A7.6 Neuropathic pain in rheumatic diseases: a cross-sectional study

Abstract

Introduction Pain is the most common symptom in rheumatic diseases. In its pathophysiology there is usually a disturbance in nociceptive perception by tissue damage, that evolve often to features of central pain, with characteristics of neuropathic pain (NP). Neuropathic pain in rheumatic diseases is a topic rarely addressed in the literature. Objectives Determine, in a cohort of patients with rheumatoid arthritis (RA), osteoarthritis (OA) axial (a-SpA) and peripheral (p-SpA) spondylarthritis, the prevalence of DN, correlations between NP and activity and disease duration. Compare the prevalence of DN with control group. Materials and Methods Cross-sectional study. Variables analysed: sex, age, duration of illness, medication. All patients answered VAS of pain, DN4 and EQol-5D. In patients with RA and p-SpA we determined DAS28, BASDAI and BASFI in a-SpA and WOMAC in OA. Control group of healthy subjects randomised with patients in age and sex responded DN4. Statistical analysis using SPSS 18. Results 216 patients enrolled (80RA, 48p-SpA, 46a-SpA, 42OA), 85 men and 131 women, with mean age 55.27 ± 14.62 years, mean disease duration 10 ± 11.87years. 48patients had ≥4 DN4, only 3 were on medication to NP. The NP prevalence was 40.47% in OA (p < 0.01), 18.75% RA, 23.91% a-SpA and 10:42% p-SpA. The prevalence of DN was higher in patients compared with controls, in OA (OR = 23.12% CI 95 (2.88–185.41) and SPA´s (OR = 8.62 CI 95% (1.1–67.25). Despite the increasing prevalence of DN with duration of disease, this difference was not statistically significant. Regarding disease activity, we found that DN increases with BASDAI (p < 0:02) in a-SpA and DAS28 in RA (p < 0.02). Higher values ​​of VAS were found in patients with DN4 ≥4 (p < 0.001). Conclusion This study reveals an important neuropathic component in our cohort of patients. The disease with the highest prevalence of DN was OA, which meets the data found in the literature. This discrepancy in prevalence, lower in inflammatory conditions, though chronic, certainly needs further study, placing the use of more aggressive therapy in these patients, like DMARD's, as a plausible hypothesis. This study demonstrates the need for a better understanding of the mechanisms and types of pain in rheumatic patients, with nociceptive pain only part of the spectrum of pain. Additional studies are needed to investigate the importance of neuropathic pain in rheumatic diseases, and its relation with the evolution of the underlying disease.

Neuropathic-like pain features and cross-sectional associations in rheumatoid arthritis

“…NP symptoms have only been sporadically tested in RA samples. The 17 % proportion of RA patients with likely NP found in this study was very similar to the 19 % prevalence reported by Meirinhos et al [ 21 ]. Conversely, Ahmed et al [ 20 ] reported that 28 % of RA patients had possible NP symptoms and 5 % were likely to be experiencing NP symptoms according to the painDETECT.…”

Neuropathic pain in rheumatoid arthritis

“…Полученные результаты согласуются с данными других авторов, согласно которым НБ при РА отмечается у 17-36% пациентов [8][9][10]. В работе S.M.W.…”

“…Частота невропатических дескрипторов при РА варьирует в пределах 17-36% [8][9][10]. Что касается других ревматических заболеваний, то, например, при остеоартрите их частота составляет 30-66% [11][12][13][14], при анкилозирующем спондилите -13-33,5% [15,16].…”

Evaluation of analgesic effectiveness of infrared radiation and interference currents in degenerative diseases

“…Pain is associated with consciousness and is a synonym of suffering; connected with motor organs, it is often caused by degenerative disease of joints [1], [2]. Progressive degenerations, at first of a cartilage and then of the following subcondral layers and finally of the bone tissue itself may be a symptom of ageing of an organism and wearing of the osteoarticular system [3], [4].…”