Background/Purpose:

There are few studies in the literature indicating that neuropathic pain occurs in rheumatoid arthritis (RA). The aim of this cross sectional study was to evaluate frequency of neuropathic hand pain in RA patients and to determine the relation with clinical variables and occurrence of neuropathic pain.

Methods:

A hundred-nineteen RA 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 (pain by VAS, functional status, disease activity and quality of life (QoL) assessed by HAQ, DAS28 and RAQoL respectively) were recorded. The neuropathic property of hand pain was assessed by both Leeds assessment of neuropathic symptoms and signs pain scale (LANSS), Douleur Neuropathique4 (DN4) and Pain-DETECT 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 for continuous and categorical variables respectively. Correlation coefficients of clinical variables and neuropathic pain scores were analyzed with Spearman correlation analyses.  The significance threshold was set as p values less than 0.05.

Results:

61 female, 58 male RA patients with a mean age of 50.51± 12.45 years, were included to the study. Neuropathic pain was detected in 76 (%63.9), 70 (%58.8), 61(%51.3) RA patients depending on the LANSS(scores>12), DN4(scores>4) and painDETECT(scores>12) questionnaires respectively. The mean levels of VAS-pain, HAQ and RAQoL scores were significantly higher in patients having neuropathic pain than in patients not having (p<0.05) (Table 1,2). The scores of the neuropathic pain scales were correlated with each other but not with the scores of disease activity.

Conclusion:

Neuropathic hand pain is determined in more than half of the patients with RA and related with pain intensity, functional status and QoL. Diagnosis and treatment of neuropathic pain are warranted in order to improve pain, disability and quality of life in RA patients.

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

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

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/neuropathic-pain-in-patients-with-rheumatoid-arthritis-relation-with-clinical-variables/