Should central sensitization and neuropathic pain be considered in disease activity and treatment decision in axial ankylosing spondilitis?

Abstract

Purpose: The aim of this study was to evaluate the prevalence of central sensitization syndromes and the relation between severity of central sensitization and disease activity in patients with axial ankylosing spondylitis (AS). Materials and Methods: Study included 105 patients who were diagnosed with AS. Patients' age, sex, body mass index (BMI), disease duration, accompanying disease (diabetes, hypertension) were recorded. The severity of back pain was assessed by visual analog scale (VAS), disease activity by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Ankylosing Spondylitis Disease Activity Score-C-reactive protein (ASDAS_CRP). Central sensitization inventory (CSI) was used for central sensitization. Results: Central sensitization was found in 45.7% of all participants and neuropathic pain was found in 34.3% of them. When we divided the group according to the central sensitization score ≥40, we found that those who were diagnosed with central sensitization were at an advanced age and have higher BMI, higher erythrocyte sedimentation rate, longer disease duration, higher disease activity, higher neuropathic pain presence and scores than others. Conclusion: Central sensitization syndromes and neuropathic pain are frequently associated with AS. Positive correlations of central sensitization and neuropathic pain scores with disease activity scores support that chronic pain components should be taken into consideration in the follow-up of the disease