Characterization of Neuropathic Pain in Sickle Cell Disease

Objective: Sickle cell disease (SCD) is a multifaceted, chronic disease that severely affects the quality of life of patients globally. Recurrent episodes of pain are a hallmark of SCD; however, there are limited data on the characterization of the pain. This paper characterizes the types of pain experienced by persons living with SCD in Grenada, West Indies. More specifically, it assesses the presence of neuropathic pain in these individuals. This study hopes to increase awareness of the types of pain in SCD and contribute to the development of effective pain management guidelines. Methods: A cross-sectional study was performed to assess the presence and characteristics of pain in patients with a confirmed diagnosis of SCD in Grenada. Participants were selected randomly from the registry provided by the Sickle Cell Association of Grenada. The painDETECT questionnaire was used to provide quantitative data and the McGill-Melzack Pain Questionnaire to provide qualitative data. Results: The study examined 63 participants, 24 males and 39 females, with a mean age of 21.16 years. In the McGill-Melzack Pain Questionnaire, participants chose pain descriptors for all three types of pain: nociceptive, affective/evaluative and neuropathic. An independent sample median test found neuropathic pain descriptors to be significantly different across age groups (p = 0.046). There was no age dependency in nociceptive and affective/evaluative pain. The mean final score of all participants in the painDETECT survey was 19.27 (95% CI: 17.25, 21.29), which is a score suggestive of a neuropathic pain component. There was also a positive correlation of 0.41 (p = 0.01) between age and painDETECT final score. Furthermore, a positive correlation of 0.56 (p < 0.001) existed between the number of neuropathic pain descriptors chosen and the painDETECT final score. Conclusion: The presence of all three types of pain, as well as the presence of neuropathic pain with increasing age, indicates the need for a multimodal pain management plan that is individually targeted and varied throughout the life of a patient with SCD.