Incidence rates and treatment of neuropathic pain conditions in the general popu

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Pain. 2008 Apr 23

Incidence rates and treatment of neuropathic pain conditions in the

general population.

Dieleman JP, Kerklaan J, Huygen FJ, Bouma PA, Sturkenboom MC.

Department of Medical Informatics, Erasmus MC, P.O. Box 2040, 3000

CA, Rotterdam, The Netherlands.

Incidence rate estimates of neuropathic pain are scanty and mostly

address single types whereas the scope of the disease is wide. We

aimed to calculate the incidence rates of neuropathic pain conditions

in the Dutch general population and to assess treatment strategies in

primary care.

The study population included persons registered for at least one

year in the Integrated Primary Care Information (IPCI) database

between 1996 and 2003.

Neuropathic pain was ascertained and classified by systematic review

of computerized longitudinal medical records. Incidence rates (IR)

were calculated, and the treatment for pain was compared to age and

gender matched controls. Among 362,693 persons contributing 1,116,215

person years (PY), we identified 9135 new cases of neuropathic pain

(IR: 8.2/1000 PY, 95%CI: 8.0-8.4).

Mononeuropathy and carpal tunnel syndrome were the most frequent

types with 4.3 and 2.3 cases/1000 PY followed by diabetic peripheral

neuropathy and post-herpetic neuralgia at 0.72 and 0.42/1000 PY.

Neuropathic pain was 63% more common in women than in men and peaked

between the ages 70 and 79.

More than 50% of cases received pain medication within 6 months after

diagnosis, mostly consisting of NSAIDs or aspirin. Anticonvulsants

and tricyclic antidepressants were only used by 4.8 and 4.7% of

cases. Neuropathic pain is a rather frequent condition with an annual

incidence of almost 1% of the general population and affecting women

and middle-aged persons more often.

The treatment mostly consisted of regular analgesics suggesting that

pharmacological treatment of neuropathic pain is suboptimal.