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The important role of central sensitization in chronic musculoskeletal pain seen in different rheumatic diseases

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Abstract

Objective

This study explored the role of central sensitization (CS) pain in patients with various rheumatic diseases using the CS inventory (CSI).

Methods

A total of 193 patients of mean age 50.72 ± 9.65 years were included; they were divided into four different groups in terms of their rheumatic diseases. Patients with rheumatoid arthritis (RA), spondyloarthropathy (SpA), osteoarthritis (OA), and fibromyalgia syndrome (FMS) were evaluated in tertiary care rheumatology/pain medicine settings. Disease duration and activity, the Bath Ankylosing Spondylitis Disease Activity Index, the Disease Activity Score-28, and pain severity (evaluated using a visual analog scale) were assessed, and the Turkish version of the CSI administered.

Results

CS syndromes were present in almost half the patients (45% of SpA, 41% of RA, 62% of OA, and 94% of FMS patients). We found no significant relationship between disease activity and the CSI-A scores in SpA or RA patients (p = 0.731 and p = 0.390, respectively). As expected, the CSI-A scores were highest in the FMS group (p = 0.000), but were similar in the other groups (p < 0.05). CS-related syndromes (CSI-B conditions) were present at similar frequencies in the RA, SpA, and OA groups, but were less common in the FMS group (p = 0.000).

Conclusions

The CSI usefully detects CS pain in patients with rheumatic diseases. Treatment of such pain can enhance the quality of daily life in patients with rheumatic diseases.

Key Point

• Central sensitization pain is common in patients with rheumatic diseases including rheumatoid arthritis, spondyloarthropathies, and osteoarthritis.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Gaziosmanpasa Taksim Training and Research Hospital, Mevlana District, 884. Street No: 23, 34255 Gaziosmanpasa, Istanbul, Turkey

    Mehmet Akif Guler

  2. Department of Physical Medicine and Rehabilitation, Divisions of Rheumatology, Pain Medicine, Health Sciences University, Ankara Training and Research Hospital, Ankara, Turkey

    Omer Faruk Celik & Fikriye Figen Ayhan

  3. Department of Physical Therapy and Rehabilitation, Usak University, High School of Health Sciences, Usak, Turkey

    Fikriye Figen Ayhan

Authors
  1. Mehmet Akif Guler
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  2. Omer Faruk Celik
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  3. Fikriye Figen Ayhan
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Correspondence to Mehmet Akif Guler.

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The study was approved by the Ankara Training and Research Hospital Ethics Committee and followed all relevant dictates of the Helsinki Declaration as revised in 2008.

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Guler, M.A., Celik, O.F. & Ayhan, F.F. The important role of central sensitization in chronic musculoskeletal pain seen in different rheumatic diseases. Clin Rheumatol 39, 269–274 (2020). https://doi.org/10.1007/s10067-019-04749-1

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  • DOI: https://doi.org/10.1007/s10067-019-04749-1

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