Inflammation and Deformity in Type of Pain in Rheumatoid Hands: Cross Sectional Study
Rheumatology and Orthopedic Medicine
Rheumatoid arthritis (RA) is a chronic autoimmune disorder that can cause persistent pain, joint damage and permanent deformities, especially in hands and feet bilaterally. The presence of pain in RA has been explained by activation of local nociceptors, resulting from the destruction and cell death in the articular and periarticular structures affected. However, recent studies have been suggested that neuropathic pain is common in RA. Objective: To investigate the association between the level
... n between the level of inflammation and the degree of deformity to the type of pain in functional joints of the hands in individuals with RA. Methodology: Cross-sectional study carried out in a teaching-service outpatient referral, in Salvador, Bahia, Brazil. The deformations were performed by the Larsen scale on hands radiographs of hands and wrists, the level of inflammation by means of C-reactive protein and the type of pain by the DN4 questionnaire. We used the chi-square test for statistical analysis (5% alpha). CAAE number: 51642315.5.0000.5544. Results: The sample was composed by 95 participants with level of disease activity from moderate too high. Differences were found between neuropathic and nociceptive pain in relation to the degree of deformity to the left (p=0.004) and right (p=0.039) wrists. The pain was made available evenly between nociceptive and neuropathic (P>0.050). Lower degree of deformity was associated with the presence of right wrist neuropathic pain and greater deformity condition with presence of left wrist nociceptive pain. Conclusion: The wrist is the joint most affected by nociceptive pain. Small deformities associated with neuropathic pain while high degrees of deformity are more frequent in nociceptive pain.