Pain in systemic inflammatory rheumatic diseases

Atzeni, Fabiola; Masala, Ignazio Francesco; Salaffi, Fausto; Franco, Manuela Di; Casale, Roberto; Sarzi-Puttini, Piercarlo

doi:10.1016/j.berh.2015.04.016

Cited by 32 publications

(20 citation statements)

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“…Due to expected clinical heterogeneity between the trials, it was decided a priori to use a random-effects model for all outcomes. Heterogeneity was tested with χ 2 measured by inspection of the I2 values that describes the percentage of the variability in effect estimates that is due to heterogeneity rather than sampling error 25. An I 2 value of 0% to 40% is considered negligible, 30% to 60% represents moderate heterogeneity, 50% to 90% represents substantial heterogeneity and 75% to 100% represents considerable heterogeneity 25.…”

Section: Methodsmentioning

confidence: 99%

“…The most prominent clinical feature of IRDs is pain, which may have a central as well as peripheral origin, caused by current systemic inflammation or by joint and tissue damage due to a previous inflammatory condition 2. Disease activity in IRDs is often expressed as an index of inflammation, joint damage and symptoms like pain, stiffness and fatigue.…”

Section: Introductionmentioning

confidence: 99%

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Effect of cardiorespiratory and strength exercises on disease activity in patients with inflammatory rheumatic diseases: a systematic review and meta-analysis

et al. 2017

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Objective To investigate the effects of cardiorespiratory and strength exercises on disease activity for patients with inflammatory rheumatic diseases (IRDs). Design A systematic review with meta-analysis registered at PROSPERO (CRD42015020004). Participants Patients with IRDs. Data sources The databases MEDLINE, AMED, Embase and CINAHL were searched from inception up to April 2016. Eligibility criteria for selecting studies Trials were included if they were randomised controlled trials of adults with IRDs, comparing the effect of cardiorespiratory and strength exercises with usual care on disease activity and followed the American College of Sports Medicine's exercise recommendations. The primary outcome was disease activity in terms of inflammation, joint damage and symptoms. Data synthesis Data were pooled in a randomeffect model for all outcomes, and standardised mean differences (SMDs) were calculated. The quality of evidence was evaluated according to the Grading of Recommendations Assessment, Development and Evaluation approach. Results Twenty-six trials with a total of 1286 participants were included. There was high to moderate quality evidence, for a small beneficial effect on disease activity scores (0.19 (95% CI 0.05 to 0.33), p<0.01) and joint damage (SMD 0.27 (95% CI 0.07 to 0.46), p<0.01). Furthermore, moderate quality evidence for a small beneficial effect on erythrocyte sedimentation rate (SMD 0.20 (95% CI 0.0 to 0.39), p=0.04) and for no effect on C reactive protein (SMD −0.14 (95% CI −0.37 to 0.08), p=0.21). Beneficial effects were also seen for symptoms. Conclusions The results of this review suggest beneficial effects of exercises on inflammation, joint damage and symptoms in patients with IRDs. InTRODuCTIOnThe term inflammatory rheumatic diseases (IRDs) covers a large group of heterogeneous disorders sharing common features and clinical presentations. 1 The most prominent clinical feature of IRDs is pain, which may have a central as well as peripheral origin, caused by current systemic inflammation or by joint and tissue damage due to a previous inflammatory condition. 2 Disease activity in IRDs is often expressed as an index of inflammation, joint damage and symptoms like pain, stiffness and fatigue. Additionally, the last decade has produced evidence that patients with IRDs also have an increased risk of cardiovascular diseases (CVDs).3 The mechanisms underlying the premature CVD events in IRDs are not fully elucidated, but it is clear that the systemic inflammation, and its interaction with traditional risk factors, plays an important role. and exercises are considered an important part of the management. 6 Exercise is defined as physical activity that is planned, structured and repetitive, with a final or intermediate objective to improve or maintain physical fitness.7 Due to the clinical features of IRDs, exercises to maintain range of motion (ROM) and pain-relieving exercises in hot pools have been recommended. 6 Unfortunately, these types of exercises have no effect on cardiov...

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of cardiorespiratory and strength exercises on disease activity in patients with inflammatory rheumatic diseases: a systematic review and meta-analysis

et al. 2017

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“…Some of these could be related to another disorder with overlapping symptoms (34). Fibromyalgia patients generally use more antiinflammatory drugs for their chronic pain management (50). The use of modulating agents, including blocking production of pro-inflammatory cytokines and prostaglandins with anti-inflammatory drugs has been postulated to be of therapeutic value as an adjunctive therapy to the management of chronic periodontitis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Chronic Periodontitis, Bruxism and Temporomandibular Joint Disorders in Patients with Fibromyalgia Syndrome

Yüce¹,

Inanir²,

Göktürk³

et al. 2017

meandros

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“…They also introduced the use of patient-reported areas of "pain or tenderness" for the WPI, whereas this assessment was restricted to physicians in the ACR 2010 criteria. These changes were suggested because it had been shown that a quarter of all FM patients failed to satisfy the 1990 ACR classification criteria [6] ; however, the new criteria did not overcome this limitation as their exclusion of inflammatory and other painful disorders means that they cannot be applied in the case of patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or other similar conditions [20], [21], [22] , and do not distinguish primary and secondary FM. Furthermore, a 2010 criteria-based diagnosis requires a physician's evaluation of the extent and severity of a patient's somatic symptoms, and it is likely that the absence of the need for a physical examination will lead to possibly important physical findings and other potential causes of symptoms being overlooked [6], [7] .…”

Section: Are the 2010 Acr Criteria Better Than The 1990 Acr Criteria?mentioning

confidence: 99%

Are the ACR 2010 diagnostic criteria for fibromyalgia better than the 1990 criteria?

Sarzi‐Puttini

Atzeni

Masala

et al. 2018

Autoimmunity Reviews

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Fibromyalgia (FM) is difficult to diagnose and manage chronic pain condition whose symptoms have no clear pathophysiological cause, although it is thought that patient hypersensitivity to a range of stimuli may give rise to mechanical hyperalgesia as a result of altered central nociceptive processing. The 1990 American College of Rheumatology (ACR) classification criteria, which have been widely used in clinical practice, require the existence of chronic widespread pain (CWP) for >3months, and the presence of at least 11 out of 18 specified tender points upon digital palpation, although this latter criterion has long been criticised. The newer 2010 ACR diagnostic criteria state that FM can be defined as CWP associated with somatic symptoms, and recommend the use of a widespread pain index and a scale to rate symptom severity. A modified version of the 2010 criteria removed the physician assessment of the extent of somatic symptoms and replaced it by a summary score of three self-reported symptoms, thus making it easier to use while maintaining its sensitivity. This review discusses the advantages and limitations of all of these criteria.

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Pain in systemic inflammatory rheumatic diseases

Cited by 32 publications

References 96 publications

Effect of cardiorespiratory and strength exercises on disease activity in patients with inflammatory rheumatic diseases: a systematic review and meta-analysis

Effect of cardiorespiratory and strength exercises on disease activity in patients with inflammatory rheumatic diseases: a systematic review and meta-analysis

Prevalence of Chronic Periodontitis, Bruxism and Temporomandibular Joint Disorders in Patients with Fibromyalgia Syndrome

Are the ACR 2010 diagnostic criteria for fibromyalgia better than the 1990 criteria?

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