Pain in individuals with multiple sclerosis, knee prosthesis, and post-herpetic neuralgia: learning from focus group...

Pain is a common symptom in patients with multiple sclerosis (MS) and it is thought to be the result of a mixture of neuropathic and nociceptive pain. Different elements of pain need to be recognized and treated differently, but a clinical tool to classify these components still remains to be defined.

The aim of our study was to evaluate subjective feeling of pain in people with MS, including pain quality description and pain impact in daily functioning. We also investigated which descriptors are related to nociceptive pain and which to neuropathic pain. Finally, we explored if there are differences between the descriptors spontaneously used by individuals with MS and the ones included in the McGill Pain Questionnaire (MGPQ).

We used focus group (FG) of discussion to collect participants' opinion about their pain. We organized 2 FGs for persons with MS. We also gathered 2 FGs of individuals who had a recent knee arthroplasty, suffering a pure nociceptive pain, and 2 FGs of individuals with post-herpetic neuralgia, suffering a pure neuropathic pain, to compare their experience with the one of the people with MS.

Original spontaneous descriptors emerged in all the groups. People with MS in particular used various symbolic descriptors to express their pain's quality and underlined the high impact of pain on their lives. The use of specific descriptors for neuropathic and nociceptive pain in the different groups did not appear easily definable. Finally, pain descriptors used during FG appeared to be different than the ones included in the MGPQ.

Original spontaneous descriptors, possibly pathology-specific, emerged in all groups not included in the MGPQ and pointed out the need to use assessment tools based on people experience.