Analysis of neuropathic pain in nontraumatic lower limb musculoskeletal injuries Prevalence and associated factors

Neuropathic pain (NP) is a type of pain that originates from damage or dysfunction within the nervous system. Unlike typical musculoskeletal pain, which is often mechanical or inflammatory in nature, NP can present as burning, tingling, or electric shock-like sensations, often without any visible injury. In clinical practice, this form of pain is frequently under recognized, especially in individuals with nontraumatic musculoskeletal (MSK) conditions such as tendinopathies, plantar fasciitis, patellofemoral pain, and osteoarthritis of the lower limbs. Many patients continue to experience discomfort even during or after standard physiotherapy treatments. One possible reason for this persistent pain is the overlooked presence of a neuropathic component, which is not routinely screened for during conventional MSK assessments. This can lead to incomplete recovery, prolonged suffering, and frustration for both patients and healthcare providers.This study aims to assess how commonly NP occurs in nontraumatic lower limb MSK injuries and to explore the various risk factors that may be linked with it. These include lifestyle and psychosocial factors like physical inactivity, obesity, smoking, poor sleep quality, emotional distress, and anxiety or depression all of which may contribute to pain becoming chronic through central sensitization. To evaluate this, patients will be assessed through validated tools such as the painDETECT questionnaire, the Pain Catastrophizing Scale (PCS), and the Hospital Anxiety and Depression Scale (HADS), alongside clinical tests for nerve sensitivity and physical function. These tools help differentiate between nociceptive (mechanical) and neuropathic pain origins and provide insight into psychological influences on pain perception. By identifying the hidden neuropathic pain component in MSK conditions, this study aims to support a more mechanism based, individualized approach to physiotherapy. This shift is crucial, as unrecognized NP can lead to prolonged suffering, patient dissatisfaction, and incomplete recovery. Ultimately, the research hopes to empower physiotherapists with better screening strategies to offer more effective and targeted rehabilitation. Ultimately, this research addresses a critical gap in physiotherapy practice by emphasizing the need to identify hidden neuropathic components in musculoskeletal pain for better, individualized patient care.