OP0073 Central sensitisationpredicts fatigue independently of musculoskeletal pain. (12th June 2018)

• Record Type: Journal Article
• Authors: Druce, K.L.; McBeth, J.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 87
• Page End: 88
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.2190
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Fatigue is a common musculoskeletal (MSK) pain comorbidity that is associated with increased healthcare use and poor quality of life. Central sensitisation (CS), the amplification of sensory input across multiple systems, has been associated with MSK pain. It has been hypothesised that similar mechanisms may explain the co-occurrence of fatigue, but data are conflicting. Objectives: To test the hypothesis that CS was associated with the presence of fatigue, and to establish whether the relationship was independent of the relationship between MSK pain and fatigue. Methods: 2455 participants in a prospective cohort study completed a baseline questionnaire collecting data on fatigue (Chalder Fatigue Scale, score 0–33 (CFQ); pain (body map, score range 0–44); demographics (date of birth, sex); Rapid Assessment of Physical Activity (RAPA); analgesic use; and mental health (Hospital Anxiety and Depression (HAD) scale). During a clinic visit a random sample of participants (n=290, 11.8%) had a wind-up ratio test (the perceived intensity of a single 256mN pinprick/intensity of a series of 10 pinpricks) at the thenar eminence of the right hand (WUR-H) and dorsum of the left foot (WUR-F) to assess CS, and bioelectric impedance (Tanita BC-418 Segmental Body Composition Analyzer) to determine proportion body fat. All participants were followed up 12 months later, at which time they completed the CFQ. Linear regression, with inverse probability sampling weights, tested the relationship between WUR at baseline and CFQ at 12 months, adjusted for baseline CFQ, demographics, lifestyle factors, HAD and in a final model baseline MSK pain. Results are expressed as beta coefficients with p values. Results: The median (IQR) WUR-H and WUR-F were similar (2.4 (1.5, 3.8) and 2.5 (1.6, 4.0) respectively), did not differ by sex but were significantly lower in older people. After adjusting for age and sex, WUR-H (β=0.17, p=0.00) and WUR-F (0.18, 0.00) predicted CFQ at follow-up. In a fully adjusted model, WUR-H (Model 1: 0.13, 0.00) and WUR-F (Model 2: 0.13, 0.00) predicted CFQ at follow-up, independently of baseline MSK pain. Independent predictors of CFQ were age, MSK pain, depression, anxiety, physical activity and body fat (table 1). Conclusions: Fatigue is predicted by CS, independently of the presence of MSK pain. For those seeking to treat fatigue, the potential benefit of interventions which reduce sensitisation should be investigated. Acknowledgements: J.Anderson, M. Mulvey, A. Rashid Disclosure of Interest: None declared