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Description of Stable Pain in Rheumatoid Arthritis:
A 6 Year Study
PATRICIA A. ROCHE, ALEXANDER C. KLESTOV, and HELEN M. HEIM
ABSTRACT.
Methods. Pain, disease activity, and functional status were assessed 3 times over 6 years in an initial cohort of 120 clinic patients with chronic pain from RA. A pain visual analog scale and the McGill Pain Questionnaire (MPQ) were used to record pain intensity and quality. RA disease activity and function were measured. Results. There was no statistically significant difference in any measure over the 3 assessments. RA pain intensity was moderate. The MPQ showed that sensory components of the pain were described in terms of pressure and constriction. Pain related affect was described with adjectives suggesting positive psychological adaptation to pain. Conclusion. The results indicate a general profile of no change in pain sensation, affect, and emotional quality in clinic monitored patients with ongoing RA and ongoing, moderate levels of disease activity and function. The MPQ provides qualitative detail to patient's report of pain severity that could be a useful addition to longterm documentation of RA outcome. Regular MPQ documentation of current pain in outpatients could indicate whether any significant change in pain levels is reflected in altered word selection that reflects physiological or psychological change, and could assist clinicians to select the most appropriate form of therapy for RA pain. (J Rheumatol 2003;30:1733-8) Key Indexing Terms:
RHEUMATOID ARTHRITIS From the Department of Physiotherapy, School of Health and Rehabilitation Science, The University of Queensland, and the Rheumatology Department, Royal Brisbane Hospital, Brisbane, Queensland, Australia. P.A. Roche, MSc, PhD, Lecturer, Department of Physiotherapy, School of Health and Rehabilitation Science, University of Queensland; A.C. Klestov, FRACP, Director, Rheumatology Department, Royal Brisbane Hospital; H.M. Heim, BA (Hons), Research Assistant, Department of Physiotherapy, School of Health and Rehabilitation Science, University of Queensland. Address reprint requests to Dr. P.A. Roche, School of Health Sciences, Queen Margaret University College, Leith, Edinburgh, Scotland EH6 8HF, UK. Submitted June 4, 2001; revision accepted January 10, 2003. |