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Published on: January 14, 2009
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What does pain sensitivity really predict in rheumatoid arthritis patients?
Aysegül Altun Güvenir1, Aslı Çalışkan Uçkun2, Fatma Gül Yurdakul3
1Department of Physical Medicine and Rehabilitation, Malatya Park Hospital, Malatya, Türkiye.
Summary
Pressure-pain threshold (PPT) in rheumatoid arthritis (RA) patients did not differ from controls, but lower PPT in female RA patients correlated with depression, suggesting PPT may detect pain-depression overlap.
Area of Science:
- Rheumatology
- Pain Medicine
- Psychosomatic Medicine
Background:
- Rheumatoid arthritis (RA) is a chronic inflammatory disease.
- Pain sensitization and its predictors in RA require further investigation.
- Fibromyalgia can complicate pain assessment in RA.
Purpose of the Study:
- Compare pressure-pain threshold (PPT) in RA patients versus chronic low back pain controls.
- Assess PPT as a potential predictor of disease activity in RA.
- Investigate the relationship between PPT and psychological factors.
Main Methods:
- Cross-sectional observational study comparing RA patients and controls without fibromyalgia.
- Utilized Visual Analog Scale (VAS), Fatigue Severity Scale (FSS), Pain Catastrophizing Scale (PCS), Health Assessment Questionnaire (HAQ), Hospital Anxiety and Depression Scale (HADS), and Disease Activity Score (DAS28).
- Measured PPT using a dolorimeter at the thumbnail bed, wrist, and trapezius muscle.
Main Results:
- No significant differences in PPT were found between RA and control groups overall.
- Female RA patients exhibited significantly lower PPT at the wrist and trapezius, indicating heightened pain sensitization.
- Hospital Anxiety and Depression Scale-Depression scores were the sole significant determinant of PPT across all measured points.
Conclusions:
- Lower PPT in RA patients is associated with depressive symptoms.
- Pressure algometry may serve as a valuable tool for identifying the overlap between pain and depression in RA.
- PPT assessment could enhance the comprehensive evaluation of RA patients.
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