4.4 Article

The important role of central sensitization in chronic musculoskeletal pain seen in different rheumatic diseases

Journal

CLINICAL RHEUMATOLOGY
Volume 39, Issue 1, Pages 269-274

Publisher

SPRINGER LONDON LTD
DOI: 10.1007/s10067-019-04749-1

Keywords

Central nervous system sensitization; Osteoarthritis; Rheumatoid arthritis; Spondyloarthropathy

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Objective This study explored the role of central sensitization (CS) pain in patients with various rheumatic diseases using the CS inventory (CSI). Methods A total of 193 patients of mean age 50.72 +/- 9.65 years were included; they were divided into four different groups in terms of their rheumatic diseases. Patients with rheumatoid arthritis (RA), spondyloarthropathy (SpA), osteoarthritis (OA), and fibromyalgia syndrome (FMS) were evaluated in tertiary care rheumatology/pain medicine settings. Disease duration and activity, the Bath Ankylosing Spondylitis Disease Activity Index, the Disease Activity Score-28, and pain severity (evaluated using a visual analog scale) were assessed, and the Turkish version of the CSI administered. Results CS syndromes were present in almost half the patients (45% of SpA, 41% of RA, 62% of OA, and 94% of FMS patients). We found no significant relationship between disease activity and the CSI-A scores in SpA or RA patients (p = 0.731 and p = 0.390, respectively). As expected, the CSI-A scores were highest in the FMS group (p = 0.000), but were similar in the other groups (p < 0.05). CS-related syndromes (CSI-B conditions) were present at similar frequencies in the RA, SpA, and OA groups, but were less common in the FMS group (p = 0.000). Conclusions The CSI usefully detects CS pain in patients with rheumatic diseases. Treatment of such pain can enhance the quality of daily life in patients with rheumatic diseases.

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