Neuromuscular Disorders

Painful Polyneuropathy

Polyneuropathy is a disease with a range of potential causes, resulting in a combination of sensory loss, weakness, and pain. Treatments for painful polyneuropathy include oral medications, topical treatments, meditation, yoga, Tai Chi, physical exercise, and electrical stimulation. Management of nerve pain sometimes requires multidisciplinary intervention including a referral to a pain management specialist or the Neurological Institute’s Chronic Pain Rehabilitation Program.

Painful Polyneuropathy Patients: Change in Pain Score (N = 213)

2023

In 2023, 213 patients with polyneuropathy reported the severity of their pain using a numeric rating scale, ranging from 0 ("no pain") to 10 ("worst possible pain") at 2 visits at least 90 days apart. Among those patients whose baseline pain score was ≥ 2 (N = 200), 23% (N = 46) showed improvement, 59% (N = 118) remained stable, and 18% (N = 36) worsened. Clinically meaningful change was defined as one-half a standard deviation¹ or a total point change of 2 in those whose baseline pain score was ≥ 2. Median duration of follow-up was 1038 days (range, 92-4112 days).

Of the 46 patients who improved, 10 (21.7%) did not receive any treatment prior to their visit to the Neuromuscular Center. At follow-up, 6 (13%) of these patients reported being treated with medication for neuropathic pain (eg, pregabalin, gabapentin, duloxetine, etc.), and 12 (26%) reported using other treatments such as yoga, exercise, meditation, and other nonpharmacologic therapies.

References
  1. Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care. 2003 May;41(5):582-592.