Neuropathic pain may be common in chronic lower limb tendinopathy: a prospective cohort study

To identify the prevalence of neuropathic pain, through the use of the painDETECT questionnaire, in a cohort of patients with chronic lower limb tendinopathy conditions.

Patients with chronic lower limb tendinopathy conditions treated within a Sport and Exercise Medicine hospital clinic were identified from clinical records. At the time of the clinical consultation, pain and painDETECT scores were recorded.

In total, 282 suitable patients with chronic lower limb tendinopathy conditions were identified who had completed a painDETECT questionnaire. There was a median age of 51.9 years, 35% of patients were male and a median duration of symptoms of 24.0 months. There was a median score of 7.0/10 for self-reported 'average' pain and 8.0/10 for self-reported 'worst' pain. There was a median painDETECT score of 14.0, 28% of respondents scored 19 or higher with painDETECT (neuropathic component to pain may be likely), 29% scored 13-18 (equivocal result) and 43% of respondents scored 12 or less (neuropathic pain component was unlikely).

This study suggests that neuropathic pain as identified by the painDETECT questionnaire may be common in patients with chronic lower limb tendinopathy conditions. It is unclear if patients with tendinopathy who have neuropathic pain may have poorer outcomes from initial treatments, contributing to the high proportion seen in secondary care. These are results from a single hospital clinic, and comparison with a control group is currently lacking. However, on the results to date, neuropathic pain should be considered in management strategies in patients with chronic tendinopathy.