Download PDF
Aktuelle Rheumatologie 2020; 45(05): 443-452
DOI: 10.1055/a-1244-1760
Review Article

Pain and Neuropathic Pain in Rheumatic Diseases

Bedeutung des neuropathischen Schmerzes bei rheumatischen Erkrankungen
Olga Seifert
Abteilung für Rheumatologie, Medizinische Klinik III, Universitätskliniken Leipzig, Leipzig
,
Christoph Baerwald
Abteilung für Rheumatologie, Medizinische Klinik III, Universitätskliniken Leipzig, Leipzig
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Pain is a challenge to rheumatologists. Not only patients with active arthritis but also patients with a good therapeutic response and even in remission complain of persistent joint pain. It has been proposed that a chronic pain stimulus may have a greater impact in a chronic inflammatory state, and the process towards a pain condition may be influenced by individual predisposition for development of chronic pain. In addition, features of peripheral pain processing may be exacerbated by inflammation, and disturbed pain processing may be a feature contributing to widespread pain. Furthermore, a neuropathic component may be part of the total pain experience of our patients. There are many different strategies of pain therapy in patients with rheumatic diseases, such as pharmacological and non- pharmacological modalities.

Zusammenfassung

Chronische Schmerzen sind eine Herausforderung im Alltag der rheumatologischen Praxis. Nicht nur die Patienten mit aktiver rheumatischen Erkrankungen, sondern auch die Patienten in Remission leiden an Schmerzen. Entzündliche Veränderungen können die individuelle Schmerzempfindlichkeit verstärken. Störungen der peripheren Schmerzregulation führen zur Verbreitung und Verstärkung der Schmerzempfindlichkeit und können als Folge die Persistenz der Schmerzen unterstützen. Bei vielen Patienten mit rheumatischen Erkrankungen und chronischen Schmerzen spielt ein neuropathischer Schmerz eine Rolle bei der Schmerzausprägung. Pharmakologische und nicht pharmakologische Methoden stehen als therapeutische Optionen zur Verfügung.

