Diabetic foot ulcer related pain and its impact on health-related quality of life

Background: Diabetic foot ulcers (DFUs) are a prevalent complication of diabetes. Individuals with DFUs can experience wound-related pain, which could be nociceptive and/or neuropathic in origin, which adversely affects health-related quality of life (HRQoL).

Aim: To determine the prevalence and characteristics of DFU-related pain and its impact on HRQoL in community-dwelling individuals with active DFUs.

Methods: A cross-sectional quantitative study was conducted, employing the Short-form McGill Pain Questionnaire (SF-MPQ) and the Cardiff Wound Impact Schedule (CWIS), involving patients with DFU at a Podiatry Clinic in the West of Ireland.

Results: This study evaluated 30 patients with DFUs, of whom 70.0 % (n = 21) were male. Among the participants, 70.0 % (n = 21) reported at least one sensory pain descriptor from the SF-MPQ, and 40.0 % (n = 12) chose descriptors indicative of neuropathic pain. "Tender" emerged as the most frequently selected sensory pain descriptor (n = 11, 36.7 %). The mean Visual Analogue Scale (VAS) score was 23.3 (±30.9) mm. For present pain intensity (PPI), 43.3 % (n = 13) reported pain ranging from mild to horrible pain. Spearman's correlation analysis revealed a significant negative correlation between SF-MPQ, VAS, PPI, and HRQoL, with moderate to strong associations. Patients with multiple DFU locations or neuropathic pain presented poorer HRQoL evaluation. Sensory pain (β = -3.582, P = 0.026) and PPI (β = -2.682, P = 0.020) were identified as independent predictors of HRQoL based on multiple linear regression analysis.

Conclusion: DFU-related pain is prevalent and significantly impacts patients' HRQoL. It is important to prioritise comprehensive and regular assessment of DFU-related pain during patient consultations. A patient-centred and holistic approach should be adopted, guided by the outcomes of pain assessments.