Neuropathic Pain Component in Patients of Different Age with Knee Osteoarthritis

V.V. Povoroznyuk, U.I. Pryimych

Abstract


Mechanisms of pain syndrome in patients with osteoarthritis (OA) remain poorly understood. Recent data indicate that, in addition to nociceptive mechanism, patients with osteoarthritis may experience signs of central sensitization and neuropathic pain (NP) component. The objective of the study was to assess the quantitative and qualitative characteristics of pain syndrome and to determine the prevalence of probable neuropathic pain component in patients of all ages with primary knee osteoarthritis using screening questionnaires, to identify the most specific signs and symptoms of neuropathic pain in these patients. Materials and methods. The study involved 37 female patients aged 47 to 85 years with clinical and radiographic evidence of primary knee OA (II–III degree by Kellgren-Lawrence, 1957) and duration of pain syndrome for more than 1 month. Patients were divided into three age groups according to gerontological classification: middle-aged (47–59 years), elderly (60–74 years) and senile (75–89 years) patients. To identify neuropathic pain component, we have used screening questionnaires (scales) of neuropathic pain — painDETECT, LANSS, DN4. In addition, patients completed a visual analog scale (VAS), the McGill questionnaire, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index). Quality of life was assessed by means of EuroQol-5D. For statistical analysis of the results, we have used regression-correlation analysis, ANOVA, chi-square (χ2). Results were considered statistically significant at p < 0.05. Results. According to painDETECT questionnaire, among patients with knee OA (n = 37), 70.3 % (n = 26) had unlikely neuropathic pain, 24.3 % (n = 9) — possible (indefinite), 5.4 % (n = 2) — probable NP. In accordance with the LANSS scale, probable NP was detected in 29.7 % of patients (n = 11), unlikely — in 70.3 % (n = 26). According to DN4, probable NP was found in 35.1 % (n = 13), unlikely — in 64.9 % (n = 24) patients. A close correlation was revealed between the scales of neuropathic pain ­painDETECT and LANSS (r = 0.76; p < 0.001), and painDETECT and DN4 (r = 0.86; p < 0.001). Using correlation analysis, we have found a moderate correlation between VAS values and indicators of all screening questionnaires of neuropa­thic pain — ­painDETECT (r = 0.4; p < 0.05), LANSS (r = 0.4; p < 0.05), DN4 (r = 0.42; p < 0.05).


Keywords


knee osteoarthritis; neuropathic pain component; central sensitization; allodynia; screening questionnaires; verbal descriptors

References


Поворознюк В.В. Остеоартроз: современные принципы лечения / Поворознюк В.В. // Новости медицины и фармации. — 2004. — № 4(144). — С. 10-13.

Поворознюк В.В. Нейропатичний компонент болю при захворюваннях кістково-м’язової системи: огляд літератури за результатами власних досліджень / Поворознюк В.В., Шинкаренко Т.Є., Приймич У.І. // Боль. Суставы. Позвоночник. — 2014. — 4(16). — P. 5-13.

Arendt-Nielsen L. Basic aspects of musculoskeletal pain: from acute to chronic pain / Arendt-Nielsen L., Fernandez-de-las-Penas C., Graven-Nielsen T. // J. Man Manip. Ther. — 2011. — 19(4). — P. 186-193.

Bennet M. The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs / Bennet M. // Pain. — 2001. — 92. — P. 147-157.

Bennett M. Using screening tools to identify neuropathic pain / Bennett M., Attal N., Backonja M.M., Baron R., Bouhassira D. Freynhagen R. [et al.] // Pain. — 2007. — 127. — P. 199-203.

Costigan M. Neuropathic Pain: A Maladaptive Response of the Nervous System to Damage / Costigan M., Scholz J., Woolf C. J. // Annu Rev Neurosci. — 2009. — 32. — P. 1-32.

Gwilym S.E. Psychophysical and functional imaging evi­dence supporting the presence of central sensitization in a cohort of osteoarthritis patients / Gwilym S.E., Keltner J.R., Warnaby C.E., Carr A.J. [et al.] // Arthritis Rheum. — 2009. — 61(9). — P. 1226-1234.

Haanpaa M. NeuPSIG guidelines on neuropathic pain assessment / Haanpaa M., Attal N., Backonja M., Baron R., Bennett M., Bouhassira D., Cruccu G. [et al.] // Pain. — 2011. — 152. — P. 14-27.

