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The impact of neuropathic pain on health-related quality of life

Review and implications

From the Department of Rehabilitation Medicine (M.P.J.), University of Washington School of Medicine, Seattle, WA; and the Departments of Medicine (M.J.C.) and Anesthesiology and Neurology (R.H.D.), University of Rochester School of Medicine and Dentistry, Rochester, NY.

Address correspondence and reprint requests to Dr. Mark P. Jensen, Department of Rehabilitation Medicine, Box 356490, University of Washington School of Medicine, Seattle, WA, 98195-6490.

A number of high-quality studies have recently been published that examine the association between neuropathic pain and health-related quality of life (HRQoL). The current review identified 52 such studies in patients with six neuropathic pain conditions associated with lesions of either the peripheral (postsurgical neuropathic pain associated with breast and amputation surgery, postherpetic neuralgia, and painful diabetic neuropathy) or central (poststroke pain, spinal cord injury pain, multiple sclerosis pain) nervous system. The results provide strong evidence that the presence and severity of neuropathic pain are associated with greater impairments in a number of important HRQoL domains. However, the evidence also indicates that this impact varies somewhat as a function of the HRQoL domain being considered and that different measures of HRQoL are differentially sensitive to the effects of neuropathic pain. The findings have important implications for the selection of HRQoL domains and measures to use in clinical trials and in clinical research on HRQoL in persons with neuropathic pain and suggest that a biopsychosocial (as opposed to a primarily biomedical) approach would be appropriate for understanding and treating neuropathic pain.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the April 10 issue to find the title link for this article.

Supported by a grant from Pfizer to the University of Rochester Office of Professional Education.

Disclosure: M.P.J. has received research support, consulting fees, or honoraria in the past year from Anesiva, Depomed, Endo Pharmaceuticals, Fralex Therapeutics (also stock options), GW Pharmaceuticals, Pfizer, and U.S. National Institutes of Health. R.H.D. has received research support, consulting fees, or honoraria in the past year from Allergan, Cephalon, Dov Pharmaceuticals, Eli Lilly & Co., Endo Pharmaceuticals, EpiCept Corporation, Fralex Therapeutics, GW Pharmaceuticals, Johnson & Johnson, Merck & Co., NeurogesX (also stock options), Novartis, Pfizer, Schwarz Pharma, Supernus Pharmaceuticals, U.S. Food and Drug Administration, U.S. National Institute of Health, and U.S. Veterans Administration.

Received September 10, 2006. Accepted in final form November 26, 2006.