Rofecoxib and tramadol do not attenuate delayed-onset muscle soreness or ischaemic pain in human volunteers

We assessed the effect of rofecoxib, a cyclo-oxygenase-2 inhibitor, and tramadol, a centrally acting analgesic, on both delayed-onset muscle soreness (DOMS) and experimentally induced ischaemic pain. We induced DOMS in 10 male and 5 female healthy volunteers by downhill running for 30 min at a 12% decline and a speed of 9 km x h(-1). We also induced ischaemic pain by finger movements with an arterial tourniquet around the arm. In a randomized, double-blind crossover format, we administered rofecoxib (50 mg, daily), tramadol (50 mg, 3 times per day), and a placebo (orally for 3 days), starting immediately after exercise. A 100 mm visual analogue scale (VAS) and McGill pain questionnaire were used to describe muscle soreness and ischaemic forearm pain 24 h after the exercise. The pressure pain threshold (PPT) in the thigh and ischaemic pain tolerance in the forearm were measured before exercise and 24 and 72 h after exercise. PPT decreased 24 h after exercise, compared with pre-exercise values (ANOVA, p < 0.05), but neither drug had any significant effect on the PPT. Neither rofecoxib nor tramadol had any effect on time of ischaemia tolerated or amount of finger activity during ischaemia. The VAS and pain-rating index, for both muscle soreness and experimental ischaemic pain, were not affected significantly by either drug. Both DOMS and ischaemic pain share peripheral and central mechanisms, yet neither are attenuated by rofecoxib or tramadol.     

Transient pain developers show increased abdominal muscle activity during prolonged sitting

BackgroundSitting is a commonly adopted posture during work and prolonged exposures may have detrimental effects. Little attention has been paid to the thoracic spine and/or multiple axes of motion during prolonged sitting. Accordingly, this study examined three-dimensional motion and muscle activity of the trunk during two hours of uninterrupted sitting.MethodsTen asymptomatic males sat during a simulated office task. Kinematics were analyzed from six segments (Neck, Upper-, Mid-, and Lower-thoracic, Lumbar, and Pelvis) and electromyography was recorded from eight muscles bilaterally.ResultsFour participants developed transient pain. These participants showed higher average muscle activations in the abdominal muscles. Additionally, the non-pain group showed less lateral bend positional change in the mid-thoracic region compared to the upper- and lower-thoracic regions. Weak-to-moderate positive correlations were also found between rated pain and low back muscle activation.DiscussionThe results provided further evidence of reduced movement in non-pain developers and altered muscle activation patterns in pain developers. Low-level, prolonged static contractions could lead to an increased risk of injury; and though the increased abdominal activity in the pain developers was not directly associated with increased rated pain scores, this could indicate a pre-disposition to, or enhancer of, transient pain development.     

Comparison of clinical findings and electromyography results in patients with preliminary diagnosis of carpal tunnel syndrome

ObjectiveTo evaluate the link between EMG findings and clinical status, the Boston questionnaire and the severity of pain in patients with pre-diagnosis of carpal tunnel syndrome.MethodsA total of 85 patients (133 hands) who presented to the Physical Therapy and Rehabilitation outpatient clinic consecutively with complaints of numbness, tingling, pain and weakness in their hands were evaluated for their demographic and clinical features. After the initial evaluation, the diagnosis of CTS was confirmed by EMG. Visual analog scale (VAS), the Boston Questionnaire (Symptom Severity Scale = SSS, Functional Status Scale = FSS) and nerve conduction study results (sensory conduction velocity = SCV, distal motor latency = DML, compound muscle action potential = CMAP) were enrolled.ResultsEighty-five patients (58 female and 27 male) participated in this study yielding 133 hands (73 right hands, 60 right hands) with CTS. The mean age was 48.3 ± 10.41 years. Of all patients, 68.2 % were female and 31.8 % were male. A statistically significant relationship was found between SSS and duration of symptoms, VAS, both right and left SCV, DML and CMAP. A statistically significant relationship was found between FSS and duration of symptoms, VAS and only right SCV, DML and CMAP.ConclusionThe diagnosis of CTS should be evaluated not only as an electrodiagnostic finding, but also the clinical picture of the patients. According to our results, both SSS and FSS had good correlations with VAS and the findings of EMG. Therefore, the Boston Questionnaire can provide a standardized measure of symptom severity and functional status in patients with CTS.     

