Evaluation of neuropathic pain in lower extremity wounds using different assessment tools: A cross-sectional study

Background: Patients with lower extremity wounds often experience neuropathic pain; however, there is no validated assessment tool to specifically measure wound-related neuropathic pain. The study aimed to assess the prevalence of neuropathic pain in lower extremity wounds using different assessment tools and to identify factors associated with neuropathic pain. Methods: A cross-sectional study of 130 patients with lower extremity wounds of different etiologies assessed neuropathic pain through clinical examinations, the Short Form McGill Pain Questionnaire-2 (SF-MPQ-2), and the Douleur Neuropathique 4 Questions (DN4). Pain intensity was measured using the Visual Analog Scale (VAS). Results: In total, 38 (29%) experienced neuropathic pain (DN4 score ≥ 4), and 75% (n = 97) described pain using one or more neuropathic pain descriptors on the SF-MPQ-2. The frequently reported descriptors on the neuropathic sub-scale were “pain caused by light touch” (59%) and “tingling or pins and needles” (49%). There was a positive correlation between DN4 and the neuropathic sub-scale of SF-MPQ-2, and the major difference between the tools is the design and time consumption. Univariate analysis revealed that younger age, arterial wound type, infection, and morphine consumption were associated with neuropathic pain (DN4 score ≥ 4). In multivariate analysis, arterial wound type increased the risk of neuropathic pain five-fold. Younger age and morphine consumption were also significantly associated with neuropathic pain, whereas infection was not. Conclusion: Neuropathic wound pain is frequent, and the prevalence relies on the applied assessment tool. Arterial wound type, younger age, and morphine consumption are associated with neuropathic wound pain.