Prevalence of neuropathic pain and its associated factors among diabetic patients with chronic lower limb pain in a university primary care clinic

Neuropathic pain (NP), a common cause of chronic pain among diabetic patients. NP results in low quality of life among its sufferers due to various physical and psychological impacts. Appropriate mechanism-based pain treatment can be given if NP is correctly identified, resulting in better pain management. This study aimed to determine the prevalence of NP and its associated factors among diabetic patients with chronic lower limb pain at a teaching primary care clinic. This cross-sectional study involved conveniently sampled adult diabetic patients with lower limb pain for at least three months’ duration. The Douleur Neuropathique 4 Questions (DN4) was used to screen for NP, whereas pain intensity was measured using the Numeric Pain Rating Scale (NPRS). The patients' sociodemographic, anthropometric measurements and blood investigation results were also collected. Multiple logistic regression was performed to identify independently associated factors with NP. The prevalence of NP was 15.7%. Moderate pain (Adj OR=13.0, 95% CI= 5.98, 27.82) and severe pain (Adj OR = 127.00, 95%CI 10.67, 1512.85) were independently associated with NP. In conclusion, moderate to severe lower limb pain was more likely due to NP among diabetic patients. NP should be considered as a diagnosis in the assessment of chronic lower limb pain among diabetic patients in the primary care setting.