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Neuropathic features of joint pain: a community-based study

Neuropathic features of joint pain: a community-based study
Neuropathic features of joint pain: a community-based study
OBJECTIVE:
Quantitative sensory testing (QST) and questionnaire-based assessments have been used to demonstrate features of neuropathic pain in subjects with musculoskeletal pain. However, their direct relationship has not been investigated in the community. The purpose of this study was to conduct an observational study to describe the characteristics of joint pain and to examine the relationship between QST measures and the PainDETECT Questionnaire (PD-Q).
METHODS:
Warm detection, heat pain, and mechanical pain thresholds as well as mechanical pain sensitivity over the sternum were determined and the PD-Q scores were calculated in a cross-sectional study of 462 participants in the Chingford Study. Comparisons were made between subjects with and those without joint pain. Logistic regression modeling was used to describe the association between neuropathic pain features, as determined by the PD-Q score, and each of the QST measures individually, adjusting for age, body mass index, and use of pain-modifying medications.
RESULTS:
A total of 66.2% of the subjects reported recent joint pain, with a median average pain severity of 5 of 10. There was increased sensitivity to painful stimuli in the group with pain as compared to the pain-free group, and this persisted after stratification by pain-modifying medication use. While only 6.7% of subjects had possible neuropathic pain features and 1.9% likely neuropathic pain features according to the standard PD-Q thresholds, features of neuropathic pain were common and were present in >50% of those reporting pain of at least moderate severity. Heat pain thresholds and mechanical pain sensitivity were significantly associated with features of neuropathic pain identified using the PD-Q, with an odds ratio (OR) of 0.88 (95% confidence interval [95% CI] 0.79-0.97; P = 0.011) and an OR of 1.24 (95% CI 1.04-1.48; P = 0.018), respectively.
CONCLUSION:
QST measures and the PD-Q identified features of neuropathic pain in subjects in this community-based study, with significant overlap between the findings of the two techniques.
0004-3591
1942-1949
Soni, A.
7a4196ff-0f6b-429e-af54-d1036e9c433b
Batra, R.N.
1dcf5c66-3a03-4e58-8f59-c07b48044257
Gwilym, S.E.
00310152-07bd-4c77-b781-4adf9f4f1762
Spector, T.D.
87d1f285-3f22-4c9a-b006-d65cfda6d3e0
Hart, D.J.
00e78191-ce14-4b5f-a720-9f1bb51b2b62
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Tracey, I.
2f5bcaa5-5654-4865-b49c-27beeef98710
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3
Soni, A.
7a4196ff-0f6b-429e-af54-d1036e9c433b
Batra, R.N.
1dcf5c66-3a03-4e58-8f59-c07b48044257
Gwilym, S.E.
00310152-07bd-4c77-b781-4adf9f4f1762
Spector, T.D.
87d1f285-3f22-4c9a-b006-d65cfda6d3e0
Hart, D.J.
00e78191-ce14-4b5f-a720-9f1bb51b2b62
Arden, N.K.
23af958d-835c-4d79-be54-4bbe4c68077f
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Tracey, I.
2f5bcaa5-5654-4865-b49c-27beeef98710
Javaid, M.K.
51d3310b-032e-4c15-83ac-b878bce090f3

Soni, A., Batra, R.N., Gwilym, S.E., Spector, T.D., Hart, D.J., Arden, N.K., Cooper, C., Tracey, I. and Javaid, M.K. (2013) Neuropathic features of joint pain: a community-based study. Arthritis & Rheumatism, 65 (7), 1942-1949. (doi:10.1002/art.37962.). (PMID:23553508)

Record type: Article

Abstract

OBJECTIVE:
Quantitative sensory testing (QST) and questionnaire-based assessments have been used to demonstrate features of neuropathic pain in subjects with musculoskeletal pain. However, their direct relationship has not been investigated in the community. The purpose of this study was to conduct an observational study to describe the characteristics of joint pain and to examine the relationship between QST measures and the PainDETECT Questionnaire (PD-Q).
METHODS:
Warm detection, heat pain, and mechanical pain thresholds as well as mechanical pain sensitivity over the sternum were determined and the PD-Q scores were calculated in a cross-sectional study of 462 participants in the Chingford Study. Comparisons were made between subjects with and those without joint pain. Logistic regression modeling was used to describe the association between neuropathic pain features, as determined by the PD-Q score, and each of the QST measures individually, adjusting for age, body mass index, and use of pain-modifying medications.
RESULTS:
A total of 66.2% of the subjects reported recent joint pain, with a median average pain severity of 5 of 10. There was increased sensitivity to painful stimuli in the group with pain as compared to the pain-free group, and this persisted after stratification by pain-modifying medication use. While only 6.7% of subjects had possible neuropathic pain features and 1.9% likely neuropathic pain features according to the standard PD-Q thresholds, features of neuropathic pain were common and were present in >50% of those reporting pain of at least moderate severity. Heat pain thresholds and mechanical pain sensitivity were significantly associated with features of neuropathic pain identified using the PD-Q, with an odds ratio (OR) of 0.88 (95% confidence interval [95% CI] 0.79-0.97; P = 0.011) and an OR of 1.24 (95% CI 1.04-1.48; P = 0.018), respectively.
CONCLUSION:
QST measures and the PD-Q identified features of neuropathic pain in subjects in this community-based study, with significant overlap between the findings of the two techniques.

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Published date: July 2013
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 355684
URI: http://eprints.soton.ac.uk/id/eprint/355684
ISSN: 0004-3591
PURE UUID: c54efeea-df19-4af4-9231-194c22fdec2e
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 03 Sep 2013 15:11
Last modified: 03 Dec 2019 01:58

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Contributors

Author: A. Soni
Author: R.N. Batra
Author: S.E. Gwilym
Author: T.D. Spector
Author: D.J. Hart
Author: N.K. Arden
Author: C. Cooper ORCID iD
Author: I. Tracey
Author: M.K. Javaid

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