Association between ABO blood types and pain perception

Aim of the study: Pain perception is associated with different phenotypic characteristics such as sex, eye, and hair color. Hence, it is assumed that ABO blood type can also affect pain perception.

Materials and methods: In order to investigate this hypothesis, an experimental study with healthy volunteers (18–40?years) was designed. The experimental procedure included a blood type test and two rounds of pressure pain threshold assessments separated by a cold pressor test. Pressure pain threshold was assessed bilaterally at the temporalis, masseter, and deltoid muscles, where the muscle sites were randomized. Cold pressor test was conducted by immersion of participants’ non-dominant hand into iced water of 1–4?°C for 2?min.

Results: Thirty-seven healthy volunteers, distributed in the four blood type groups, completed the study. Participants with blood type B scored the highest pressure pain thresholds at the examined craniofacial muscles, while participants with blood type AB tended to score the lowest. Furthermore, participants with blood type AB displayed the highest elevation in pressure pain thresholds after cold pressor test.

Conclusions: Participants with blood type B displayed the lowest mechanical pain sensitivity and the blood type AB group exhibited the strongest conditioned pain modulation effect. These findings emphasize the necessity of considering ABO blood types in future pain research.     

Effect of pain location on spatial reorganisation of muscle activity

IntroductionWe aimed to determine whether the changes in muscle activity (in terms of both gross electromyography (EMG) and motor unit (MU) discharge characteristics) observed during pain are spatially organized with respect to pain location within a muscle which is the main contributor of the task.MethodsSurface and fine-wire EMG was recorded during matched low-force isometric plantarflexion from soleus (from four quadrants with fine-wire EMG and from the medial/lateral sides with surface EMG), both gastrocnemii heads, peroneus longus, and tibialis anterior. Four conditions were tested: two control conditions that each preceded contractions with pain induced in either the lateral (Pain_L) or medial (Pain_M) side of soleus.ResultsNeither the presence (p = 0.28) nor location (p = 0.19) of pain significantly altered gross muscle activity of any location (lateral/medial side of soleus, gastrocnemii, peroneus longus and tibialis anterior). Group data from 196 MUs show redistribution of MU activity throughout the four quadrants of soleus, irrespective of pain location. The significant decrease of MU discharge rate during pain (p < 0.0001; Pain_L: 7.3 ± 0.9–6.9 ± 1.1 Hz, Pain_M: 7.0 ± 1.1 to 6.6 ± 1.1 Hz) was similar for all quadrants of the soleus (p = 0.43), regardless of the pain location (p = 0.98). There was large inter-participant variation in respect to the characteristics of the altered MU discharge with pain.ConclusionResults from both surface and fine-wire EMG recordings do not support the hypothesis that muscle activity is reorganized in a simple systematic manner with respect to pain location.     

Changes in muscle activation patterns and subjective low back pain ratings during prolonged standing in response to an exercise intervention

BackgroundLow back pain (LBP) development has been associated with occupational standing. Increased hip and trunk muscle co-activation is considered to be predisposing for LBP development during standing in previously asymptomatic individuals. The purpose of this work was to investigate muscle activation and LBP responses to a prescribed exercise program. Pain-developing (PD) individuals were expected to have decreased LBP and muscle co-activation following exercise intervention.MethodsElectromyography (EMG) data were recorded from trunk and hip muscle groups during 2-h of standing. An increase of >10 mm on visual analog scale (VAS) during standing was threshold for PD categorization. Participants were assigned to progressive exercise program with weekly supervision or control (usual activity) for 4 weeks then re-tested.ResultsForty percent were categorized as PD on day 1, VAS = 24.2 (±4.0) mm. PD exercisers (PDEX) had lower VAS scores (8.93 ± 3.66 mm) than PD control (PDCON) (16.5 ± 6.3 mm) on day 2 (p = 0.007). Male PDEX had decreased gluteus medius co-activation levels (p < 0.05) on day 2.DiscussionThe exercise program proved beneficial in reducing LBP during standing. There were changes in muscle activation patterns previously associated with LBP. Predisposing factors for LBP during standing were shown to change positively with appropriate exercise intervention.     

