NOCICEPTIVE AND NEUROPATHIC PAIN IN PATIENTS WITH LUNG CANCER: A COMPARISON OF PAIN QUALITY DESCRIPTORS

摘要

Predictive validity of each word from the McGill Pain Questionnaire (MPQ) has not been investigated independent of pain etiology. The purpose of this study was to explore differences in the words used to describe nociceptive and neuropathic pain. Patients with lung cancer (N = 123) selected words from the 78 MPQ pain quality descriptors and indicated the corresponding pain site for each word. Using only the MPQ pain location and the disease and treatment data abstracted from medical records, each pain site was classified as nociceptive, neuropathic (etiology). Pain etiology and quality descriptors were tested for proportional differences. Of the 457 pain sites, 343 were classified as nociceptive (75%), 114 as neuropathic (25%). Lacerating, stinging, terrifying and suffocating were selected for a significantly larger proportion of nociceptive sites whereas throbbing, aching, numb, tender, punishing, pulling, tugging, pricking, punishing, miserable, and nagging were selected for a larger proportion of neuropathic sites. Interestingly, several pain quality descriptors (burning, shooting, flashing, tingling, itching, and cold) previously associated with neuropathic pain did not distinguish between neuropathic and nociceptive pain etiologies in this lung cancer sample. Infrequent selection of most MPQ words and lack of neurological exam data in the categorizing scheme are possible explanation for inconsistency with previous literature. Prospective investigations are needed to validate pain quality descriptors for nociceptive and neuropathic types of pain.