Neuropathic pain in patients with chronic leg ulcers

Background: Leg ulcers are a frequent and often painful disorder. This pain is not always correctly evaluated and relieved.

Objectives: The aim of this prospective study is to assess the contribution of neuropathic pain in leg ulcers.

Methods: A visual analog scale and the DN4 questionnaire were fulfilled by 81 patients with leg ulcers.

Results: Of the patients with leg ulcers, 58% (n = 47) had a positive DN4 score. No predictive factor leading to neuropathic pain was found. The aetiology of the ulcers did not influence the DN4 score.

Conclusions: This high prevalence of neuropathic pain in leg ulcers might be explained by an impairment of peripheral nerves due to ischaemia. This study also highlights the difficulty to relieve pain in chronic wounds; 16 patients had an analogous visual scale above 7. These results should encourage practitioners to regularly screen for neuropathic pain and to initiate appropriate treatment if necessary.