Summary: A new study shows that neuropathy is more common in clinical practice than believed. In the study, where the majority of the patients had diabetes and metabolic disorders, neuropathy was present in 73% of the cases. However, what is worrisome is that it also remains undiagnosed in the vast majority of cases. Thus, the study found that it was undiagnosed in 75% of the cases.
Many people are living with neuropathic pain. Neuropathy not only causes pain but has many other symptoms, like a tingling sensation in hands and feet, since it also affects sensory pathways. Further, those affected by peripheral neuropathy may also have autonomous neuropathy, resulting in other health issues due to poor regulation of the working of various organs.
Hence, those with neuropathy have reduced life expectation. This means that many of them might experience unexpected adverse and life-threatening events. Neuropathic pain is also challenging to manage, causing much emotional distress, depression, and other mental health issues.
Neuropathy often starts years before it is clinically diagnosed. There are several reasons for its delayed diagnosis; such patients may not seek medical attention early enough. Similarly, many doctors or general physicians are not well-trained enough to diagnose the condition early. Even worse, there is a lack of awareness about its prevalence, which justifies the study of its prevalence in primary care clinics.
A new study by Elafros and colleagues from Michigan State University, US, was published in the journal Neurology. It explored the prevalence of distal symmetric polyneuropathy (DSP) among Medicaid patients who were older than 40 years of age.
Neuropathy Affects Significant Number of Patients, and Yet Remains Undiagnosed
The study collected data from 169 patients in Flint, Michigan. Since neuropathy is more common in those living with metabolic disorders, other data like fasting lipids and HbA1C were also collected. They measured the prevalence of DSP using Peripheral Neuropathy Quality of Life Instrument–97.
The study mainly included non-Hispanic blacks, who comprised 69% of patients. Both genders were almost equally represented, and the mean age of patients was 58.2 years. The study had some unexpected findings. It found that DSP was present in 73% of patients. What came as a surprise for the researchers was the fact that DSP was undiagnosed in 75% of cases. Moreover, they could document neuropathic pain in 57% of the patients.
Neuropathy was more common in those living with diabetes or metabolic disorders. Similarly, there was a correlation with older age. However, non-Hispanic Blacks had slightly lower odds of developing neuropathy compared to non-Hispanic White and Hispanic participants.
Of course, some of the findings were quite expected, like the association of neuropathic pain with advancing age and metabolic syndrome. The study found that neuropathic pain was slightly less common among non-Hispanic Blacks. However, these differences could be due to a smaller sample size.
Despite numerous limitations of the study, one thing cannot be neglected: it found that neuropathy was far more common in the patients than expected. Even worse, it goes undiagnosed in so many cases. Undiagnosed neuropathy not only increases the risk of adverse outcomes, but it may also result in the wrong treatment approach.
The Bottom Line
Chronic pain is quite challenging to manage. However, what is worrisome is that its cause often remains unidentified. This highlights the importance of seeking care for chronic pain in specialized clinics. Moreover, neuropathic pain requires a unique therapeutic approach.
It is not likely that healthcare providers were not aware of chronic pain in their patients. However, there is a lack of awareness that neuropathic pain is more common than many healthcare professionals believe. Undiagnosed cause of chronic pain translates into inadequate care for mood and emotional disorders among patients and may even lead to substance abuse.
Finally, it is also worth noticing that certain steps must be taken to prevent neuropathic pain since reversing or overcoming such pain is quite challenging.
References
Elafros, M. A., Brown, A., Marcus, H., Dawood, T., Bachuwa, G. I., Banerjee, M., Winch, P. J., Kvalsund, M., Feldman, E. L., Skolarus, L. E., & Callaghan, B. C. (2024). Prevalence and Risk Factors of Distal Symmetric Polyneuropathy Among Predominantly Non-Hispanic Black, Low-Income Patients. Neurology, 102(11), e209390. https://doi.org/10.1212/WNL.0000000000209390