Effect of eccentric strength testing on delayed-onset muscle pain

This investigation was designed to determine the effect of eccentric strength testing on delayed-onset muscle pain in 20 untrained university students. Initially, eccentric strength testing (5-repetition maximum [5RM]) was performed bilaterally. Next, 1 arm completed 3 sets of 10 eccentric repetitions to induce delayed-onset muscle pain. Then, in a subsequent session, whichever arm previously performed only the 5RM test completed the 5RM test a second time and the 3 sets of 10 eccentric repetitions. Statistical analyses supported significantly increased pain intensity and unpleasantness across 48 hours post-5RM test alone. However, pain intensity and unpleasantness after the eccentric training bouts were significantly lower in the arm that performed 2 5RM tests than the arm that performed only 1. Thus, the eccentric strength testing produced delayed-onset muscle pain and protected against future delayed-onset muscle pain. These effects should be considered when such testing is used in baseline strength assessments.     

Experimental knee pain impairs submaximal force steadiness in isometric,eccentric, and concentric muscle actions

IntroductionPopulations with knee joint damage, including arthritis, have noted impairments in the regulation of submaximal muscle force. It is difficult to determine the exact cause of such impairments given the joint pathology and associated neuromuscular adaptations. Experimental pain models that have been used to isolate the effects of pain on muscle force regulation have shown impaired force steadiness during acute pain. However, few studies have examined force regulation during dynamic contractions, and these findings have been inconsistent. The goal of the current study was to examine the effect of experimental knee joint pain on submaximal quadriceps force regulation during isometric and dynamic contractions.MethodsThe study involved fifteen healthy participants. Participants were seated in an isokinetic dynamometer. Knee extensor force matching tasks were completed in isometric, eccentric, and concentric muscle contraction conditions. The target force was set to 10 % of maximum for each contraction type. Hypertonic saline was then injected into the infrapatella fat pad to generate acute joint pain. The force matching tasks were repeated during pain and once more 5 min after pain had subsided.ResultsHypertonic saline resulted in knee pain with an average peak pain rating of 5.5 ± 2.1 (0–10 scale) that lasted for 18 ± 4 mins. Force steadiness significantly reduced during pain across all three muscle contraction conditions. There was a trend to increased force matching error during pain but this was not significant.ConclusionExperimental knee pain leads to impaired quadriceps force steadiness during isometric, eccentric, and concentric contractions, providing further evidence that joint pain directly affects motor performance. Given the established relationship between submaximal muscle force steadiness and function, such an effect may be detrimental to the performance of tasks in daily life. In order to restore motor performance in people with painful arthritic conditions of the knee, it may be important to first manage their pain more effectively.     

The effects of experimental knee pain on lower limb corticospinal and motor cortex excitability

IntroductionNotable weakness of the quadriceps muscles is typically observed as a consequence of knee joint arthritis, knee surgery and knee injury. This is partly due to ongoing neural inhibition that prevents the central nervous system from fully activating the quadriceps, a process known as arthrogenic muscle inhibition (AMI). To investigate the mechanisms underlying AMI, this study explored the effects of experimental knee pain on lower limb corticospinal and motor cortex excitability.MethodsTwenty-four healthy volunteers participated in this study. In experiment 1, experimental knee pain was induced by the injection of hypertonic saline into the infrapatellar fat pad (n = 18). In experiment 2, isotonic saline was injected into the fat pad as a non-painful control (n = 8). Pain intensity was measured on a 10-cm electronic visual analogue scale. Transcranial magnetic stimulation and electromyography were used to measure lower limb motor-evoked potential amplitude and short-interval intracortical inhibition before and after the injection.ResultsThe peak VAS score following hypertonic saline (5.0 ± 0.5 cm) was higher than after isotonic saline (p <0.001). Compared with baseline, there was a significant increase in vastus lateralis (p = 0.02) and vastus medialis motor-evoked potential amplitude (p = 0.02) during experimental knee pain that was not apparent during the control condition. Biceps femoris and tibialis anterior motor-evoked potential amplitude did not change following injection (all p >0.05). There was no change in short-interval intracortical inhibition measured from vastus lateralis following injection (both p >0.05).ConclusionsQuadriceps corticospinal excitability increases during experimental knee pain, providing no evidence for a supraspinal contribution to quadriceps AMI.     

