Comprehensive analysis of pain syndrome in patients with rheumatoid arthritis

Authors

  • I.M. Grygus National university of water and environmental engineering, department of medical and biological disciplines, Soborna str., 11, Rivne, 33028, Ukraine https://orcid.org/0000-0003-2856-8514
  • A.O. Nogas National university of water and environmental engineering, department of medical and biological disciplines, Soborna str., 11, Rivne, 33028, Ukraine https://orcid.org/0000-0003-1287-9828

DOI:

https://doi.org/10.26641/2307-0404.2023.1.276049

Keywords:

rheumatoid arthritis, pain syndrome, morning stiffness, visual analog scale

Abstract

Rheumatoid arthritis is a chronic systemic disease of connective tissue of immune genesis and unknown etiology. In the developed countries of the world, about 1 in 100 people suffer from rheumatoid arthritis, while in Ukraine the occurrence of the disease is 340 cases per 100,000 adult population. Chronic pain syndrome and limitation of joint functions significantly reduce the life quality of patients. At this stage, along with drug therapy, physical rehabilitation / therapy plays an important role in the restorative treatment of patients with rheumatoid arthritis. The purpose of the study is a comprehensive assessment of the main indicators of pain syndrome and morning stiffness of joints in patients with rheumatoid arthritis. 216 patients with rheumatoid arthritis were examined: 178 (82%) of them were women, 38 (18%) were men. The age of the patients is from 25 to 59 (average age is 46±0,24). The diagnosis was established on the basis of the ACR/EULAR 2010 criteria and in accordance with the Order of the Ministry of Health of Ukraine No. 263 dated November 04, 2014. A comprehensive analysis of the pain syndrome in patients with rheumatoid arthritis was carried out. Pain and severity of morning stiffness in the joints were determined using Huskisson’s visual analog scale (VAS, 100 mm). Statistical analysis was performed on the basis of the statistical analysis Statistica 10 (Serial Number: STA999K347150-W) and MEDCALC®. It was found that pain of low intensity was observed in 62 (28,7%), pain of medium intensity – in 120 (55,6%), and maximum intensity pain was experienced by 34 (15,7%) patients. It was found that in women with rheumatoid arthritis of radiological stage I, the average morning stiffness index according to VAS (100 mm) is 46,1±7,3, in men – 45,3±4,8; in women of radiological stage II, the average indicator is 52,6±7,9, in men – 50,3±6,1; in women of radiological stage III, the average indicator is 66,8±5,9, in men – 63,6±1,7. The analysis of the indicators showed that the severity of morning stiffness is more pronounced in women of all radiological stages than in men. All the above determines an urgent need to develop and implement in practice the concept of physical therapy for patients with rheumatoid arthritis in order to reduce the pain syndrome, severity of rheumatoid arthritis, eliminate morning stiffness, improve the functional condition and restore the motor functions of the joints, improve the health and quality of life of patients.

References

Vizir VA, Buriak VV, Sholokh SH, Zaika IV, Shkolovyi VV. [Basics of diagnosis, treatment and prevention of diseases of the musculoskeletal system and connective tissue]. Zaporizhzhia: ZDMU; 2021. Ukrainian. Available from: http://dspace.zsmu.edu.ua/handle/123456789/9603

Kononenko NM, Chikitkina VV. [Basic Methods of Physical Rehabilitation of Patients with Rheumatoid Arthritis]. Ukrainskyi zhurnal medytsyny, biolohii ta sportu. 2022;7,4(38):19-24. Ukrainian. doi: https://doi.org/10.26693/jmbs07.04.019

Kuriata OV, Sirenko OIu, Lysunets TK. [Joint pain in rheumatology patients: the role of anxiety-depressive disorders]. Ukrainian Journal of Rheumatology. 2017;2(68):52-7. Ukrainian. Available from: https://www.rheumatology.kiev.ua/article/10099/bil-u-suglobax-u-xvorix-revmatologichnogo-profilyu-rol-kontrolyu-trivozhno-depresivnix-rozladiv

[World Health Organization. International clas-sification of functioning, limitations of vital activity and health]. Kyiv; 2018. 1048 p. Ukrainian.

[Rheumatoid arthritis adapted evidence-based clinical guideline. Order of the Ministry of Health of Ukraine No. 263 of 11 April 2014]. Ukrainian.

Nogas AO. Karpinskyi AIu. [Motor activity in physical rehabilitation of patients with rheumatoid arthritis. Youth scientific bulletin of Lesya Ukrainka East European National University]. Fizychne vykhovannia i sport. 2017;1(37):130-5. Ukrainian.

Nogas A, Grygus I, Prymachok L. Application physiotherapy in rehabilitation rheumatoid arthritis. Journal of Education, Health and Sport. 2016;6(11):184-94. doi: https://doi.org/10.5281/zenodo.166045

Ponyk RM, Korytko ZI. [Disease and peculiarities of rehabilitation of patients with rheumatoid arthritis in the present time]. Zdobutky klinichnoi i eksperymentalnoi medytsyny. 2019;3:183-7. Ukrainian. doi: https://doi.org/10.11603/1811-2471.2019.v.i3.10504

Grygus I, Nogas A. [Recourses use modern aspects of physical rehabilitation of patients with rheumatoid arthritis. In: Pop T, editor. Research in rehabilitation]. Rzeszów: Wydawnictwo Uniwersytetu Rzeszowskiego; 2014. р. 80-87. Polish.

Grygus I, Nogas A. Improvement of Life Quality of the Patients with Rheumatoid Arthritis with Help of Physical Activity. Journal of Health Sciences. 2013;3(1):97-104.

Boers M. Patient global assessment to define remission in rheumatoid arthritis: quo vadis? Ann Rheum Dis. 2021;80:277-9. doi: 10.1136/annrheumdis-2020-218802

Hawker GA, Mian S, Kendzerska T, French M. Measures of Adult Pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care & Research. 2011;63(Suppl 11):S240-52. doi: https://doi.org/10.1002/acr.20543

Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2021;73:1108-23. doi: https://doi.org/10.1002/acr.24596

Smolen JS, Landewe RB, Bijlsma JW, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020;79:685-99. doi: https://doi.org/10.1136/annrheumdis-2019-216655

Studenic P, Aletaha D, de Wit M, Stamm TA, Alas¬ti F, Lacaille D, et al. American College of Rheumatology/EULAR Remission Criteria for Rheumatoid Arthritis: 2022 Revision. Arthritis & Rheumatology. 2022;2022:1-8. doi: https://doi.org/10.1002/art.42347

Published

2023-03-30

How to Cite

1.
Grygus I, Nogas A. Comprehensive analysis of pain syndrome in patients with rheumatoid arthritis. Med. perspekt. [Internet]. 2023Mar.30 [cited 2024Dec.22];28(1):148-52. Available from: https://journals.uran.ua/index.php/2307-0404/article/view/276049

Issue

Section

CLINICAL MEDICINE