Open AccessPredictors of Persistent Neuropathic Pain – A Systematic Review
Author(s) -
Sabine Boogaard,
Martijn W. Heymans,
H.C.W. de Vet,
Madelon L. Peters,
Stephan A. Loer,
W. W. A. Zuurmond,
Roberto Pérez
Publication year - 2015
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2015/18/433
Subject(s) - medicine , neuropathic pain , postherpetic neuralgia , radicular pain , neuralgia , hypoesthesia , physical therapy , sciatica , mcgill pain questionnaire , anesthesia , surgery , lumbar , visual analogue scale
Background: Characterization of the prognostic variables for persistent neuropathic pain (PNP)remains incomplete despite multiple articles addressing this topic. To provide more insight into therecovery and prognosis of neuropathic pain, high-quality data are required that provide informationabout the predictors that contribute to the development of PNP.Objective: To determine the methodological quality of studies about predictors for PNP and tosummarize findings of predictors found in high-quality studies.Study Design: A systematic review.Setting: VU University Medical Center, Amsterdam, The Netherlands.Methods: Studies were identified by searching the electronic databases PubMed, Embase, andCochrane Library. Methodological quality of each article was independently assessed by 2 reviewers.Results: Forty-six relevant studies were identified, classified into 4 different neuropathic pain (NP)-syndromes: postherpetic neuralgia (n = 35), radicular pain and sciatica (n = 3), postsurgical pain (n= 6), and other types of NP (n = 2). Seven studies were of high quality. The 3 high-quality studiesfound for PHN reported male gender, older age, smoking, trauma at the site of lesion, missed antiviralprescriptions, higher acute pain severity, higher rash severity, more neuropathic characteristics, shorterrash duration, and a lower health status as predictors for PNP. For persistence of radicular pain onehigh-quality study reported negative outcome expectancies, pain-related fear of movement, andpassive pain coping as predictors for PNP. Psychological distress, acute pain, breast cancer surgery,higher body mass index, area of secondary hyperalgesia, neuropathic characteristics, hypoesthesia,and hyperesthesia were found to be predictive for postsurgical pain in 3 high-quality studies.Limitations: Some publications may have been missed during literature search. The low-qualityof the studies could be the result of an incomplete description of their methods.Conclusions: High-quality studies mainly assessed factors related to disease functions andstructures. Due to shortcomings in methodological quality and limited areas of predictor selection,there is a need for high-quality studies focusing on predictor measurement, statistical analysis andthe use of a standardized set of predictors.Key words: Neuropathic pain, persistent pain, systematic review, literature search, predictors,quality assessment, ICF-model