Neuropathic Pain Component in Patients of Different Age with Knee Osteoarthritis
Journal Title: Біль. Суглоби. Хребет - Year 2015, Vol 3, Issue 19
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).
Authors and Affiliations
V. V. Povoroznyuk, U. I. Pryimych
Keywords
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