School of Physiotherapy, University of Otago, Dunedin, New Zealand.
School of Medicine, University of Otago, Dunedin, New Zealand.
Pain Pract. 2020 Jan;20(1):24-33. doi: 10.1111/papr.12821. Epub 2019 Aug 24.
Musculoskeletal conditions are well documented in inflammatory bowel disease (IBD). However, whether IBD activity influences musculoskeletal pain experiences is uncertain. Central sensitization has been proposed in patients with IBD who are suffering from persistent pain. Identification of central sensitization symptomology using the Central Sensitization Inventory (CSI) has been reported in many pain-related disorders. Aims of this study were to explore predictive relationships between IBD activity and musculoskeletal pain experiences (severity/interference), and the mediating effects of the CSI.
A cross-sectional online survey was performed exploring self-reported musculoskeletal pain in adults with IBD. Survey questionnaires included IBD activity indices, numeric rating scales, PROMIS Pain Interference, and the CSI. Linear regression was used to examine the relationship between active IBD and pain experiences. Simple and serial mediation analyses were used to explore mediation models: independent variable (IBD activity), dependent variables (severity/interference), and mediators (CSI/severity).
208 adults with IBD, 18 to 88 years of age, reported musculoskeletal pain. Regression analysis identified IBD activity as a significant predictor of worse pain severity (R = 0.039, P < 0.005) and interference (R = 0.067, P < 0.001). Simple mediation showed a significant indirect effect from CSI scores between IBD activity and pain severity. Serial mediation analysis showed a significant indirect effect from CSI scores and pain severity, between IBD activity and pain interference.
Active IBD demonstrated a positive association with worse musculoskeletal pain experiences. The CSI demonstrated significant mediation between active IBD and pain severity. Additionally, the CSI and pain severity demonstrated significant mediation between active IBD and pain interference. This suggests that symptoms of central sensitization significantly influence musculoskeletal pain experiences in IBD.
肌肉骨骼疾病在炎症性肠病（IBD）中已有充分记录。然而，IBD 活动是否会影响肌肉骨骼疼痛体验尚不确定。在患有持续性疼痛的 IBD 患者中，已经提出了中枢敏化。使用中枢敏化量表（CSI）识别中枢敏化症状已在许多与疼痛相关的疾病中得到报道。本研究的目的是探讨 IBD 活动与肌肉骨骼疼痛体验（严重程度/干扰）之间的预测关系，以及 CSI 的中介作用。
进行了一项横断面在线调查，调查了成年人 IBD 患者的肌肉骨骼疼痛情况。调查问卷包括 IBD 活动指数、数字评分量表、PROMIS 疼痛干扰量表和 CSI。线性回归用于检查活动性 IBD 与疼痛体验之间的关系。简单和串联中介分析用于探索中介模型：自变量（IBD 活动）、因变量（严重程度/干扰）和中介变量（CSI/严重程度）。
208 名 18 至 88 岁的 IBD 成年人报告了肌肉骨骼疼痛。回归分析确定 IBD 活动是疼痛严重程度（R = 0.039，P < 0.005）和干扰（R = 0.067，P < 0.001）恶化的显著预测因子。简单中介显示 CSI 评分在 IBD 活动与疼痛严重程度之间存在显著的间接效应。序列中介分析显示，CSI 评分和疼痛严重程度在 IBD 活动和疼痛干扰之间存在显著的间接效应。
活动性 IBD 与更严重的肌肉骨骼疼痛体验呈正相关。CSI 在 IBD 与疼痛严重程度之间表现出显著的中介作用。此外，CSI 和疼痛严重程度在 IBD 与疼痛干扰之间表现出显著的中介作用。这表明中枢敏化症状会显著影响 IBD 患者的肌肉骨骼疼痛体验。
