Article

This research analysed general pain intensity, hand pain at rest and hand
pain during activity in women and men in early rheumatoid arhtritis (RA). Method
Out of the 454 patients that were recruited into the Swedish early RA project
"TIRA" the 373 patients (67% women) that remained at 12 months follow-up are
reported here. Disease activity 28 joint score (DAS-28), disability (Health
Assessment Questionnaire = HAQ) and pain (VAS) were recorded at inclusion and
after 3 (M3), 6 (M6) and 12 (M12) months. General pain, hand pain during rest,
hand pain during test of grip force as assessed by Grippit, prescribed
disease-modifying anti-inflammatory drugs (DMARDs) and hand dominance were
recorded. Results DAS-28 and HAQ scores were high at inclusion and improved
thereafter in both women and men. There were no significant differences between
sexes at inclusion but women had higher DAS-28 and HAQ at all follow-ups. Women
were more often prescribed DMARDs than were men. In both women and men all pain
types were significantly lower at follow-up compared to at inclusion and women
reported higher pain than men at follow-ups. The pain types differed
significantly from each other at inclusion into TIRA, general pain was highest
and hand pain during rest was lowest. There were no significant differences in
hand pain related to hand dominance or between right and left hands. Conclusions
Disease activity, disability and pain were high at inclusion and reduced over the
first year. Despite more DMARDs prescribed in women than in men, women were more
affected than were men. General pain was highest and not surprisingly hand pain
during active grip testing was higher than hand pain during rest that was lowest
in both sexes. Although our cohort was well controlled, it was evident that hand
pain remains a problem. This has implications for rehabilitation and suggests
potential ongoing activity limitations that should continue to receive attention
from a multi-professional team. Implications for Rehabilitation General pain and
hand pain remain a problem in RA despite today's early intervention and effective
disease control with new era biologics. The extent of hand pain evidenced in our
work gives a more detailed and comprehensive account of pain status. Higher hand
pain during active grip testing than that during rest indicates a potential
relationship to ongoing activity limitation. Hand pain assessment can help
guiding multi-professional interventions directed to reduce hand pain and thereby
probably reduce activity limitations.

Langue : ANGLAIS