQ) can assist in making those important treatment decisions.

Presented at PAINWeek 2016 in Las Vegas, Nevada, the researchers concentrated on the three types of pain pathophysiology — nociceptive, neuropathic (NeP), and sensory hypersensitivity (SH). The responses to the CPQ, in conjunction with medical history, can help determine SH pain. It is not known, however, if the questionnaire can determine if a patient is suffering from SH or other types of chronic pain, like NeP. So that’s what the team set out to uncover.

The CPQ consists of 14 items indicated to help primary physicians screen and monitor patients. Questions are meant to identify the presence of pain, how intense the pain is (0 to 10 scale), where the pain is, and how activities play a role in pain interference. In addition, the CPQ includes questions on sleep, mood, trouble with thinking or remembering, and sensitivity to lights, noises, and smells. The questionnaire also utilizes a tool that differentiates between nociceptive and non-nociceptive pain, called the ID Pain.

• MD Magazine is on Facebook, Twitter, Instagram, and LinkedIn!

A total of 98 patients — 81.6% female, 73.5% Caucasian, and average age of 54.8 – were recruited for the study. All of the participants were diagnosed with either a NeP or SH condition. Those in the SH group had a mix including fibromyalgia, irritable bowel syndrome (IBS), interstitial cystitis, chronic fatigue syndrome, and temporomandibular joint (TMJ) disorder.

Although the CPQ can be administered online, the researchers had the cohort take the paper version. The patients also took a sociodemographic form as well as:

• Pain Outcomes Questionnaire — Short Form (POQ-SF)
• Short Form Health Survey 36 (SF-36)
• Hospital Anxiety and Depression Scale (HADS)
• Medical Outcomes Study Sleep (MOS-S) scale
• Fibromyalgia Survey Questionnaire (FSQ)

More women had SH conditions than NeP (94.1% vs. 53.3%) and anxiety was found in more patients with SH than NeP (41.2% vs. 16.7%). Both groups, however, experienced relatively similar amounts of arthritis (48% to 50%), hypertension (44.1% to 60%), and depression (30% to 47.1%).

Results from the SF-36 showed that patients with SH had significantly lower Vitality, Mental Health, and Mental Component Summary Scores than those with NeP. The HADS and MOS-S scales did not show significant differences between the groups. There wasn’t a major difference on the POQ-SF subscales, aside from the Negative Affect subscale where those with SH had higher scores. And finally, all FSQ subscales showed that the SH group had higher levels of impairment than the NeP group.

“The results above generally support findings related to CPQ,” the authors confirmed. “Differences in CPQ responses between groups were statistically significant (p<0.05) for seven items and ID Pain total score with NeP participants reporting higher total scores (3.4 vs. 2.3).”

Not only did this analysis determine that the CPQ can identify SH, but it can also differentiate between SH and NeP.

Also on MD Magazine >>> More News from PAINWeek 2016 in Las Vegas