Overlapping Chronic Pain Conditions ‘Strikingly Common’ Among Rheumatology Patients

More than half of patients with rheumatoid arthritis, Sjögren syndrome, and systemic lupus erythematosus had a concomitant diagnosis of a chronic overlapping pain condition, according to a single-institution study published in ACR Open Rheumatology.

“Our findings suggest that chronic overlapping pain conditions are strikingly common among patients with rheumatic disease and are associated with lower quality of life and greater health care needs,” wrote a research team from Stanford University School of Medicine in California.

The retrospective study included 5992 patients who visited rheumatology clinics at a single academic medical center in Northern California between 2010 and 2020 for 5 common rheumatic conditions. Among the patients, 846 had psoriatic arthritis, 2605 had rheumatoid arthritis, 956 had Sjögren syndrome, 975 had systemic lupus erythematosus, and 610 had systemic sclerosis.

Overall, between 36% and 62% of patients had a concomitant diagnosis of a chronic overlapping pain condition. The highest prevalence was among patients with Sjögren syndrome: 62%. Additionally, approximately 44% of patients with psoriatic arthritis and 36% of patients with systemic sclerosis also had chronic overlapping pain conditions, according to the study.

Having a diagnosis of 1 or more chronic overlapping pain conditions was highest among Black patients and lowest among Asian patients, researchers reported. Public insurance was also associated with an increased prevalence compared with private insurance.

Patients with chronic overlapping pain conditions had more than double the prevalence of anxiety, depression, mood disorders, and substance/alcohol use disorders compared with patients without chronic pain diagnoses, the study found. Visits to the emergency department, hospitalizations, and surgeries were also higher among those with chronic pain.

“Specifically, it appears that individuals with chronic overlapping pain conditions had complex and/or more debilitating clinical and mental health profiles and treatment needs. These findings are consistent with previous studies suggesting that individuals with multimorbidity are more vulnerable, have lower quality of life, and use health care resources more frequently than patients without multimorbidity,” researchers wrote. “However, we found that only 18% to 29% of these patients received specialty pain clinic care.”

—Jolynn Tumolo

Reference:
Falasinnu T, Nguyen T, Jiang TE, et al. The problem of pain in rheumatology: clinical profiles associated with concomitant diagnoses with chronic overlapping pain conditions. ACR Open Rheumatol. 2022;4(10):890-896. doi:10.1002/acr2.11488