Neuropathic Spinal Pain Descriptors in Ankylosing Spondylitis

Study Overview
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Brief Summary
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The investigators have aimed to explore and interpret the neuropathic pain (NP) descriptors of spinal pain in patients with ankylosing spondylitis (AS). For this purpose they have attempted to initiate a prospective, cross-sectional study with AS patients.

Detailed Description
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NP descriptors have been investigated in several pain syndromes such as post-herpetic neuralgia, post-surgical nerve trauma, peripheral diabetic neuropathy and low back pain. But there is no study examining descriptors of inflammatory spinal pain with or without neuropathic characteristics seen in AS. To date, only one study reported distribution of sensory descriptors in neuropathic and non-neuropathic pain (nonNP) in AS patients, but in this paper the painful region was not specified and the results related to sensory descriptors were not discussed. Therefore, investigators have aimed to explore and interpret the sensory descriptors of inflammatory spinal pain in patients with AS. For this purpose investigators have attempted to initiate a study investigating whether sensory descriptors in neuropathic pain (NP) are differ from those seen in non-neuropathic pain (nonNP). The aims of this study are; To determine NP descriptors that associated with spinal pain in ankylosing spondylitis patients To compare the patients with and without NP with respect to sensory descriptors To evaluate the relation between neuropathic pain (NP) descriptors and functional status

Official Title
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Descriptors of Neuropathic Spinal Pain and Their Relations With Functional Status in Ankylosing Spondylitis Patients

Conditions
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Ankylosing Spondylitis

Intervention / Treatment
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* Other: questionnaires and inventories


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being diagnosed with AS according to the Modified NewYork Criteria Visual Analogue Scale spinal pain score ≥ 3 Exclusion Criteria: Diabetes mellitus, renal insufficiency, hypothyroidism Postherpetic neuralgia, spinal cord compression Being diagnosed as fibromyalgia in the last month or widespread pain indicating fibromyalgia Malignancy Pregnancy Severe cardiac disease In the last three months medical treatment leading to neuropathy (colchicine etc.) In the last three months drug use for the treatment of fibromyalgia, depression or anxiety

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: questionnaires and inventories|questionnaires and inventories related to primary end secondary outcomes will be applied and physical examination will be performed|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neuropathic pain | It will be assessed using the painDETECT questionnaire. This questionnaire, contains nine questions all of which are selfreport. Seven items are rated on a six point Likert scale and thus are scored between 0-5. These seven questions query some sensations such as burning, tingling or prickling, allodynia, numbness etc. Apart from these seven items, one item assesses the radiation of pain and the other one item looks for the temporal characteristics of pain. A total score of 12 or less indicates neuropathic component is unlikely, 13-18 means possible neuropathic component and 19 or greater means a neuropathic component is likely. Beside these, there are three items in a separate section measuring severity of pain at the time of evaluation, on average and maximum over the past month. This section is not taken into account in scoring. | Once, at baseline | 
| Neuropathic pain descriptors | In the painDETECT questionnaire, seven items querying sensory abnormalities are scored between 0-5. Each of these abnormal sensations represent a pain descriptor. These descriptors are; burning, tingling, allodynia, pain attacks, thermal hyperalgesia, numbness and pressure hyperalgesia. A descriptor will accepted as positive if it is scored between 3 to 5 | Once, at baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional status | To measure functional status of patients, Bath Ankylosing Spondylitis Functional Index will be used. It is a 10 item questionnaire querying patients' ability in performing daily activities (such as dressing, bending forward, climbing stairs, reaching a shelf, etc.) on a line of 10 centimeters. The final score is the average of the items, between 0 (no limitation) to 10 (maximal limitation in function). | Once, at baseline |