The frequency of neuropathic pain in patients with Ankylosing spondylitis and its relationship with clinical parameters

Introduction and purpose: AS is a prototype of SpA group diseases characterized by involvement of the axial skeleton which may also show peripheral joint involvement. Pain in AS has a nociceptive character and is the most important complaint with concomitant morning stiffness and functional impairment. Neuropathic Pain (NP) is a pain which differs from nociceptive pain in that it has the characteristics of flammable, stinging, throbbing, tingling, numbness, and sensitization due to pathological changes and sensitivity that develops in the pathways that transmit pain. Recently, it has been demonstrated that pain associated with rheumatologic diseases is accompanied by a neuropathic component. Therefore, this study was planned to investigate the frequency of NP in AS patients and also the relationship between the presence of NP and disease activity, functional capacity, depression and quality of life. Materials and Methods: Female and male patients aged between 19-71 years (150 patients) who were evaluated according to ASAS criteria and admitted to the Physical Medicine and Rehabilitation Policlinic of our hospital were included in the study. Patients were evaluated for pain with the painDETECT questionnaire. According to the calculated score, the patients were divided into two groups. Then, socio-demographic characteristics, disease activity, functional status, quality of life and depression were analyzed between the two groups. Results: 42 of the 150 patients included in the study were evaluated as NP according to the painDETECT score. BASDAI, BASFI, ASQoL, and BDI scores were found to be statistically significantly higher in the group with NP than in the group without NP. However, the rate of female patients was found to be significantly higher in the group with NP compared to the group without NP. Disease duration, smoking status, age and BMI were not significantly different between the groups. In addition, the frequency of NP was lower in the group of patients who did regular exercise compared to the group of patients who did not exercise regularly. NP was found to be higher in patients with low educational level. Peripheral arthritis was found to be significantly higher in patients with NP than in patients without NP. Conclusion: In this study, it was determined that nociceptive pain may be associated with NA in AS patients. It was found that NA associated with AS may be associated with high disease activity, poor quality of life, depression, and poor functional status. Therefore, NP should be kept in mind in pain management during the treatment process of AS patients.