Hochman J.R. The Nerve of Osteoarthritis Pain / Hochman J.R., French M.R. [et al.] // Arthritis Care & Research. — 2010. — 62(7). — P. 1019-1023

Hochman J.R. Neuropathic pain symptoms in a community knee OA cohort / Hochman J.R., Gagliese A.M., Davis A.M. [et al.] // Osteoarthritis and Cartilage. — 2011. — 19. — P. 647-654.

Hochman J.R. Neuropathic pain symptoms on the modified painDETECT correlate with signs of central sensitization in knee osteoarthritis / Hochman J.R., Davis A.M. // Osteoarthritis and Cartilage. — 2013. — 21. — P. 1236-1242.

Hoper J. The (un)doubtful neuropathic pain component in nonneuropathic pain disorders / Hoper J. // Divisio on Neurolo­gical Pain Research and Therapy, Department of Neurology, Kiel, Germany, Nice, 15 may 2015.

Jensena T.S., Baron R. Translation of symptoms and signs into mechanisms in neuropathic pain / Jensena T.S., Baron R. // Pain. — 2003. — 102. — P. 1-8.

Moreton B.J. Pain Phenotype in Patients With Knee Osteoarthritis: Classification and Measurement Properties of painDETECT and Self-Report Leeds Assessment of Neuropathic Symptoms and Signs Scale in a Cross-Sectional Study / Moreton B.J., Tew V. // Arthritis Care Res. (Hoboken). — 2015. — 67(4). — P. 519-528.

Neogi T. The epidemiology and impact of pain in osteoarthritis / Neogi T. // Osteoarthritis Cartilage. — 2013. — 21(9). — P. 1145-1153.

Ochiai N. Efficacy of Combination of Meloxicam and Pregabalin for Pain in Knee Osteoarthritis / Ochiai N., Ohtori S., Sasho T. [et al.] // Yonsei Med J. — 2013. — 54 (5). — P. 1253-1258.

Ohtori S. Existance of a Neuropathic Pain Component in Patients with Osteoarthritis of the Knee / Ohtori S., Orita S. [et al.] // Yonsei Med. J. — 2012. — 53 (4). — P. 801-805.

Oteo-Álvaro Á1. High Prevalence of Neuropathic Pain Features in Patients with Knee Osteoarthritis: A Cross-Sectional Stud / Oteo-Álvaro Á1., Ruiz-Ibán M.A. [et al.] // Pain Pract. — 2015. — 15(7). — P. 618-626.

Phillips J.R. The natural history of pain and neuropathic pain after knee replacement: a prospective cohort study of the point prevalence of pain and neuropathic pain to a minimum three-year follow-up / Phillips J.R., Hopwood B., Arthur C., Stroud R. [et al.] // Bone Joint J. — 2014. — 96 B(9). — P. 1227-1233.

Rakel B. Mechanical hyperalgesia and reduced quality of life occur in people with mild knee osteoarthritis pain / Rakel B., Vance C., Zimmerman M.B. [et al.] // Clin. J. Pain. — 2015. — 31(4). — P. 315-322

Roubille C. The presence of meniscal lesions is a strong predictor of neuropathic pain in symptomatic knee osteoarthritis: a cross-sectional pilot study / Roubille C., Raynauld J.P. [et al.] // Arthritis Res. Ther. — 2014. — 16(6). — Р. 507.

Soni A. Neuropathic Features of Joint Pain: a Community-Based Study / Soni A., Batra R.N.[et al.] // Published in final edi­ted form as: Arthritis Rheum. — 2013. — 65(7). — P. 1942–1949.

Valdes A.M. History of knee surgery is associated with higher prevalence of neuropathic pain-like symptoms in patients with severe osteoarthritis of the knee / Valdes A.M., Suokas A.K., Doherty S.A., Jenkins W. [et al.] // Arthritis Rheum. — 2014. –43(5). — P. 1010-1016.

Wylde V. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants / Wylde V., Hewlett S., Learmonth I.D. [et al.] // Pain. — 2011. — 152(3). — P. 566-572.

Wylde V. Somatosensory abnormalities in knee OA / Wylde V., Palmer S., Ian D., Learmonth I.D., Dieppe P. // Rheumatology. — 2012. — 51. — P. 535-543.

Povoroznyuk V.V. Neuropathic pain component in patients of various age with knee osteoarthritis / Povoroznyuk V.V. [et al.] // 9th Congress of the European Pain Federation EFIC. — Vienna, 2015. — P. 396-397.




DOI: https://doi.org/10.22141/2224-1507.3.19.2015.79266

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