Chronic widespread pain affects half of axSpA patients
CHICAGO — Nearly 50% of patients with axial spondyloarthritis are affected by chronic widespread pain, with women reporting higher pain intensity and sensitivity than men, according to data presented at ACR/ARHP 2018 Annual Meeting.
“Pain is a complex symptom and common in all rheumatic diseases,” Elisabeth Mogard, PT, PhD, of the department of clinical sciences and rheumatology at Lund University in Sweden, said during a presentation. “It is an emotional and unique experience for every person.”
SpA-related pain is often caused by inflammation in the joints and ligaments or structural damage, according to Mogard. It reduces physical function and quality of life, and increases the risk for comorbidities, such as chronic pain.
Despite the availability of treatments for inflammation, increased pain sensitivity and chronic widespread pain continue to be a burden for patients. However, few studies have focused on chronic pain in axial SpA (axSpA).
To further investigate, Mogard and colleagues examined data from the SPARTAKUS trial — a cross-sectional study evaluating specific comorbidities in axial diseases — to explore aspects of pain and potential associations with health outcomes. The analysis included 110 patients with ankylosing spondylitis (AS) and 116 patients with undifferentiated SpA (USpA). The patients were at least 45 years of age and had experienced chronic back pain for a minimum of 3 months. During a clinic visit, they self-reported characteristics of pain, including intensity, duration and distribution. A computerized cuff pressure algometry was used to assess pain sensitivity.
Overall, three-quarters of patients with established axSpA had chronic pain. Chronic widespread pain was reported in 42% of those with AS and 53% of those with USpA. It was more common among women than men (60% vs. 34%; P < .001).
The researchers found that AS and USpA were associated with similar pain intensity and sensitivity measures. There was, however, a significant difference between genders. For pain sensitivity measures, women had a lower pain tolerance than men, irrespective of disease type (AS, P = .03; USpA, P = .01). Women with USpA also had lower pain thresholds compared with men (P < .01).
Regardless of AS or USpA diagnosis, Mogard reported that lower pain tolerance was associated with higher disease activity, more fatigue and less spinal mobility.
“The results imply that an individualized and thorough pain assessment is important throughout the whole disease course in SpA and for adequate pain management, including pharmacological and nonpharmacological treatment for both the underlying disease and the possibly non-inflammatory care for pain,” she said. – by Erin Michael
Mogard E, et al. Abstract 2887. Presented at: ACR/ARHP Annual Meeting, Oct. 20-24, 2018; Chicago.
Disclosures: Mogard reports no relevant financial disclosures.