Abstract
IntroductionIncreasing evidence indicates that features suggestive of neuropathic pain may also be present in patients with common rheumatic conditions. The objective of this study was to examine neuropathic-like pain symptoms and associated factors in patients with rheumatoid arthritis.MethodsWe used the painDETECT screening tool to identify possible or likely neuropathic pain in 159 outpatients with rheumatoid arthritis. Patients additionally completed other self-reported measures, while clinical measures were assessed to calculate the 28-joint Disease Activity Score. Univariate analyses and multivariable logistic regression were used to identify factors associated with neuropathic pain features.ResultsAccording to the painDETECT, 27 patients (17.0 %) were classified as having likely neuropathic pain and 34 patients (21.4 %) as having possible neuropathic pain. Besides reporting more severe pain, patients with likely or possible neuropathic pain were more likely to meet the diagnostic criteria for fibromyalgia, to use analgesics, and to have more tender joints and a worse physical and mental health status as measured by the 36-item Short-Form health survey. In multivariable analysis, physical (P < 0.001) and mental health status (P = 0.006) remained significantly associated with neuropathic pain features, even after controlling for pain severity.ConclusionsThese findings suggest that a sizeable proportion of patients with relatively well-controlled rheumatoid arthritis report symptoms suggestive of neuropathic pain. Neuropathic-like pain symptoms are independently associated with worse self-reported physical and mental health.
Highlights
Increasing evidence indicates that features suggestive of neuropathic pain may be present in patients with common rheumatic conditions
Study population and data collection Data for this study were collected within the Dutch Rheumatoid Arthritis Monitoring (DREAM) registry
Complete medical and clinical data were available for 159 patients
Summary
Increasing evidence indicates that features suggestive of neuropathic pain may be present in patients with common rheumatic conditions. The objective of this study was to examine neuropathic-like pain symptoms and associated factors in patients with rheumatoid arthritis. Rheumatoid arthritis (RA) is the most common type of autoimmune arthritis. For patients with RA, pain is the predominant impairment and most important priority for improvement [1]. RA pain is traditionally attributed to peripheral inflammation of the joints [2]. In recent years much progress has been made in the treatment of RA and especially in reducing this inflammation. With the help of combinations of disease-modifying antirheumatic drugs (DMARDs) and biologic therapies, an increasing number of RA patients experience extensive periods of low disease activity. Pain control is often inadequate and significant pain persists in a
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