Background/Purpose: There is only one study in the literature indicating that neuropathic pain occurs in ankylosing spondylitis (AS) (1).

Methods: The aim of this cross sectional study was to evaluate frequency of neuropathic pain in AS patients and to determine the relation with disease variables and occurrence of neuropathic pain. Fifty-eight AS patients who were not having any comorbid disease and/or using drugs that would cause neuropathy, were recruited to the study. Demographic properties (age, sex, disease duration) and clinical characteristics (functional status and disease activity assessed by BASFI and BASDAI respectively, ESR, CRP and quality of life determined by ASQoL questionnaire) were recorded. The neuropathic property of back pain was assessed by both LANSS and DN4 scales. Descriptive statistics was used for clinical variables and frequency of neuropathic pain. The difference of clinical variables between patients with and without neuropathic pain, were examined using t tests and chi square tests. Spearman test was used for correlation analyses. The significance threshold was set as p <0.05.

Results: Fifty-eight AS patients (17 female, 41 male) with a mean age of 45±18 years were included to the study. 33 patients (56.9%) and 31 patients (53.4%) were defined as having neuropathic pain depending on the LANSS (scores>12) and DN4 (scores>4) questionnaire scores respectively. The mean score of LANSS scale was correlated with ASQoL, BASFI, BASDAI, and DN4; and the mean score of DN4 scale was correlated with ASQoL, BASFI, LANSS and BMI.  The mean levels of BASFI and ASQoL were significantly higher in patients having neuropathic pain than in patients not having (p<0.05) (Table 1). The percentage of patients with neuropathic pain was higher in female than in male patients (58.8% vs 51.2% by DN4, 64.7% vs 53.6% by LANSS).

Conclusion: Neuropathic pain is determined in more than half of the patients with AS and related with functional status and quality of life. In conclusion neuropathic pain is common in AS patients. Diagnosis and treatment of neuropathic pain are warranted in order to increase functional ability and quality of life in patients suffering from AS.

References

1. Wu Q, Inman RD, Davis KD. Neuropathic pain in ankylosing spondylitis: a psychophysics and brain imaging study. Arthritis Rheum. 2013 Jun;65(6):1494-503. doi: 10.1002/art.37920.

Table 1.The difference of demographic and clinical properties, in patients having and lacking  neuropathic pain, determined by LANSS.

	Neuropathic pain (+) n=33	Neuropathic pain (-) n=25	p
Age (years)	40,12 ± 10,67	39,68 ± 11,41	0,880
Duration of disease(years)	8,69 ± 7,17	8,77 ± 6,55	0,965
BASFI (mean+SD)	3,57 ± 2,43	2,02 ± 2,06	0,013
BASDAI (mean+SD)	3,80 ± 1,80	2,84 ± 2,07	0,064
ESR (mean+SD)	14,00 ± 9,78	11,64 ± 9,68	0,365
CRP (mean+SD)	1,02 ± 1,24	0,79 ± 1,02	0,470
ASQoL (mean+SD)	8,81 ± 4,48	4,36 ± 4,23	0,000

Table 2.The difference of demographic and clinical properties, in patients having and lacking  neuropathic pain, determined by DN4.

	Neuropathic pain (+) n=33	Neuropathic pain (-) n=25	p
Age (years)	39,93 ± 9,59	39,92 ± 12,43	0,997
Duration of disease(years)	9,33 ± 7,05	8,02 ± 6,67	0,475
BASFI (mean+SD)	3,42 ± 2,43	2,30 ± 2,24	0,077
BASDAI (mean+SD)	3,51 ± 1,72	3,24 ± 2,24	0,606
ESR (mean+SD)	13,83 ± 10,11	12,00 ± 9,34	0,477
CRP (mean+SD)	1,06 ± 1,24	0,76 ± 1,03	0,337
ASQoL (mean+SD)	8,35 ± 4,82	5,22 ± 4,46	0,013

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