Pain and its relationship with fatigue in Sjögren disease: an Italian single-centre experience

Pain is frequently reported by patients with primary Sjögren disease (SD). The 0-10 visual analogue scale (VAS) is broadly used to quantify the extent of pain, but it does not capture its nuances and the impact on the individual's quality of life. The aim of this study was to explore the characteristics of pain and how it is affected by different daily activities in patients with SD.

Consecutive patients with SD fulfilling the ACR-EULAR 2016 classification criteria, without fibromyalgia, depression, and/or anxiety disorders, and with a VAS pain >0 were recruited. Patients filled out the McGill Pain Questionnaire, rated their current pain on a 1-5 Likert scale according to previous pain experiences and reported which activities affected their pain.

Of 167 screened patients with SD, 131 were enrolled in the study. The mean pain score was 35.5, and it was directly correlated with VAS scales for dryness but not with age, disease duration, and disease activity. The McGill domains used by >80% of patients were those about pressure, sensory, dullness, tension, brightness, and the affective component of pain. Sleep, rest, and mild exercise reduced pain in half of the patients, whereas damp weather changes, fatigue, and tension worsened the pain in up to 81% of patients. Thirty percent of patients reported that pain worsened by intercourse.

Although VAS pain is reliable and broadly used in clinical practice and research, multidimensional tools such as the McGill Pain Questionnaire should be used to better understand the individual's experience of pain and establish tailored pharmacologic and nonpharmacologic strategies.