Key words

pain - rheumatic disease - neuropathic pain

Schlüsselwörter

Schmerzen - rheumatische Erkrankungen - neuropathische Schmerzen


Publication History

Article published online:
14 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Smith BH, Fors EA, Korwisi B. et al. IASP Taskforce for the Classification of Chronic Pain. The IASP classification of chronic pain for ICD-11: applicability in primary care. Pain 2019; 160: 83-87
    CrossrefPubMedGoogle Scholar
  • 2 Trouvin AP, Perrot S. New concepts of pain. Best Pract Res Clin Rheumatol 2019; 33: 101415
    CrossrefPubMedGoogle Scholar
  • 3 Zhao SS, Duffield SJ, Goodson NJ. The prevalence and impact of comorbid fibromyalgia in inflammatory arthritis. Best Pract Res Clin Rheumatol 2019; 33: 101423
    CrossrefPubMedGoogle Scholar
  • 4 Lampa J. Pain without inflammation in rheumatic diseases. Best Pract Res Clin Rheumatol 2019; 33: 101439
    CrossrefPubMedGoogle Scholar
  • 5 Scholz J, Finnerup NB, Attal N. et al. Classification Committee of the Neuropathic Pain Special Interest Group (NeuPSIG). The IASP classification of chronic pain for ICD-11: chronic neuropathic pain. Pain 2019; 160: 53-59
    CrossrefPubMedGoogle Scholar
  • 6 Thorpe J, Shum B, Moore RA. et al. Combination pharmacotherapy for the treatment of fibromyalgia in adults. Cochrane Database Syst Rev 2018; 2: CD010585
    PubMedGoogle Scholar
  • 7 Honda Y, Sakamoto J, Hamaue Y. et al. Effects of Physical-Agent Pain Relief Modalities for Fibromyalgia Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pain Res Manag 2018; 2018: 2930632
    CrossrefPubMedGoogle Scholar
  • 8 Audede M. Does the IASP definition of pain need updating?. Pain Rep 2019; 4: e777
    CrossrefPubMedGoogle Scholar
  • 9 Williams AC, Craig KD. Updating the definition of pain. Pain 2016; 157: 2420-2423
    CrossrefPubMedGoogle Scholar
  • 10 Aydede M, Shriver A. Recently introduced definition of “nociplastic pain” by the International Association for the Study of Pain needs better formulation. Pain 2018; 159: 1176-1177
    CrossrefPubMedGoogle Scholar
  • 11 Freynhagen R, Parada HA, Calderon-Ospina CA. et al. Current understanding of the mixed pain concept: a brief narrative review. Curr Med Res Opin 2019; 35: 1011-1018
    CrossrefPubMedGoogle Scholar
  • 12 Treede RD, Rief W, Barke A. et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain 2019; 160: 19-27
    CrossrefPubMedGoogle Scholar
  • 13 Nugraha B, Gutenbrunner C, Barke A. et al. IASP Taskforce for the Classification of Chronic Pain. The IASP classification of chronic pain for ICD-11: functioning properties of chronic pain. Pain 2019; 160: 88-94
    CrossrefPubMedGoogle Scholar
  • 14 Nicholas M, Vlaeyen JWS, Rief W. et al. IASP Taskforce for the Classification of Chronic Pain. The IASP classification of chronic pain for ICD-11: chronic primary pain. Pain 2019; 160: 28-37
    CrossrefPubMedGoogle Scholar
  • 15 Perrot S, Cohen M, Barke A. et al. IASP Taskforce for the Classification of Chronic Pain. The IASP classification of chronic pain for ICD-11: chronic secondary musculoskeletal pain. Pain 2019; 160: 77-82
    CrossrefPubMedGoogle Scholar
  • 16 Scholz J, Finnerup NB, Attal N. et al. Classification Committee of the Neuropathic Pain Special Interest Group (NeuPSIG) The IASP classification of chronic pain for ICD-11: chronic neuropathic pain. Pain 2019; 160: 53-59
    CrossrefPubMedGoogle Scholar
  • 17 Bouhassira D. Neuropathic pain: Definition, assessment and epidemiology. Rev Neurol (Paris) 2019; 175: 16-25
    CrossrefPubMedGoogle Scholar
  • 18 Cavalli E, Mammana S, Nicoletti F. et al. The neuropathic pain: An overview of the current treatment and future therapeutic approaches. Int J Immunopathol Pharmacol 2019; 33: 2058738419838383
    CrossrefPubMedGoogle Scholar
  • 19 CADTH Rapid Response Reports. Diagnostic Methods for Neuropathic Pain: A Review of Diagnostic Accuracy. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2015
    Google Scholar
