Features of chronic pain syndrome in professional polyneuropathies
Authors: Greben’kov S. V. , Kochetova O. A. , Mal’kova N. Yu. , Milutka E. V. 
Published: August 2020

Pain in the hands is a key symptom of professional upper limb polyneuropathy. Its occurrence is caused by physical overloads and functional overstrain of the upper limb muscles, leading to traumatization of peripheral nerve fibers due to tension or damage to the nerve endings in the tense muscle in conditions of a pronounced decrease in blood flow.The aim of study was to study the features of pain syndrome in professional polyneuropathies is an important task, the solution of which can contribute to more effective treatment of the main clinical manifestations of this disease.We examined 236 patients with a diagnosis of occupational upper limb polyneuropathy aged 18 to 65 years without significant comorbidities. The study was conducted using standard questionnaires (DN4 neuropathic pain diagnostic questionnaire, short pain questionnaire, hospital scale of anxiety and depression).The DN4 questionnaire survey revealed the presence of a neuropathic component of pain syndrome in 91.4% of patients. Quantitative assessment of pain using a short pain questionnaire confirmed the high intensity of pain in the hands of patients, as well as its impact on professional activities and other areas of life. In addition, most of the examined individuals showed signs of subclinical and clinical anxiety and depression.Pain in the hands is a key symptom of professional upper limb polyneuropathy. Its occurrence is caused by physical overloads and functional overstrain of the upper limb muscles, leading to traumatization of peripheral nerve fibers due to tension or damage to the nerve endings in the tense muscle in conditions of a pronounced decrease in blood flow. The study of the features of pain syndrome in professional polyneuropathies is an important task, the solution of which can contribute to more effective treatment of the main clinical manifestations of this disease.We examined 236 patients with a diagnosis of occupational upper limb polyneuropathy aged 18 to 65 years without significant comorbidities. The study was conducted using standard questionnaires (DN4 neuropathic pain diagnostic questionnaire, short pain questionnaire, hospital scale of anxiety and depression).The DN4 questionnaire survey revealed the presence of a neuropathic component of pain syndrome in 91.4% of patients. Quantitative assessment of pain using a short pain questionnaire confirmed the high intensity of pain in the hands of patients, as well as its impact on professional activities and other areas of life. In addition, most of the examined individuals showed signs of subclinical and clinical anxiety and depression.Hand pain in patients with occupational polyneuropathy is a complex problem due to its high intensity, long-term chronic course and impact on many aspects of the patient’s daily life. The disease is characterized by a mixed nociceptive-neuropathic nature of the pain syndrome. This explains the persistence of pain for many years after the termination of contact with the etiological harmful production factor (physical overload) and the low effectiveness of conventional courses of conservative therapy. Persistent symptoms of professional upper limb polyneuropathy, confirmed by clinical and instrumental methods of diagnosis, dictate the need to search for new methods of therapy aimed at reducing patient complaints and clinical manifestations of the disease.