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Dr. Bernatsky is recipient of a Canadian Arthritis Network Scholar award
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Systemic Sclerosis
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Prevalence, severity, and clinical correlates of pain in patients with systemic sclerosis†
Article first published online: 25 FEB 2010
DOI: 10.1002/acr.20108
Copyright © 2010 by the American College of Rheumatology
Additional Information
How to Cite
Schieir, O., Thombs, B. D., Hudson, M., Boivin, J.-F., Steele, R., Bernatsky, S., Hanley, J., Baron, M. and Canadian Scleroderma Research Group (2010), Prevalence, severity, and clinical correlates of pain in patients with systemic sclerosis. Arthritis Care & Research, 62: 409–417. doi: 10.1002/acr.20108
- †
Investigators of the Canadian Scleroderma Research Group are listed in §.
Publication History
- Issue published online: 25 FEB 2010
- Article first published online: 25 FEB 2010
- Manuscript Accepted: 29 OCT 2009
- Manuscript Received: 13 APR 2009
Funded by
- Fonds de la Recherche en Santé du Québec Bourse de Formation
- Formation Maîtrise
- Canadian Scleroderma Research Group Studentship
- Canadian Institutes of Health Research Frederick Banting
- Charles Best Canada Graduate Scholarships Master's award
- New Investigator awards from the Canadian Institutes of Health Research
- Établissement de Jeunes Chercheurs awards from the Fonds de la Recherche en Santé du Québec
- Canadian Institutes of Health Research
- Fonds de la Recherche en Santé du Québec
- McGill University Health Centre Research Institute and Department of Medicine
- Canadian Institutes of Health Research
- Scleroderma Society of Canada
- Cure Scleroderma Foundation
- Pfizer Pharmaceuticals
- Actelion Pharmaceuticals
- Inova Diagnostics
- Ontario Arthritis Society
- Abstract
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Abstract
Objective
Large descriptive studies of pain in systemic sclerosis (SSc) are lacking. The present study estimated prevalence, severity, and associations between SSc clinical variables and pain in all patients with SSc and in limited cutaneous (lcSSc) and diffuse cutaneous (dcSSc) subsets.
Methods
Patients enrolled in a multicenter SSc registry (n = 585) completed a standardized clinical assessment and questionnaires about their physical and psychosocial health, including a pain severity numerical rating scale (NRS; range 0–10). Pain prevalence and severity were estimated with descriptive statistics. Crude and adjusted associations between specific SSc clinical variables and pain were estimated with linear regression for the entire group and by SSc subtype.
Results
Of the patients, 484 (83%) reported pain (268 [46%] mild pain [NRS 1–4], 155 [27%] moderate pain [NRS 5–7], and 61 [10%] severe pain [NRS 8–10]). More frequent episodes of Raynaud's phenomenon, active ulcers, worse synovitis, and gastrointestinal (GI) symptoms were associated with pain in multivariate analysis adjusting for demographic variables, depressive symptoms, and comorbid conditions. Patients with dcSSc reported only slightly higher mean ± SD pain than those with lcSSc (dcSSc 3.9 ± 2.8 versus lcSSc 3.4 ± 2.7; Hedges's g = 0.18, P = 0.05). Regression estimates did not differ significantly between SSc subsets.
Conclusion
Pain symptoms were common in the present study of patients with SSc and were independently associated with more frequent episodes of Raynaud's phenomenon, active ulcers, worse synovitis, and GI symptoms. Subsetting by extent of skin involvement was only minimally related to pain severity and did not affect associations with clinical variables. More attention to pain and how to best manage it is needed in SSc.