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Neuropathic pain: is it an underestimated symptom in systemic sclerosis?

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Abstract

Pain is one of the most common symptoms in systemic sclerosis (SSc) patients, yet not considered in the assessment of disease severity. This study aimed to investigate the frequency of neuropathic pain (NP) and to evaluate its interference with the quality of life (QoL) in SSc patients. Diffuse and Limited SSc patients diagnosed by American College of Rheumatology 2013 criteria were included in the study. Pain was evaluated with Visual Analogue Scale (VAS); presence of NP was screened with The Leeds Assessment of Neuropathic Symptoms and Signs (LANNS) questionnaire; disease activity was evaluated with modified Medsger Severity Scale (MSS) and QoL with short-form 36 (SF-36). One hundred twenty patients were included in the study (mean age 53.64 ± 11.44 years, female/male 83.3–16.7%). Total pain frequency was found 69.2% and NP was 35.9% in the entire patient group. Pain was most frequently seen in wrist-hand (50.6%) and ankle-foot (43.4%) regions; albeit, NP rates were highest in face (94.4%), lower leg (87.5%), and hip-thigh (78.6%) regions. SF-36 scores were significantly lower in patients with NP than the patients without NP (P < 0.05). The most associated factors with NP were MSS score for muscle involvement and drug consumption of the patient. According to our results, high frequency of NP is seen in SSc patients, and NP is associated with low QoL. Differential diagnosis of NP is important to consider right treatment options and accurate management of pain in all rheumatologic diseases including SSc.

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Acknowledgements

We owe special thanks to Claire Brady for providing linguistic support.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Cukurova University School of Medicine, Adana, Turkey

    Nihan Cuzdan

  2. Department of Internal Medicine, Division of Rheumatology, Cukurova University School of Medicine, Adana, Turkey

    Ipek Turk & Eren Erken

  3. Department of Physical Medicine and Rehabilitation, Cukurova University School of Medicine, Adana, Turkey

    Tunay Sarpel

  4. Department of Biostatistics, Cukurova University School of Medicine, Adana, Turkey

    Zeliha Nazan Alparslan

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  1. Nihan Cuzdan
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  5. Zeliha Nazan Alparslan
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Correspondence to Nihan Cuzdan.

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The local ethics committee has approved the research (June 10, 2016;54).

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Cuzdan, N., Turk, I., Sarpel, T. et al. Neuropathic pain: is it an underestimated symptom in systemic sclerosis?. Clin Rheumatol 37, 1845–1851 (2018). https://doi.org/10.1007/s10067-018-4107-1

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  • DOI: https://doi.org/10.1007/s10067-018-4107-1

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