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PAIN IN POST-POLIO SYNDROME: A SEPARATE PAIN ENTITY?
Evert Christiaan Boshuis1, Eva Melin2, Kristian Borg2
1Department of Psychiatry, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands.
Journal of Rehabilitation Medicine. Clinical Communications
|February 17, 2022
Summary
Post-polio syndrome causes significant muscle pain, often described as deep aching with cramps, particularly in weakened limbs. This "post-polio muscular pain" is more intense during movement but distinct from fatigue and does not impact physical function.
Area of Science:
- Neurology
- Pain Medicine
- Rehabilitation Medicine
Background:
- Post-polio syndrome (PPS) affects millions with long-term polio sequelae, including muscle weakness, pain, and fatigue.
- While often nociceptive, PPS pain can have neuropathic components.
- Characterizing post-polio pain is crucial for effective management.
Purpose of the Study:
- To further characterize the nature of pain experienced by patients with post-polio syndrome.
- To differentiate post-polio pain from established pain classifications.
Main Methods:
- A cohort of 20 patients with diagnosed post-polio syndrome was recruited.
- Methods included physical examination, pain drawing, visual analogue scales (VAS) for pain and fatigue, and a walk test.
- Pain intensity at rest and during motion was quantitatively assessed.
Main Results:
- Patients reported high pain intensity (VAS 42/100 at rest, 62/100 with motion).
- Pain was localized to joints and muscles, with muscle pain described as deep aching and cramping.
- Muscle pain predominantly affected polio-weakened limbs.
Conclusions:
- The described muscle pain in PPS does not meet criteria for nociceptive or neuropathic pain.
- The term "post-polio muscular pain" is proposed for this distinct pain type.
- Post-polio muscular pain is exacerbated by movement but is independent of fatigue and physical function.
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