  • 20 Vitali C, Del Papa N. Pain in primary Sjögren’s syndrome. Best Pract Res Clin Rheumatol 2015; 29: 63-70
    CrossrefPubMedGoogle Scholar
  • 21 Calvo M, Davies AJ, Hébert HL. et al. The Genetics of Neuropathic Pain from Model Organisms to Clinical Application. Neuron 2019; 104: 637-653
    CrossrefPubMedGoogle Scholar
  • 22 Yin Y, Yi MH, Kim DW. Impaired Autophagy of GABAergic Interneurons in Neuropathic Pain. Pain Res Manag 2018; 2018: 9185368
    PubMedGoogle Scholar
  • 23 Zheng LX, Li KX, Hong FF. et al. Pain and bone damage in rheumatoid arthritis: role of leukotriene B4. Clin Exp Rheumatol 2019; 37: 872-878
    PubMedGoogle Scholar
  • 24 Malcangio M. Role of the immune system in neuropathic pain. Scand J Pain 2019; 20: 33-37
    CrossrefPubMedGoogle Scholar
  • 25 Davies AJ, Rinaldi S, Costigan M. et al. Cytotoxic Immunity in Peripheral Nerve Injury and Pain. Front Neurosci 2020; 14: 142
    CrossrefPubMedGoogle Scholar
  • 26 Sántha P, Dobos I, Kis G. et al. Role of Gangliosides in Peripheral Pain Mechanisms. Int J Mol Sci 2020; 21: pii: E1005
    CrossrefPubMedGoogle Scholar
  • 27 Mohd Noh AS, Ismail CAN. A Review on Chronic Pain in Rheumatoid Arthritis: A Focus on Activation of NR2B Subunit of N-Methyl-D-Aspartate Receptors. Malays J Med Sci 2020; 27: 6-21
    PubMedGoogle Scholar
  • 28 Ueda H. Systems Pathology of Neuropathic Pain and Fibromyalgia. Biol Pharm Bull 2019; 42: 1773-1782
    CrossrefPubMedGoogle Scholar
  • 29 Viswanath O, Urits I, Burns J. et al. Central Neuropathic Mechanisms in Pain Signaling Pathways: Current Evidence and Recommendations. Adv Ther 2020; 37: 1946-1959
    CrossrefPubMedGoogle Scholar
  • 30 Spallone V, RMorganti R, CD’Amato C. et al. Validation of DN4 as a Screening Tool for Neuropathic Pain in Painful Diabetic Polyneuropathy. Diabet Med 2012; 29: 578-585
    CrossrefPubMedGoogle Scholar
  • 31 Portenoy R. Development and testing of a neuropathic pain screening questionnaire: ID Pain. Current Medical Research and Opinion 2006; 22: 1555-1565
    CrossrefPubMedGoogle Scholar
  • 32 Bennett M. The LANSS Pain Scale: The Leeds Assessment of Neuropathic Symptoms and Signs. Clinical Trial Pain 2001; 92: 147-157
    PubMedGoogle Scholar
  • 33 Freynhagen R, Baron R, Ulrich Gockel U. et al. PainDETECT: A New Screening Questionnaire to Identify Neuropathic Components in Patients With Back Pain. Curr Med Res Opin 2006; 22: 1911-1920
    CrossrefPubMedGoogle Scholar
  • 34 Krause SJ, Backonja MM. Development of a Neuropathic Pain Questionnaire. Clin J Pain 2003; 19: 306-314
    CrossrefPubMedGoogle Scholar
  • 35 Mathieson S, Maher CG, Terwee CB. et al. Neuropathic pain screening questionnaires have limited measurement properties. A systematic review. J Clin Epidemiol 2015; 68: 957-966
    CrossrefPubMedGoogle Scholar
  • 36 Freynhagen R, Tölle TR, Gockel U. et al. The painDETECT project−far more than a screening tool on neuropathic pain. Curr Med Res Opin 2016; 32: 1033-1057
    CrossrefPubMedGoogle Scholar
  • 37 Garcia-Larrea L, Hagiwara K. Electrophysiology in diagnosis and management of neuropathic pain. Rev Neurol (Paris) 2019; 175: 26-37
    CrossrefPubMedGoogle Scholar
  • 38 Ørstavik K, Kleggetveit IP, Jørum E. Microneurography and research on peripheral neuropathic pain. Tidsskr Nor Laegeforen 2013; 133: 302-305
    CrossrefPubMedGoogle Scholar
  • 39 Gwathmey KG, Pearson KT. Diagnosis and management of sensory polyneuropathy. BMJ 2019; 365: l1108 doi:10.1136/bmj.l1108
    CrossrefPubMedGoogle Scholar
  • 40 Whittle SL, Colebatch AN, Buchbinder R. et al. Multinational evidence-based recommendations for pain management by pharmacotherapy in inflammatory arthritis: integrating systematic literature research and expert opinion of a broad panel of rheumatologists in the 3e Initiative. Rheumatology (Oxford) 2012; 51: 1416-1425
    CrossrefPubMedGoogle Scholar
  • 41 Goodman CW, Brett AS. A Clinical Overview of Off-label Use of Gabapentinoid Drugs. JAMA Intern Med 2019; 79: 695-701
