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46. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 32. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

19.09. - 22.09.2018, Mannheim

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Patients with chronic back pain independent of underlying condition are at an increased risk to develop signs of depression and reduced quality of life

Meeting Abstract

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  • Natalie Frede - Klinik für Rheumatologie und Klinische Immunologie, Universitätsklinikum Freiburg, Freiburg; Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg
  • Georg Herget - Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Freiburg; Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg
  • Dominique Endres - Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg; Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg
  • Ludger Tebartz van Elst - Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg; Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg
  • Cornelia Glaser - Klinik für Rheumatologie und Klinische Immunologie, Universitätsklinikum Freiburg, Freiburg
  • Stephanie Finzel - Klinik für Rheumatologie und Klinische Immunologie, Universitätsklinikum Freiburg, Freiburg; Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg
  • Reinhard Voll - Klinik für Rheumatologie und Klinische Immunologie, Universitätsklinikum Freiburg, Freiburg; Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg
  • Jens Thiel - Klinik für Rheumatologie und Klinische Immunologie, Universitätsklinikum Freiburg, Freiburg; Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg
  • Nils Venhoff - Klinik für Rheumatologie und Klinische Immunologie, Universitätsklinikum Freiburg, Freiburg; Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg

Deutsche Gesellschaft für Rheumatologie. Deutsche Gesellschaft für Orthopädische Rheumatologie. Gesellschaft für Kinder- und Jugendrheumatologie. 46. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 32. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh), Wissenschaftliche Herbsttagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR). Mannheim, 19.-22.09.2018. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocSpA.32

doi: 10.3205/18dgrh169, urn:nbn:de:0183-18dgrh1696

Veröffentlicht: 5. Februar 2019

© 2019 Frede et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Background: Ankylosing spondylitis (AS) constitutes one of the most common inflammatory rheumatic disorders with an estimated prevalence of up to 0.5% in Germany. The disease is characterized by inflammatory back pain as well as inflammation of mainly axial but also peripheral joints, leading to an irreversible destruction and bony fusion if left untreated. Extraarticular manifestations such as uveitis, enthesitis/tendinitis and dactylitis contribute to morbidity.

Methods: A questionnaire-based screening tool is used to screen patients presenting with chronic back pain as well as confirmed AS to assess for signs of inflammatory back pain, function and quality of life (MAIL-Scale, Inflammatory back pain, BASDAI, BASFI, FFbH, WHOQOL-BREF, Phq9, GHQ-12).

Results: We have assessed 100 patients with chronic back pain as well as 100 patients with confirmed ankylosing spondylitis for signs of arthritis, depression and quality of life. The majority of patients presenting with chronic back pain exhibited characteristics of both, mechanical and inflammatory back pain (74%) in the MAIL Scale questionnaire. Only 12% of patients had purely inflammatory pain, whereas 14% of patients had solely mechanical back pain. A third of all questioned chronic back pain patients reported significant functional impairment through their back pain (FFbH <60%) regardless of the pain character compared to 11% of patients with confirmed AS, who are seen on a regular basis in the rheumatology outpatient clinic. Self-reported quality of life was reduced for both, chronic back pain as well as ankylosing spondylitis regarding the domains physical health and psychological wellbeing in the WHOQOL-BREF questionnaire when compared to healthy donors. There were no significant differences between patients with inflammatory or mechanical back pain for the domains physical health, psychological wellbeing as well as social relationships. However, AS patients had a significantly higher score than chronic back pain patients in the environmental health domain. 24, respectively 25%, of patients with chronic back pain or AS showed moderate or severe symptoms of depression when assessed by Phq9. There were no significant differences between patients with inflammatory or mechanical back pain.

Conclusion: These results suggest that chronic back pain is associated with a high morbidity and reduced quality of life regardless of the pain character (inflammatory vs. mechanical). Chronic back pain patients have a significantly reduced environmental health score when compared to ankylosing spondylitis patients, which may be associated with a lower social status of chronic back pain patients.