Assessment of cervical pain and function in patients with rheumatoid arthritis

Assessment of cervical pain and function in patients with rheumatoid arthritis

Author Souza, Marcelo Cardoso de Autor UNIFESP Google Scholar
Fernandes, Eloy de Avila Autor UNIFESP Google Scholar
Jones, Anamaria Autor UNIFESP Google Scholar
Lombardi, Imperio Autor UNIFESP Google Scholar
Natour, Jamil Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Rheumatoid arthritis (RA) is characterized by inflammation of the synovial membrane, which can lead to deformities and functional disability. Unlike the dorsal and lumbar spine, the cervical spine is often affected by RA. the objective of this paper is to assess cervical pain and function in patients with RA and correlate these variables with overall function, quality of life, and radiographic findings on the cervical spine. One hundred individuals aged 18 to 65 years were divided into study group (50 patients with rheumatoid arthritis) and control group (50 healthy individuals, paired for gender and age). Patients with prior surgery, prior trauma or other symptomatic cervical spine condition were excluded. the visual analogue pain scale (VAS), Neck Pain and Disability Scale (NPDS), SF-36, HAQ and X-rays were used for evaluation purposes. Mean disease duration was 11.1 years. the cervical VAS was 2.4 cm and 1.3 cm for the study and control groups, respectively (p = 0.074). Statistical differences were found in NPDS scores, mean = 26.7 and 6.9, and HAQ scores, mean = 1.1 and 0.1, for the study and control groups, respectively (p < 0.001). SF-36 scores were statistically worse in the study group, except for the vitality, social aspects and mental health subscales. There was a positive correlation between the NPDS and VAS (r = 0.54) and between the NPDS and HAQ (r = 0.67). There was a negative correlation between the NPDS and SF-36 functional capacity domain (r = -0.53) and physical limitation domain (r = -0.58). the radiographic findings revealed more prevalent anterior atlanto-axial subluxation (p = 0.030), listhesis in neutral posture (p = 0.037), listhesis in extension (p = 0.007), degenerative alteration of C4-C5 segment (p = 0.023), size of C2 spinal canal (p = 0.002) and C3 spinal canal (p = 0.029) in the study group. Patients with RA have poorer cervical function than healthy individuals, although there is no difference in cervical pain.
Keywords Cervical spine
Function
Pain
Rheumatoid arthritis
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Date 2011-06-01
Published in Clinical Rheumatology. London: Springer London Ltd, v. 30, n. 6, p. 831-836, 2011.
ISSN 0770-3198 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 831-836
Origin http://dx.doi.org/10.1007/s10067-011-1687-4
Access rights Closed access
Type Article
Web of Science ID WOS:000290960700012
URI http://repositorio.unifesp.br/handle/11600/33743

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