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


METHODS
We 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.


RESULTS
According 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.


CONCLUSIONS
These 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.
Department of Internal Medicine, Hospital Group Twente, Almelo, The Netherlands. s.koop@zgt.nl.
Sanne M W
SM
Koop
Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands. p.m.tenklooster@utwente.nl.
Peter M
PM
ten Klooster
Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands. h.vonkeman@mst.nl.|Arthritis Center Twente, Department of Rheumatology and Clinical Immunology, Medical Spectrum Twente, Enschede, The Netherlands. h.vonkeman@mst.nl.
Harald E
HE
Vonkeman
Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands. lmm.steunebrink@mst.nl.
Laura M M
LM
Steunebrink
Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands. m.vandelaar@mst.nl.|Arthritis Center Twente, Department of Rheumatology and Clinical Immunology, Medical Spectrum Twente, Enschede, The Netherlands. m.vandelaar@mst.nl.
Mart A F J
MA
van de Laar
D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005356:Fibromyalgia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D009437:Neuralgia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010147:Pain Measurement / Q000379:methods* / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D000700:Analgesics