Neuropathic Pain in Hand Osteoarthritis: A Cross-Sectional Study

Abstract

Symptomatic hand osteoarthritis (OA) is a severely debilitating condition. Neuropathic pain (NP) has been shown to be a factor affecting pain severity, hand function, psychological wellbeing, body schema, and the number of pain medications in people with OA of other joints. The aim of this study was to assess the prevalence of NP in symptomatic hand OA and assess its association with pain, hand function, measures of psychological wellbeing, sleep, body schema disturbances, and number of pain medications. Participants with symptomatic hand OA diagnosed through the American College of Rheumatology criteria, were recruited and completed a series of online questionnaires. These included the Douleur Neuropathique 4 interview (DN4-interview), Short Form Brief Pain Inventory (SF-BPI), Neglect-like Symptoms questionnaire, Functional Index of Hand Osteoarthritis (FIHOA), Centre for Epidemiologic Studies Depression Scale (CES-D), Pain Catastrophising Scale (PCS), and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression with age, body mass index, and sex as covariates were utilised to assess differences between participants with and without NP as identified through the DN4-interview. Correlation analysis assessed the relationship between pain intensity, body schema alterations, and number of pain medications. A total of 121 participants were included in the present study. Forty-two percent of participants presented with NP. Participants with NP reported higher levels of worst pain (OR: 10.2 95%CI: 2.2 to 48.5; p = 0.007). Worst pain intensity correlated with the number of pain medications (rho = 0.2; p = 0.04), and neglect-like symptoms (rho = 0.4; p < 0.0001). No difference between phenotypes was shown for catastrophising, function, depression, neglect-like symptoms, pain interference, or sleep. A large proportion of people with symptomatic hand OA present with NP. This phenotype is characterised by greater levels of pain intensity. Pain intensity is associated with number of pain relief medications and body schema alteration. Psychological factors, hand function, and sleep do not appear to be affected by the presence of NP.

Assessment of Neuropathic Pain in Erosive Hand Osteoarthritis

“…We also used two other questionnaires: DN4 and PainDETECT, as well as NPSI, which was specifically designed to evaluate NP. A previous study used the DN4 questionnaire and found that 42% of patients with hand OA experienced NP [9], in line with our own findings using the same questionnaire. Another study previously used the PainDETECT questionnaire and reported an NP frequency of 19% in patients with hand OA [10], which is lower than that observed in our study (32.4%) using this questionnaire.…”

“…In subjects affected by knee OA, NP correlates with the severity of symptoms, joint function, psychological well-being, and the intake of painkillers [ 7 , 8 ]. Although understudied, it has been reported that NP may occur in 16–42% of patients with hand OA using different assessment questionnaires [ 9 , 10 ]. In the Magni N et al cohort of 121 patients with symptomatic hand OA, the prevalence of NP was estimated at 42% using the Douleur Neuropathique en 4 Questions (DN4) questionnaire [ 9 ].…”

Exploration beyond osteoarthritis: the association and mechanism of its related comorbidities

“…The nervous system serves as the primary system for sensing and transmitting pain signals throughout the body. Recent research has indicated a higher prevalence of neuropathic pain (NP) in individuals with OA ( 124 , 125 ), where OA may lead to stimulation or damage of nerve endings located within or surrounding the joints, resulting in persistent or intermittent pain ( 126 ). These pain-related manifestations could potentially prompt changes in neural excitability, alterations in neurotransmitter release, and reduced neural plasticity ( 127 ).…”

Association of Weight Loss and Weight Gain With Structural Defects and Pain in Hand Osteoarthritis: Data From the Osteoarthritis Initiative

“…Hand osteoarthritis (OA) is a debilitating joint disease. 1,2 It is the second most prevalent form of OA, with only knee OA being more prevalent. 3 By the time they reach 85 years of age, 40% of adults are estimated to be affected by hand OA.…”

“…Hand osteoarthritis (OA) is a debilitating joint disease 1,2 . It is the second most prevalent form of OA, with only knee OA being more prevalent 3 .…”