ABSTRACT
Aim: To assess the prevalence of neuropathic pain (NP) in patients with sciatica and to determine the associated factors with increased incidence of neuropathic component in sciatica. Methods: A cross-sectional study enrolled 80 patients with sciatica from a rheumatology outpatient Hospital. Pain severity was measured using the Visual Analogue Scale (VAS). The prevalence of NP was assessed according to the Douleur Neuropathique 4 (DN4). Statistical analysis was performed to find the factors closely related with NP. Results: A total of 70% of the participants were classified as having NP. The DN4 score≥4 was not significantly correlated with VAS, but was significantly associated with gender (sex ratio=0.9; p=0,013), low educational level (p=0,008), illiteracy (p=0,012), chronic disease (p=0,019) and facet joint osteoarthritis (p=0,06). In multivariate logistic regression analysis, only chronicity of the disease remained an independent factor associated with NP in sciatica (OR=5,8). Conclusion: In the present study, NP was a major contributor to sciatica and the DN4 scale was a practical and rapidly administered screening tool for distinguishing the relative contributions of neuropathic component. The knowledge of the associated factors with NP in sciatica may improve the management of NP when these factors can be modified and targeted for treatment.
ABSTRACT
Obesity is a state of chronic low-grade inflammation that predisposes people to several diseases and that is increasingly prevalent. Rheumatoid arthritis [RA] is marked by the presence of proinflammatory cytokines and, in general, the presence of high levels of inflammatory markers is associated with a severe disease course and joint damage. To assess the impact of obesity on disease activity, quality of life and articular damage in patients with established RA. Between July 2009 to December 2009, 119 RA patients were included and divided in two groups according to the body mass index [obeses and controls]. RA activity was assessed by the Disease Activity Score [DAS] 28, quality of life by the Health Assessment Questionnary [HAQ] and radiographic joint damage by the modified Sharp score. Obesity wasn't correlated with worsen RA activity [p=0.71] nor quality of life impairment [p=0.51]. The obese group had a lower modified Sharp score than the control group [64.97versus113.64; p < 0.032] and this association remained significant after adjustment for age, sex, disease activity, extraarticular manifestations, comorbidities, presence of rheumatoid factor, and disease duration. Obesity does not have an impact on disease activity nor changes in quality of life, but it has a protective effect on the amount of joint destruction in established rheumatoid arthritis