Effect of neuropathic pain on disease activity, functional status and quality of life in patients with Axial spondyloarthritis

Introduction and Purpose: AxSpA is one of the most important etiologic factors of chronic low back pain, characterized by inflammatory type nociceptive pain involving the spine and sakroiliac joints, causing progressive spine restriction. Neuropathic pain (NP) is a type of pain that is often described by patients as being flammable, stinging, throbbing, accompanied by tingling and numbness. In this study, we aimed to investigate the effect of NP frequency and presence of NP on disease activity scales, functional status and quality of life in axSpA patients. Materials and Method: The study included 100 patients aged between 18-65 years (F/M=57/43) diagnosed as axSpA according to ASAS SpA classification criteria and 40 healthy controls (F/M=20/20) who were admitted to Ankara Yıldırım Beyazıt University Atatürk Training and Research Hospital Physical Medicine and Rehabilitation Department outpatient clinic. In the patient group diagnosed with AxSpA, those who met the modified New York criteria were grouped as AS and others as nr-axSpA. Pain and fatigue levels were evaluated by VAS, NP was assessed by painDETECT and DN4 scales, disease activity was assessed by BASDAI and ASDAS-CRP, functional capacity was assessed by BASFI, spinal mobility by BASMI, and quality of life was assessed by ASQoL, HAQ and NHP. Results: There was no significant difference between the two groups in terms of demographic data. In the AxSpA group, 19% were determined as possible NP according to the PainDETECT scale and 36% as NP according to the DN4 scale, and these rates were significantly higher than the healthy control group. There was a significant difference between the two groups in terms of NHP and HAQ. In the AxSpA group painDETECT and DN4 scores were positively correlated with VASresting, VASmovement, VASfatigue, BASDAI, ASDAS-CRP and BASFI, HAQ, ASQoL, all NHP subcomponents except social isolation. There was no significant difference between AS and nr-axSpA in terms of demographic, clinical, quality of life and NP. Conclusion: NP is higher in patients with AxSpA than in healthy people. The presence of NP is associated with disease activity scores, functional status, quality of life and fatigue levels. We think that the planned treatment would be more beneficial considering that the pain in patients may also have neuropathic component.