Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Chronic Pain and Assessment of Pain Sensitivity in Patients With Axial Spondyloarthritis : Results From the SPARTAKUS Cohort

Mogard, Elisabeth LU orcid ; Olofsson, Tor LU ; Bergman, Stefan LU ; Bremander, Ann LU ; Kristensen, Lars-Erik LU ; Kvistgaard Olsen, Jack ; Wallman, Johan K LU and Lindqvist, Elisabet LU orcid (2021) In The Journal of rheumatology 48(11). p.1672-1679
Abstract

OBJECTIVE: To study differences in pain reports between patients with ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (nr-axSpA), and to assess how pain sensitivity measures associate with disease and health outcomes.

METHODS: Consecutive patients with axial SpA (axSpA) were enrolled in the population-based SPARTAKUS cohort (2015-2017) and classified as AS (n = 120) or nr-axSpA (n = 55). Pain was assessed with questionnaires (intensity/duration/distribution) and computerized cuff pressure algometry to measure pain sensitivity (pain threshold/pain tolerance/temporal summation of pain). Linear regression models were used to compare pain measures between patients with AS and nr-axSpA, and to assess... (More)

OBJECTIVE: To study differences in pain reports between patients with ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (nr-axSpA), and to assess how pain sensitivity measures associate with disease and health outcomes.

METHODS: Consecutive patients with axial SpA (axSpA) were enrolled in the population-based SPARTAKUS cohort (2015-2017) and classified as AS (n = 120) or nr-axSpA (n = 55). Pain was assessed with questionnaires (intensity/duration/distribution) and computerized cuff pressure algometry to measure pain sensitivity (pain threshold/pain tolerance/temporal summation of pain). Linear regression models were used to compare pain measures between patients with AS and nr-axSpA, and to assess associations between pain sensitivity measures and disease and health outcomes.

RESULTS: Of 175 patients with axSpA, 43% reported chronic widespread pain, with no significant differences in any questionnaire-derived or algometry-assessed pain measures between patients with AS and nr-axSpA. Lower pain tolerance was associated with longer symptom duration, worse Ankylosing Spondylitis Disease Activity Score using C-reactive protein (ASDAS-CRP), Bath Ankylosing Spondylitis Functional Index, and Bath Ankylosing Spondylitis Metrology Index (BASMI), more pain regions, unacceptable pain, worse Maastricht AS Enthesitis Score (MASES), fatigue, anxiety, and health-related quality of life. Further, lower pain threshold was associated with worse ASDAS-CRP and MASES, whereas higher temporal summation was associated with longer symptom duration, unacceptable pain, and worse BASMI.

CONCLUSION: Chronic pain is common in axSpA, with no observed differences in any pain measures between patients with AS and nr-axSpA. Further, higher pain sensitivity is associated with having worse disease and health outcomes. The results indicate that patients with AS and nr-axSpA, in line with most clinical characteristics, have a similar pain burden, and they highlight large unmet needs regarding individualized pain management, regardless of axSpA subgroup.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The Journal of rheumatology
volume
48
issue
11
pages
1672 - 1679
publisher
Journal of Rheumatology Publishing Company Limited
external identifiers
  • scopus:85114344936
  • pmid:33323532
ISSN
0315-162X
DOI
10.3899/jrheum.200872
language
English
LU publication?
yes
id
9e83ccce-0ade-4ac4-99e6-76a27edeb803
date added to LUP
2021-09-29 16:43:15
date last changed
2024-06-19 11:11:19
@article{9e83ccce-0ade-4ac4-99e6-76a27edeb803,
  abstract     = {{<p>OBJECTIVE: To study differences in pain reports between patients with ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (nr-axSpA), and to assess how pain sensitivity measures associate with disease and health outcomes.</p><p>METHODS: Consecutive patients with axial SpA (axSpA) were enrolled in the population-based SPARTAKUS cohort (2015-2017) and classified as AS (n = 120) or nr-axSpA (n = 55). Pain was assessed with questionnaires (intensity/duration/distribution) and computerized cuff pressure algometry to measure pain sensitivity (pain threshold/pain tolerance/temporal summation of pain). Linear regression models were used to compare pain measures between patients with AS and nr-axSpA, and to assess associations between pain sensitivity measures and disease and health outcomes.</p><p>RESULTS: Of 175 patients with axSpA, 43% reported chronic widespread pain, with no significant differences in any questionnaire-derived or algometry-assessed pain measures between patients with AS and nr-axSpA. Lower pain tolerance was associated with longer symptom duration, worse Ankylosing Spondylitis Disease Activity Score using C-reactive protein (ASDAS-CRP), Bath Ankylosing Spondylitis Functional Index, and Bath Ankylosing Spondylitis Metrology Index (BASMI), more pain regions, unacceptable pain, worse Maastricht AS Enthesitis Score (MASES), fatigue, anxiety, and health-related quality of life. Further, lower pain threshold was associated with worse ASDAS-CRP and MASES, whereas higher temporal summation was associated with longer symptom duration, unacceptable pain, and worse BASMI.</p><p>CONCLUSION: Chronic pain is common in axSpA, with no observed differences in any pain measures between patients with AS and nr-axSpA. Further, higher pain sensitivity is associated with having worse disease and health outcomes. The results indicate that patients with AS and nr-axSpA, in line with most clinical characteristics, have a similar pain burden, and they highlight large unmet needs regarding individualized pain management, regardless of axSpA subgroup.</p>}},
  author       = {{Mogard, Elisabeth and Olofsson, Tor and Bergman, Stefan and Bremander, Ann and Kristensen, Lars-Erik and Kvistgaard Olsen, Jack and Wallman, Johan K and Lindqvist, Elisabet}},
  issn         = {{0315-162X}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1672--1679}},
  publisher    = {{Journal of Rheumatology Publishing Company Limited}},
  series       = {{The Journal of rheumatology}},
  title        = {{Chronic Pain and Assessment of Pain Sensitivity in Patients With Axial Spondyloarthritis : Results From the SPARTAKUS Cohort}},
  url          = {{http://dx.doi.org/10.3899/jrheum.200872}},
  doi          = {{10.3899/jrheum.200872}},
  volume       = {{48}},
  year         = {{2021}},
}