RT Journal Article
SR Electronic
T1 Part of pain labelled neuropathic in rheumatic disease might be rather nociplastic
JF RMD Open
JO RMD Open
FD EULAR
SP e001326
DO 10.1136/rmdopen-2020-001326
VO 6
IS 2
A1 Florian Bailly
A1 Alain Cantagrel
A1 Philippe Bertin
A1 Serge Perrot
A1 Thierry Thomas
A1 Thibaud Lansaman
A1 Laurent Grange
A1 Daniel Wendling
A1 Calogera Dovico
A1 Anne-Priscille Trouvin
YR 2020
UL http://rmdopen.bmj.com/content/6/2/e001326.abstract
AB Pain in rheumatic diseases is primarily due to mechanical or inflammatory mechanism, but neuropathic pain (NP) component is also occurring in many conditions and is probably underdiagnosed. The purpose of this article is to provide an overview of prevalence, pathophysiological and currently available treatment of NP in rheumatic diseases. When associated with clinical evaluation assessing neurological clinical signs and neuroanatomical distribution, Douleur Neuropathique 4 Questions, painDETECT, Leeds assessment of neuropathic symptoms and signs and Neuropathic Pain Questionnaire can detect NP component. Inflammatory or connective diseases, osteoarthritis, back pain or persistent pain after surgery are aetiologies that all may have a neuropathic component. Unlike nociceptive pain, NP does not respond to usual analgesics such as paracetamol and non-steroidal anti-inflammatory drugs. Entrapment neuropathy, peripheral neuropathy or small-fibre neuropathy are different aetiologies that can lead to NP. A part of the pain labelled neuropathic is rather nociplastic, secondary to a central sensitisation mechanism. Identifying the right component of pain (nociceptive vs neuropathic or nociplastic) could help to better manage pain in rheumatic diseases with pharmacological and non-pharmacological treatments.