Polat Cemile Sevgi, Doğan Asuman, Sezgin Özcan Didem, Köseoğlu Belma Füsun, Koçer Akselim Sinem
Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.
Arch Rheumatol. 2017 Apr 24;32(4):333-338. doi: 10.5606/ArchRheumatol.2017.6006. eCollection 2017 Dec.
This study aims to investigate the neuropathic pain (NP) component in patients with osteoarthritis (OA) of the knee and its association with physical function, risk factors, and stages of OA.
One hundred and nine patients (16 males, 93 females; mean age 62.5±8.5 years; range 44 to 81 years) diagnosed with knee OA according to the American College of Rheumatology criteria were enrolled in this study between July 2014 and June 2015. Patients were evaluated with visual analog scale for pain severity, PainDETECT questionnaire for presence and severity of neuropathic pain, Western Ontario and McMaster Universities osteoarthritis index for physical function, and the Kellgren-Lawrence system for severity of OA. Presence of the associated risk factors were also questioned.
A total of 12 patients (11%) were classified as having likely NP and 23 patients (21.1%) were classified as having possible NP. PainDETECT scores were significantly correlated with the visual analog scale scores and Western Ontario and McMaster Universities osteoarthritis index pain, physical function and total scores. Patients with neuropathic pain had significantly longer symptom duration than the patients without NP. However, we found no relationship between the other risk factors and NP.
This study demonstrated that some of the knee OA patients had a NP component as the underlying cause of knee pain. Patients with NP had longer symptom duration, increased severity of pain, and disability. Therefore, the presence of NP component in these patients should be considered. Once it is determined, appropriate intervention strategies for NP should be incorporated in the routine treatment modalities of knee OA.
本研究旨在调查膝骨关节炎(OA)患者的神经性疼痛(NP)成分及其与身体功能、危险因素和OA分期的关系。
根据美国风湿病学会标准诊断为膝OA的109例患者(16例男性,93例女性;平均年龄62.5±8.5岁;范围44至81岁)于2014年7月至2015年6月纳入本研究。采用视觉模拟量表评估疼痛严重程度,采用疼痛检测问卷评估神经性疼痛的存在和严重程度,采用西安大略和麦克马斯特大学骨关节炎指数评估身体功能,采用凯尔格伦-劳伦斯系统评估OA严重程度。还询问了相关危险因素的存在情况。
共有12例患者(11%)被分类为可能患有NP,23例患者(21.1%)被分类为可能患有NP。疼痛检测评分与视觉模拟量表评分、西安大略和麦克马斯特大学骨关节炎指数疼痛、身体功能和总分显著相关。神经性疼痛患者的症状持续时间明显长于无NP患者。然而,我们发现其他危险因素与NP之间没有关系。
本研究表明,一些膝OA患者存在NP成分,是膝关节疼痛的潜在原因。患有NP的患者症状持续时间更长,疼痛严重程度增加,且有残疾。因此,应考虑这些患者中NP成分的存在。一旦确定,应将针对NP的适当干预策略纳入膝OA的常规治疗模式中。