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Pain thresholds in rheumatoid arthritis: the effect of tender point counts and disease duration
Louise C Pollard1, Fowzia Ibrahim, Ernest H Choy
1Department of Rheumatology, King's College London, Weston Education Centre, Denmark Hill, 10 Cutcombe Road, London SE5 9RJ, UK. louise.pollard@kcl.ac.uk
Objective:
We evaluated the influence of demographic and clinical factors on pain thresholds in patients with rheumatoid arthritis (RA).
Methods:
A cross-sectional observational study (105 patients with RA) assessed pain thresholds using an algometer. Regression analysis examined the influence of demographic and clinical assessments.
Results:
Pain thresholds (median 289, interquartile range 89-434) correlated with assessments of disease activity (tender joint counts), disability (Health Assessment Questionnaire), fatigue, depression, and anxiety. Ordinal logistic regression showed tender point counts and disease duration were the dominant contributors.
Conclusion:
These findings suggest that low pain thresholds reflect "fibromyalgic" RA (many tender points) and central pain sensitization with prolonged disease duration.