Differences in muscle activity and fatigue of the upper limb between Task-Specific training and robot assisted training among individuals post stroke

ObjectiveTo compare the activity and fatigue of upper extremity muscles, pain levels, subject satisfaction levels, perceived exertion, and number of repetitions in Task-Specific Training (TST) compared with Robot-Assisted Training (RAT) in individuals post-stroke.MethodsTwenty sub-acute post stroke subjects (16 men; median (interquartile range) age 64.0 (71.5–57.0) years) received two 30-min treatment sessions, one TST and one RAT. Before each session, the Visual Analogue Scale (VAS) was administered. Activity levels and fatigue of six muscles were monitored using surface electromyography and the number of repetitions was counted. After each session, the subjective assessment questionnaire of treatment, the Borg scale and VAS were administered.ResultsDuring TST, the Anterior Deltoid, Upper Trapezius and Biceps were more active, while during the RAT, the Triceps was more active. The Triceps activity increased during TST towards the end of the session. The pain levels increased after TST and the number of repetitions was higher compared to RAT. There were no significant differences in muscle fatigue, perceived physical exertion and subject satisfaction levels between both treatment sessions.ConclusionThis is the first study to explore the biomechanics of both treatment methods and might therefore shed light on the mechanisms behind their positive outcomes. Due to the differences in the biomechanics of the treatments, a combination of both treatments may be beneficial to the activation of different muscle groups, thereby contributing to the rehabilitation program post stroke.     

Hip muscle activity in people with hip-related pain compared to asymptomatic controls: A systematic review

BackgroundAltered hip and thigh muscle activity have been observed across a spectrum of articular hip pathologies, including hip osteoarthritis, femoroacetabular impingement syndrome, and labral pathology. No systematic reviews have examined muscle activity associated with hip pathology and hip-related pain across the life span. A greater understanding of impairments in hip and thigh muscle activity during functional tasks may assist in the development of targeted treatment strategies.MethodsWe conducted a systematic review using the PRISMA guidelines. A literature search was performed in five databases (MEDLINE, CINAHL, EMBASE, Sports Discuss, and PsychINFO). Studies were included that (i) investigated people with hip-related pain (femoroacetabular impingement syndrome, labral tears) or hip osteoarthritis; and (ii) reported on muscle activity using electromyography of hip and thigh muscles during functional tasks such as walking, stepping, squatting, or lunging. Two independent reviewers performed data extraction and assessed risk of bias using a modified version of the Downs and Black checklist.ResultsNon-pooled data demonstrated a limited level of evidence. Overall, differences in muscle activity appeared to be more prevalent in people with more advanced hip pathology.ConclusionsWe found that impairments in muscle activity in those with intra-articular hip pathology measured using electromyography were variable but appeared to be greater in severe hip pathology (e.g., hip OA).     

Are chronic neck pain,scapular dyskinesis and altered scapulothoracic muscle activity interrelated?: A case-control study with surface and fine-wire EMG

ObjectivesThe function of the scapula is important in normal neck function and might be disturbed in patients with neck pain. The surrounding muscular system is important for the function of the scapula. To date, it is not clear if patients with idiopathic neck pain show altered activity of these scapulothoracic muscles. Therefore, the objective of this study was to investigate differences in deeper and superficial lying scapulothoracic muscle activity between patients with idiopathic neck pain and healthy controls during arm elevation, and to identify the influence of scapular dyskinesis on muscle activity.MethodsScapular dyskinesis was rated with the yes/no method. The deeper lying (Levator Scapulae, Pectoralis Minor (Pm) and Rhomboid major) and superficial lying (Trapezius and Serratus Anterior) scapulothoracic muscles’ activity was investigated with fine-wire and surface EMG, respectively, in 19 female subjects with idiopathic neck pain (age 28.3 ± 10.1 years, average duration of neck pain 45.6 ± 36.3 months) and 19 female healthy control subjects (age 29.3 ± 11.7 years) while performing scaption and towel wall slide. Possible interactions or differences between subject groups, scapular dyskinesis groups or phases of the task were studied with a linear mixed model.ResultsHigher Pm activity during the towel wallslide (p = 0.024, mean difference 8.8 ± 3.3% MVIC) was shown in patients with idiopathic neck pain in comparison with healthy controls. For the MT, a significant group 1 dyskinesis interaction effect was found during scaption which revealed that patients with neck pain and scapular dyskinesis showed lower Middle Trapezius (MT) activity in comparison with healthy controls with scapular dyskinesis (p = 0.029, mean difference 5.1 ± 2.2% MVIC).ConclusionsIn the presence of idiopathic neck pain, higher Pm activity during the towel wallslide was found. Patients with neck pain and scapular dyskinesis showed lower MT activity in comparison with healthy controls with scapular dyskinesis during scaption. Scapular dyskinesis did not have a significant influence on scapulothoracic muscle activity.     

