There is a high rate of chronic widespread pain among patients with ankylosing spondylitis and undifferentiated spondyloarthritis, with an even higher prevalence among women, according to findings published in BMC Rheumatology.
However, the researchers further concluded there was no difference in pain intensity between men and women with chronic widespread pain.
“[Chronic widespread pain] can include pain from different origins, and be seen as a continuum, with [fibromyalgia] representing the more severe form,” Elisabeth Mogard, PT, MSc, from Lund University, Skåne University Hospital, Sweden, and colleagues wrote. “Therefore, studies that aim to identify patients with early and less severe [chronic widespread pain] could be important. Not only for an accurate diagnosis, but most importantly, for optimal and early treatment of both the inflammatory disease, and a possible co-existing sensitization of the nervous system, requiring other treatment strategies.”
There is a high rate of chronic widespread pain among patients with AS and undifferentiated SpA, with an even higher prevalence among women.
To analyze the differences in the prevalence of self-reported chronic widespread pain among patients with ankylosing spondylitis (AS) and undifferentiated spondyloarthritis (SpA), the researchers distributed a postal questionnaire to a cohort of individuals with spondyloarthritis from the Skåne Health Care Register. Among the 2,162 adult patients who answered the 2009 survey, the researchers selected 570 individuals with AS and 370 with undifferentiated SpA for inclusion in the study.
The survey asked respondents to answer questions related to age, sex, disease duration, fatigue, smoking habits, BMI, treatments received and disease activity, as well as the duration, distribution and intensity of their pain. Participants were categorized as having chronic widespread pain, chronic regional pain or no chronic pain. The researchers determined age- and sex-adjusted prevalence estimates within each pain group.
According to the researchers, prevalence of chronic widespread pain was 45.3% among patients with AS, and 49.3% for those with undifferentiated SpA. Among the participants, 54.1% of women, compared with 41.2% of men, reported having chronic widespread pain (P .001). Self-reported pain intensity was equal between those with AS and undifferentiated SpA, with no significant difference among men and women with chronic widespread or regional pain. In logistic regression analyses, chronic widespread pain was associated with female sex, smoking and higher BMI.
“The results highlight the importance of a thorough pain analysis included in the clinical examination, to identify patients with high and/or increasing pain levels and multiple pain regions,” Mogard and colleagues wrote. “It may also guide appropriate and individualized treatment decisions, including nonpharmacological and pharmacological treatment options.” – by Jason Laday
Disclosure: Mogard reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.