Previous epidemiological studies of neuropathic pain have reported a range of prevalences and factors associated with the disorder. This study aimed to verify these characteristics in a large UK cohort. A cross sectional analysis was conducted of 148,828 UK Biobank participants who completed a detailed questionnaire on chronic pain. The Douleur Neuropathique en Quatre Questions (DN4) was used to distinguish between neuropathic pain (NeuP) and non-neuropathic pain (Non-NeuP) in participants with pain of at least 3 months duration. Participants were also identified with less than 3 months pain or without pain (NoCP). Binomial and multinomial regression were used to identify factors associated with NeuP compared to Non-NeuP and NoCP respectively. Chronic pain was present in 76,095 participants (51.1%). The overall prevalence of NeuP was 9.2% (13,744/148,828. NeuP was significantly associated with worse health-related quality of life, having a manual or personal service type occupation and younger age compared to NoCP. As expected NeuP was associated with diabetes and neuropathy, but also other pains (pelvic, post-surgical and migraine) and musculoskeletal disorders (rheumatoid arthritis, osteoarthritis and fibromyalgia). Additionally, NeuP was associated with pain in the limbs and greater pain intensity and higher BMI compared to Non-NeuP. Female gender was associated with NeuP when compared to NoCP, whilst male gender was associated with NeuP when compared to Non-NeuP. This is the largest epidemiological study of neuropathic pain to date. The results confirm that the disorder is common in the general population and is associated with a higher health impact than non-neuropathic pain.

The authors have declared no competing interest.

This work was supported by Diabetes UK under grant agreement 19/0005984, the European Union's Horizon 2020 research and innovation programme under grant agreement No 633491 (DOLORisk) and the MRC and Versus Arthritis funding to the PAINSTORM consortium as part of the Advanced Pain Discovery Platform (MR/W002388/1). No funding body had any role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. A.C.T is supported by Academy of Medical Sciences Starter Grant SGL022\1086, and is a Honorary Senior Research Fellow and Carnegie-Wits Diaspora Fellow at the Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg. D.L.B and G.B are supported by the Wellcome Trust, grant reference 223149/Z/21/Z. For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Data for this study was obtained from the UK biobank for project Risk factors for chronic pain, Application ID: 49572. UK Biobank has approval from the North West Multi-centre Research Ethics Committee (MREC) as a Research Tissue Bank (RTB) approval, REC reference: 21/NW/0157, IRAS project ID: 299116. This approval means that researchers do not require separate ethical clearance and can operate under the RTB approval.

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Data for this study was obtained from the UK biobank for project Risk factors for chronic pain, Application ID: 49572.

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