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Incidence of chronic back pain the same between RA patients and general population

Almost three out of five people reporting chronic back pain at baseline still had it after 5 years of follow-up.

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BRUSSELS — Cervical spine disorders and back pain have long been linked to rheumatoid arthritis. But a group of Finnish spine researchers has just reported that chronic back pain instead occurs in these patients at the same rate seen for the general population.

In one of the first investigations to compare the prevalence of back pain between patients with rheumatoid arthritis (RA) and those in the general community, researchers from Tampere and Jyvaskyla, Finland, mailed an identical questionnaire to 1,495 RA patients and to 2,000 community control subjects throughout central Finland.

Researchers identified RA patients from the Central Finland RA Database, which includes information on all adult patients with RA from the Central Finland Health Care District. They randomly selected control patients from the Finnish Population Registry.

Investigators mailed similar questionnaires to the same subjects 5 years later, said Maiko Neva, MD, who presented the results at the 9th Annual Meeting of the Spine Society of Europe, here. Patients responded with a "yes" or "no" as to whether they experienced chronic back pain.

A total of 1,076 RA patients and 1,491 controls responded to the questionnaire. Of these, 205 RA patients (19%) and 367 (25%) controls reported chronic back pain (P=.001). After 5 years, 57% of RA patients who reported chronic back pain at baseline and 58% of controls still reported experiencing chronic back pain.

"We found that chronic pain is not more common in RA patients than in the general population, which is contrary to what many of us first assumed," Neva said.

However, general pain and global health scores were similar between RA patients who did not have chronic back pain and among community controls who did report having such pain. The level of disability in patients with RA "is worse than the disability caused by chronic back pain in patients without RA," Neva said.

Not surprisingly, patients who had RA as well as chronic back pain reported the greatest disability, most general pain and had the poorest global health scores, he noted.

Neva suggested that a few factors may impact the findings. Some RA patients might be on medications for their RA, which could mask some back pain. Likewise, some patients with longstanding RA might be "accustomed to living with aches and pains" and might downplay their chronic back pain, Neva added.

For more information:

• Neva MH, Haikkinen A, Isomaki P, Sokka T. Chronic back pain in patients with rheumatoid arthritis and in control population: prevalence and disability. A 5-year follow-up. #27. Presented at the 9th Annual Meeting of the Spine Society of Europe. Oct. 2-6, 2007. Brussels.