    CrossrefPubMedGoogle Scholar
  • 42 Arnold LM, Choy E, Clauw DJ. et al. An evidence-based review of pregabalin for the treatment of fibromyalgia. Curr Med Res Opin 2018; 34: 1397-1409
    CrossrefPubMedGoogle Scholar
  • 43 Noori SA, Aiyer R, Yu J. et al. Nonopioid versus opioid agents for chronic neuropathic pain, rheumatoid arthritis pain, cancer pain and low back pain. Pain Manag 2019; 9: 205-216
    CrossrefPubMedGoogle Scholar
  • 44 Derry S, Phillips T, Moore RA. et al. Milnacipran for neuropathic pain in adults. Cochrane Database Syst Rev 2015; 7: CD011789
    PubMedGoogle Scholar
  • 45 Moore RA, Derry S, Aldington D. et al. Amitriptyline for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev 2012; 12: CD008242
    PubMedGoogle Scholar
  • 46 Fattori V, Zaninelli TH, Rasquel-Oliveira FS. et al. Specialized pro-resolving lipid mediators: A new class of non-immunosuppressive and non-opioid analgesic drugs. Pharmacol Res 2020; 151: 104549
    CrossrefPubMedGoogle Scholar
  • 47 Chakravarthy K, Chen Y, He C. et al. Stem Cell Therapy for Chronic Pain Management: Review of Uses, Advances, and Adverse Effects. Pain Physician 2017; 20: 293-305
    CrossrefPubMedGoogle Scholar
  • 48 Sałat K, Jakubowska A, Kulig K. Zucapsaicin for the treatment of neuropathic pain. Expert Opin Investig Drugs 2014; 23: 1433-1440
    CrossrefPubMedGoogle Scholar
  • 49 Szok D, Tajti J, Nyári A. et al. Therapeutic Approaches for Peripheral and Central Neuropathic Pain. Behav Neurol 2019; 21: 8685954
    PubMedGoogle Scholar
  • 50 Van Laake-Geelen CCM, Smeets R, Quadflieg S. et al. The effect of exercise therapy combined with psychological therapy on physical activity and quality of life in patients with painful diabetic neuropathy: a systematic review. Scand J Pain 2019; 19: 433-439
    CrossrefPubMedGoogle Scholar
  • 51 Eccleston C, Hearn L, Williams AC. Psychological therapies for the management of chronic neuropathic pain in adults. The Cochrane Database of Systematic Reviews 2015; 10: CD011259
    PubMedGoogle Scholar
  • 52 Akyuz G, Kenis O. Physical Therapy Modalities and Rehabilitation Techniques in the Management of Neuropathic Pain. Am J Phys Med Rehabil 2014; 93: 253-259
    CrossrefPubMedGoogle Scholar
  • 53 Salaffi F, Giacobazzi G, Di Carlo M. Chronic Pain in Inflammatory Arthritis: Mechanisms, Metrology, and Emerging Targets-A Focus on the JAK-STAT Pathway. Pain Res Manag 2018; 2018: 8564215
    CrossrefPubMedGoogle Scholar
  • 54 Smolen J, Landewé R, Bijlsma J. et al. EULAR Recommendations for the Management of Rheumatoid Arthritis With Synthetic and Biological Disease-Modifying Antirheumatic Drugs: 2016 Update . Ann Rheum Dis 2017; 76: 960-977
    CrossrefPubMedGoogle Scholar
  • 55 Mousa A, Bakhiet M. Role of Cytokine Signaling During Nervous System Development. Int J Mol Sci 2013; 14: 13931-14057
    CrossrefPubMedGoogle Scholar
  • 56 Alten R, Mischkewitz M, Stefanski AL. et al. Janus kinase inhibitors : State of the art in clinical use and future perspectives. Z Rheumatol 2020; 79: 241-254
    CrossrefPubMedGoogle Scholar
  • 57 Witte T. JAK Inhibitors in Rheumatology. Dtsch Med Wochenschr 2019; 144: 748-752
    Article in Thieme ConnectPubMedGoogle Scholar
  • 58 Strand V, van der Heijde D, Tanaka Y. et al. Tofacitinib in combination with methotrexate in patients with rheumatoid arthritis: patient-reported outcomes from the 24-month Phase 3 ORAL Scan study. Clin Exp Rheumatol 2019; 19. Online ahead of print
    PubMed
  • 59 Boyce EG, Vyas D, Rogan EL. et al. Impact of Tofacitinib on Patient Outcomes in Rheumatoid Arthritis−Review of Clinical Studies. Patient Relat Outcome Meas 2016; 7: 1-12
    CrossrefPubMedGoogle Scholar
  • 60 Fautrel B, Kirkham B, Pope JE. et al. Effect of Baricitinib and Adalimumab in Reducing Pain and Improving Function in Patients With Rheumatoid Arthritis in Low Disease Activity: Exploratory Analyses From RA-BEAM. J Clin Med 2019; 8: 1394
    CrossrefPubMedGoogle Scholar