title: The evaluation of pain in amyotrophic lateral sclerosis: a case controlled observational study.
abstract: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder leading to progressive paralysis. ALS is complicated by a number of non-motor symptoms including pain. Pain in ALS has been poorly studied and poorly managed. This study aimed to collate information regarding pain in ALS using standardized pain questionnaires. Forty-two patients with ALS participated in the study. Control subjects included 41 age-matched healthy volunteers and 42 age-matched patients with neurological conditions other than ALS. Data on pain were collected using the The Brief Pain Inventory and The painDetect Questionnaire. Eighty-five percent of subjects with ALS reported pain versus 50% of neurology clinic controls and 35% of healthy controls (p < 0.01). Pain in ALS included cramping, aching, tiring, sharp and tender, and was non-neuropathic. Pain impacted significantly on mood, general activity, relationships and general enjoyment of life. Fifty-four percent of people with painful ALS used regular analgesia and 29% regular opioids. Other non-motor symptoms suffered included tiredness, constipation, urinary problems, itching and drowsiness. In conclusion, these data support the fact that pain is a significant symptom in ALS which impacts on quality of life. These data can be used to educate clinicians and patients to promote better multidisciplinary management of ALS symptoms and a better quality of life.
authors.affiliation: Kings College London, Institute of Psychiatry, Department of Clinical Neurosciences , London.
authors.forename: Victoria C J
authors.initials: VC
authors.lastname: Wallace
authors.forename: Cathy M
authors.initials: CM
authors.lastname: Ellis
authors.forename: Rachel
authors.initials: R
authors.lastname: Burman
authors.forename: Catherine
authors.initials: C
authors.lastname: Knights
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Shaw
authors.forename: Ammar
authors.initials: A
authors.lastname: Al-Chalabi
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications*; D000698:Analgesia / Q000379:methods; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D010146:Pain / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement
keywords: Amyotrophic lateral sclerosis; non-motor symptoms; pain