Discrimination of muscle tension in chronic pain patients and healthy controls

The purpose of this study was to assess the perception of muscle tension in chronic pain patients and healthy controls. Twenty chronic back pain patients, 20 patients who suffered from temporomandibular pain and dysfunction, and 20 healthy controls were instructed to produce eight different levels of muscle contraction in either the m. masseter or the m. erector spinae. Each level was produced three times; trials were presented in random order. Analyses of the accuracy and the sensitivity of discrimination of muscle tension levels revealed that the patients were less able to perceive muscle contraction levels correctly and that they underestimated their actual levels of muscle tension. Patients and controls did not differ in the extent to which they contracted muscles not involved in the task. Patients suffering from musculoskeletal disorders seem to display a genuine deficit in discrimination of muscle tension that is related to neither local physiological changes at the site of pain, lack of motivation, inattention, nor fatigue.This research was supported by a grant from the Deutsche Forschungsgemeinschaft (FI 156/1 and FI 156/2) to the first author and a grant from the German Department of Science and Technology (FKZ 0701503) to the third author. The authors are solely responsible for the contents of this publication. The authors would like to thank Barbara Streit, Dr. Karl Schweizer, and Dr. Sybille Rockstroh for assistance in data collection.     

Discrimination of muscle tension in chronic pain patients and healthy controls.

The purpose of this study was to assess the perception of muscle tension in chronic pain patients and healthy controls. Twenty chronic back pain patients, 20 patients who suffered from temporomandibular pain and dysfunction, and 20 healthy controls were instructed to produce eight different levels of muscle contraction in either the m. masseter or the m. erector spinae. Each level was produced three times; trials were presented in random order. Analyses of the accuracy and the sensitivity of discrimination of muscle tension levels revealed that the patients were less able to perceive muscle contraction levels correctly and that they underestimated their actual levels of muscle tension. Patients and controls did not differ in the extent to which they contracted muscles not involved in the task. Patients suffering from musculoskeletal disorders seem to display a genuine deficit in discrimination of muscle tension that is related to neither local physiological changes at the site of pain, lack of motivation, in-attention, nor fatigue.     

Community survey of factors associated with consultation for low back pain

ObjectiveTo investigate the psychosocial factors associated with consultation for low back pain.DesignTwo phase cross sectional postal survey.SettingBradford Metropolitan Health District.Subjects1813 adults responding to the phase 1 questionnaire. 540 of the 782 with an episode of low back pain in the past 12 months completed the second questionnaire.Results406 (52%) of the respondents reporting back pain in the past 12 months had not consulted a health professional. Logistic regression showed that consultation was associated with externalised beliefs regarding pain management (odds ratio 3.6; 95% confidence interval 2.1 to 6.0). Duration of pain affected the factors associated with consultation. Consultation for episodes lasting less than two weeks (n=290) was associated with greater than median pain (3.0; 1.7 to 5.5), consultation for episodes over two weeks (n=243) was associated with increased disability (3.7; 1.5 to 9.0), and consultation for episodes over three months (n=143) with increased depression (3.9; 1.3 to 11.8).ConclusionsThe results support a role for psychosocial factors in consultation for low back pain and suggest that the reasons for consultation vary with duration of pain. Duration of the episode may be a useful guide to management of non-specific low back pain.

Key messages

• Only half of those who experience low back pain consult a health service professional
• Most of those who consult have had low back pain for more than two weeks
• The severity of pain may influence consulting behaviour at the acute stage, but after the acute period those who consult are more likely to have increased disability, externalised beliefs about pain management, and depressive symptoms.
• Management of low back pain may need to vary according to the duration of pain

     

Evaluating skeletal muscle electromechanical delay with intramuscular pressure

IntroductionIntramuscular pressure (IMP) is the fluid pressure generated within skeletal muscle and directly reflects individual muscle tension. The purpose of this study was to assess the development of force, IMP, and electromyography (EMG) in the tibialis anterior (TA) muscle during ramped isometric contractions and evaluate electromechanical delay (EMD).MethodsForce, EMG, and IMP were simultaneously measured during ramped isometric contractions in eight young, healthy human subjects. The EMD between the onset of force and EMG activity (Δt-EMG force) and the onset of IMP and EMG activity (Δt EMG-IMP) were calculated.ResultsA statistically significant difference (p < 0.05) was found between the mean force-EMG EMD (36 ± 31 ms) and the mean IMP-EMG EMD (3 ± 21 ms).ConclusionsIMP reflects changes in muscle tension due to the contractile muscle elements.     

