Patients’ Perspectives on Axial Pain in Relation to Inflammation and Structural Damage in a Large Cohort of Axial Spondyloarthritis Patients

Abstract

ObjectiveTo explore to what extent axSpA patients link experienced pain in neck, back and hips to inflammation and/or structural damage.MethodsPatients from the GLAS cohort visiting the outpatient clinic between 2016 and 2019 filled out two additional questions in relation to BASDAI Q2: ‘To what extent do you think the pain you experience in your neck, back and hips is related to: 1. inflammation caused by axSpA?, 2. damage of the spine and joints caused by axSpA?’ Answers had to be depicted on a NRS from 0 (none) to 10 (very much); a difference of ≥2 points between the scores of these questions was considered as clinically relevant in favor of the highest scoring question.Results688 axSpA patients (24% nr‐axSpA) were included, 62% male, mean age 48±14 years and mean ASDASCRP 2.3±1.0. 75% of patients could not link the origin of their pain, 15% linked axial pain predominantly to inflammation and 10% to damage. Patients in the inflammation group were younger, had shorter symptom duration, were more frequently diagnosed as nr‐axSpA, had higher ASDASCRP, more often elevated CRP, less comorbidities, better spinal mobility and less spinal radiographic damage.ConclusionIn our large observational cohort, the majority of axSpA patients could not differentiate the origin of experienced axial pain. If patients were able to link axial pain to clinical inflammation or damage, it was in concordance with clinical assessments and radiographic outcome, which may be helpful in establishing the origin of pain supporting better patient centered treatment decisions.This article is protected by copyright. All rights reserved.