Prevalence and synergistic impact of neuropathic pain and fibromyalgia on disability and quality of life in multiple sclerosis: a cross-sectional study

This study aimed to investigate the effects of neuropathic pain and fibromyalgia syndrome (FMS) on the quality of life of patients with multiple sclerosis (MS), as assessed by functional status, disability, pain intensity, mood, and sleep quality. A total of 190 MS patients (137 females, 53 males; mean age: 45.2 ± 11.5 years; range: 20–72 years) were included in this cross-sectional study. Pain, functional status and disability of the patients were evaluated using the following tools: visual analog scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), Douleur Neuropathique 4 Questions (DN4), Kurtzke Expanded Disability Status Scale (EDSS), Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI) and Health Assessment Quality (HAQ) questionnaires. Neuropathic pain and FMS were present in 34.7% and 32.6% of the patients, respectively. The presence of both conditions was strongly associated with significantly worse scores across all tested parameters (VAS, BDI, FIQ, PSQI, EDSS, and HAQ) (p < 0.05). On most of the tools tested, male patients scored better than female patients (p < 0.05). Neuropathic pain and FMS are very common conditions in MS patients, and they appear to be associated with impaired quality of life, impaired functional status, and disability.