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. 2022 Jul 19;8(3):e001297.
doi: 10.1136/bmjsem-2021-001297. eCollection 2022.

Nearly half of patients with chronic tendinopathy may have a neuropathic pain component, with significant differences seen between different tendon sites: a prospective cohort of more than 300 patients

Patrick C Wheeler  1   2
Affiliations

Nearly half of patients with chronic tendinopathy may have a neuropathic pain component, with significant differences seen between different tendon sites: a prospective cohort of more than 300 patients

Patrick C Wheeler. BMJ Open Sport Exerc Med. .

Abstract

Objectives: Identifying the prevalence of neuropathic pain components in patients with chronic tendinopathy conditions using the Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) questionnaire.

Methods: Patients with chronic tendinopathy and 'tendon-like' conditions treated within a single hospital outpatient clinic specialising in tendinopathy were identified. Pain scores, plus global function patient-reported outcome measures (5-Level version of EuroQol-5 Dimension and Musculoskeletal Health Questionnaire (MSK-HQ)), were completed and compared with the S-LANSS questionnaire.

Results: 341 suitable patients with chronic tendinopathy and potentially similar conditions were identified. Numbers: lateral elbow tendinopathy (39), greater trochanteric pain syndrome (GTPS; 112), patellar tendinopathy (11), non-insertional Achilles tendinopathy (40), insertional Achilles tendinopathy (39), plantar fasciopathy (100). 68% were female, with a mean age of 54.0±11.3 years and a mean symptom duration of 38.1±33.7 months.There was a mean S-LANSS score of 11.4±6.4. Overall, 47% of patients scored 12 or greater points on S-LANSS, indicating the possible presence of neuropathic pain. The highest proportion was in patients with plantar fasciopathy (61%), the lowest in those with GTPS (33%). Weak correlations were found between the S-LANSS score and MSK-HQ score, the numerical rating scale (0-10) values for 'average pain' and for 'worst pain', but not with the MSK-HQ %health value.

Conclusion: S-LANSS identified nearly half of patients with chronic tendinopathy as possibly having a neuropathic pain component. This is of unclear clinical significance but worth further study to see if/how this may relate to treatment outcomes. These results are from a single hospital clinic dealing with patients with chronic tendinopathy, without a control group or those with shorter symptom duration. However, this reinforces the probability of neuropathic pain components in at least some patients with chronic tendinopathy.

Keywords: Diagnosis; Questionnaire; Soft tissue; Tendinopathy.

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Conflict of interest statement

Competing interests: The author is an associate editor for BMJ Open SEM. This manuscript has been prepared outside of this role.

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References

    1. Paavola M, Kannus P, Paakkala T, et al. . Long-Term prognosis of patients with Achilles tendinopathy. An observational 8-year follow-up study. Am J Sports Med 2000;28:634–42. 10.1177/03635465000280050301 - DOI - PubMed
    1. Lievense A, Bierma-Zeinstra S, Schouten B, et al. . Prognosis of trochanteric pain in primary care. Br J Gen Pract 2005;55:199–204. - PMC - PubMed
    1. DiGiovanni BF, Nawoczenski DA, Lintal ME, et al. . Tissue-Specific plantar fascia-stretching exercise enhances outcomes in patients with chronic heel pain. A prospective, randomized study. J Bone Joint Surg Am 2003;85:1270–7. 10.2106/00004623-200307000-00013 - DOI - PubMed
    1. Williams BS, Cohen SP. Greater trochanteric pain syndrome: a review of anatomy, diagnosis and treatment. Anesth Analg 2009;108:1662–70. 10.1213/ane.0b013e31819d6562 - DOI - PubMed
    1. Buchbinder R. Plantar fasciitis. N Engl J Med Overseas Ed 2004;350:2159–66. 10.1056/NEJMcp032745 - DOI - PubMed

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