Sensory lateralization in pain subjective perception for noxious heat stimulus

The aim of the present study was to identify and characterize hemispheric lateralization for pain intensity perception. A sample of 351 healthy volunteers was tested by the immersion of the right hand for 10 s followed by the same test for the left hand (RL group; n = 199) or in a random sequence (RND group; n = 152) into a water bath (48 degrees C, 15 s). Pain intensity was self-reported by the Visual Analogue Scale (VAS). The motor hemispherical Lateralization Index (LI) was obtained by the Edinburgh Inventory. Gender, hand skin fold, interstimulus time and menstrual cycle data in case of female subjects were recorded. The sample, 60.7% females and 39.3% males, 20.4 +/- 0.18 (mean +/- SEM) years old, showed 92.1% right-handed subjects. Left hand VAS was significantly higher than right hand VAS for RL (7.24 +/- 1.31 vs 6.74 +/- 1.52; p < 0.01) and RND (7.24 +/- 0.82 vs 6.73 +/- 1.25; p < 0.01) both for right- and left-handed subjects. A low but significant correlation for VAS scores and LI was found (r = 0.14; p < 0.05 or r = 0.18; p < 0.05, for left or right hand, respectively). Skin fold was statistically similar in both hands (p > 0.05) being highly correlated with each other (r = 0.68; p < 0.05). Pain subjective perception was not correlated to interstimulus time (r = -0.01; p > 0.05). Females showed significantly higher values than males for both left and right hand VAS scores. Periovulatory phase VAS value was significantly higher than luteal phase VAS only for the right hand test (7.57 +/- 0.20 vs 6.47 +/- 0.33; p < 0.01). The results of the present study suggest a lateralization of pain intensity perception to the right hemisphere not correlated with the motor hemispheric lateralization.     

体外冲击波联合钻孔减压术对早期股骨头坏死患者关节功能、肌力及生活质量的影响

目的:探讨体外冲击波(ESWT)联合钻孔减压术对早期股骨头坏死患者关节功能、肌力及生活质量的影响。方法:回顾性分析2017年9月~2018年12月期间收治的80例早期股骨头坏死患者的临床资料,依据治疗方式将其分为A组(n=37,钻孔减压治疗)和B组(n=43,钻孔减压联合ESWT治疗),对比两组患者关节功能、肌力、生活质量及并发症情况。结果:两组治疗后3、6、9个月的视觉模拟评分(VAS)评分较治疗前降低(P<0.05),髋关节Harris评分较治疗前升高(P<0.05);B组治疗后3、6、9个月VAS评分低于A组,髋关节Harris评分则高于A组(P<0.05)。两组患者治疗后9个月生理功能、情感职能、躯体疼痛、生理职能、活力、社会功能、总体健康、精神健康这8个维度评分均较治疗前升高,且B组高于A组(P<0.05)。B组患者治疗后9个月肌力3级者少于治疗前及A组同时间点,肌力4级者多于治疗前及A组同时间点(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论:相比于单独采用钻孔减压术,ESWT联合钻孔减压术治疗早期股骨头坏死,可有效减轻患者疼痛症状,改善患者关节功能、肌力及生活质量,且不增加并发症发生率。     

Neuropathic-like pain features and cross-sectional associations in rheumatoid arthritis

IntroductionIncreasing evidence indicates that features suggestive of neuropathic pain may also be present in patients with common rheumatic conditions. The objective of this study was to examine neuropathic-like pain symptoms and associated factors in patients with rheumatoid arthritis.MethodsWe used the painDETECT screening tool to identify possible or likely neuropathic pain in 159 outpatients with rheumatoid arthritis. Patients additionally completed other self-reported measures, while clinical measures were assessed to calculate the 28-joint Disease Activity Score. Univariate analyses and multivariable logistic regression were used to identify factors associated with neuropathic pain features.ResultsAccording to the painDETECT, 27 patients (17.0 %) were classified as having likely neuropathic pain and 34 patients (21.4 %) as having possible neuropathic pain. Besides reporting more severe pain, patients with likely or possible neuropathic pain were more likely to meet the diagnostic criteria for fibromyalgia, to use analgesics, and to have more tender joints and a worse physical and mental health status as measured by the 36-item Short-Form health survey. In multivariable analysis, physical (P < 0.001) and mental health status (P = 0.006) remained significantly associated with neuropathic pain features, even after controlling for pain severity.ConclusionsThese findings suggest that a sizeable proportion of patients with relatively well-controlled rheumatoid arthritis report symptoms suggestive of neuropathic pain. Neuropathic-like pain symptoms are independently associated with worse self-reported physical and mental health.