title: Pain in Parkinson disease: a cross-sectional survey of its prevalence, specifics, and therapy.
abstract: We aimed to evaluate prevalence, phenotype, and therapeutic realities of pain in patients with Parkinson disease (PD). Therefore, we assessed 181 outpatients with PD using a cross-sectional approach applying the German Pain Questionaire (DSF), the PainDetect, and a self-developed Parkinson Disease Pain Questionaire (UPDPQ) covering detailed therapeutic aspects. Furthermore, we investigated the association between pain and PD-disease characteristics, quality of life (PDQ-39), depression, and anxiety (HADS-D, HADS-A). Overall, prevalence of pain was high (95.4%); 91.1% suffered from chronic pain, but in only 22.3% of them, pain disorder was diagnosed. Pain impaired everyday-life moderately to very severely in 48.4% of patients and was the most distressing symptom in 10.2% of all patients. Pain was localized mainly in the back (71.4%) or joints (52.4%), frequently occurred as pain attacks (79%) but appeared with neuropathic character in only 15.3% of patients. Most patients (74.2%) received some kind of pain treatment, mainly provided by orthopedists (62.0%) or general practitioners (50.0%). Physiotherapy (61.3%), pain killers (54.4%), or massage (35.5%) were the most frequent therapeutic measures. Rehabilitative therapy (96.3%) and physiotherapy (89.5%) were rated as most effective, but with vastly temporary effects. 53.3% of patients attributed PD as the main cause for their pain, but only 33.6% found relief from anti-parkinsonian drugs. High levels of pain were associated with higher scores of depression and anxiety, and lower quality of life. Results suggest that pain in PD is frequent, complex, and quality-of-life-impairing but under-diagnosed and unsystematically treated and indicate need to systematically investigate pathophysiology-based treatment strategies.
authors.affiliation: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. buhmann@uke.uni-hamburg.de.
authors.forename: Carsten
authors.identifier: http://orcid.org/0000-0001-8540-3789
authors.initials: C
authors.lastname: Buhmann
authors.affiliation: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.|Department of Clinical Neuroscience, Karolinska Institutet, Solnavägen 1, 171 77 Solna/Stockholm, Sweden.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Wrobel
authors.affiliation: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Grashorn
authors.affiliation: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: Odette
authors.initials: O
authors.lastname: Fruendt
authors.affiliation: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Wesemann
authors.affiliation: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Diedrich
authors.affiliation: Department of Neurology, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bingel
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology; D010146:Pain / Q000453:epidemiology* / Q000209:etiology*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010300:Parkinson Disease / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Pain; Parkinson disease; Prevalence; Quality of life; Therapy