Comparative analysis of centrally mediated and inflammatory pain experiences amongst patients diagnosed with rheumatoid arthritis: A multimethods study
Abstract Background The identification of pain originating from distinct biological processes may lead to individualised pain treatment. In this study, we aimed to explore the pain experiences of patients with rheumatoid arthritis (RA), differentiating between those predominantly exhibiting features...
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Wiley
2024-06-01
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| Series: | Health Expectations |
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| Online Access: | https://doi.org/10.1111/hex.14090 |
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| author | Zoe Rutter‐Locher Tom Esterine Ruth Williams Leonie S. Taams Kirsty Bannister Bruce W. Kirkham Heidi Lempp |
| author_facet | Zoe Rutter‐Locher Tom Esterine Ruth Williams Leonie S. Taams Kirsty Bannister Bruce W. Kirkham Heidi Lempp |
| author_sort | Zoe Rutter‐Locher |
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| description | Abstract Background The identification of pain originating from distinct biological processes may lead to individualised pain treatment. In this study, we aimed to explore the pain experiences of patients with rheumatoid arthritis (RA), differentiating between those predominantly exhibiting features of peripheral inflammatory versus centrally mediated pain. Methods Through a multimethods approach we (i) quantitatively analysed the differences in pain descriptors between patients diagnosed with RA experiencing peripheral inflammatory and centrally mediated pain, utilising the Short Form‐McGill Pain Questionnaire which includes the pain visual analogue scale (VAS) and (ii) qualitatively explored their subjective pain experiences grounded in the biopsychosocial model, commonly applied in chronic pain. Results Participants with centrally mediated pain reported higher pain scores on the VAS, used a wider range of pain descriptors, and a higher proportion selected each descriptor compared to those with inflammatory pain (p < .001). The qualitative analysis revealed the centrally mediated pain group's experiences were overwhelming and relentless, struggling to precisely articulate the nature of their pain. In contrast, individuals with inflammatory pain expressed their pain in more tangible terms and shared their adaptive and coping strategies. Importantly, both groups revealed the substantial psychological, functional and social impacts of their pain, highlighting the often ‘invisible’ and misunderstood nature of their symptoms. Conclusion This study has gained a deeper insight into the pain experiences of patients living with RA, particularly in differentiating between centrally mediated and inflammatory types of pain, potentially facilitating a more individualised approach to pain treatment. Patient Contribution Patients actively participated in the study conception and design. This engagement includes collaboration with key stakeholders, such as members of the National Rheumatoid Arthritis Society and Patient Research Partners (PRPs), who provided continuous feedback and guidance throughout the research process. Specifically, the qualitative element was coproduced with two PRPs, who were involved in co‐leading the focus groups and data analysis. |
| format | Article |
| id | doaj-art-e96a65cb53fc4d8f9c3c0f2c0538b3bf |
| institution | Kabale University |
| issn | 1369-6513 1369-7625 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Wiley |
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| series | Health Expectations |
| spelling | doaj-art-e96a65cb53fc4d8f9c3c0f2c0538b3bf2025-08-20T03:47:21ZengWileyHealth Expectations1369-65131369-76252024-06-01273n/an/a10.1111/hex.14090Comparative analysis of centrally mediated and inflammatory pain experiences amongst patients diagnosed with rheumatoid arthritis: A multimethods studyZoe Rutter‐Locher0Tom Esterine1Ruth Williams2Leonie S. Taams3Kirsty Bannister4Bruce W. Kirkham5Heidi Lempp6Rheumatology Department Guy's and St Thomas' NHS Trust London UKDepartment of Inflammation Biology, Centre for Rheumatic Diseases, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences King's College London London UKDepartment of Inflammation Biology, Centre for Rheumatic Diseases, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences King's College London London UKDepartment of Inflammation Biology, Centre for Inflammation Biology and Cancer Immunology, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences King's College London London UKCentral modulation of pain group, Wolfson Centre for Age‐Related Diseases, Guy's Campus King's College London London UKRheumatology Department Guy's and St Thomas' NHS Trust London UKDepartment of Inflammation Biology, Centre for Rheumatic Diseases, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences King's College London London UKAbstract Background The identification of pain originating from distinct biological processes may lead to individualised pain treatment. In this study, we aimed to explore the pain experiences of patients with rheumatoid arthritis (RA), differentiating between those predominantly exhibiting features of peripheral inflammatory versus centrally mediated pain. Methods Through a multimethods approach we (i) quantitatively analysed the differences in pain descriptors between patients diagnosed with RA experiencing peripheral inflammatory and centrally mediated pain, utilising the Short Form‐McGill Pain Questionnaire which includes the pain visual analogue scale (VAS) and (ii) qualitatively explored their subjective pain experiences grounded in the biopsychosocial model, commonly applied in chronic pain. Results Participants with centrally mediated pain reported higher pain scores on the VAS, used a wider range of pain descriptors, and a higher proportion selected each descriptor compared to those with inflammatory pain (p < .001). The qualitative analysis revealed the centrally mediated pain group's experiences were overwhelming and relentless, struggling to precisely articulate the nature of their pain. In contrast, individuals with inflammatory pain expressed their pain in more tangible terms and shared their adaptive and coping strategies. Importantly, both groups revealed the substantial psychological, functional and social impacts of their pain, highlighting the often ‘invisible’ and misunderstood nature of their symptoms. Conclusion This study has gained a deeper insight into the pain experiences of patients living with RA, particularly in differentiating between centrally mediated and inflammatory types of pain, potentially facilitating a more individualised approach to pain treatment. Patient Contribution Patients actively participated in the study conception and design. This engagement includes collaboration with key stakeholders, such as members of the National Rheumatoid Arthritis Society and Patient Research Partners (PRPs), who provided continuous feedback and guidance throughout the research process. Specifically, the qualitative element was coproduced with two PRPs, who were involved in co‐leading the focus groups and data analysis.https://doi.org/10.1111/hex.14090chronic painmultiresearch methods patient involvementrheumatology |
| spellingShingle | Zoe Rutter‐Locher Tom Esterine Ruth Williams Leonie S. Taams Kirsty Bannister Bruce W. Kirkham Heidi Lempp Comparative analysis of centrally mediated and inflammatory pain experiences amongst patients diagnosed with rheumatoid arthritis: A multimethods study Health Expectations chronic pain multiresearch methods patient involvement rheumatology |
| title | Comparative analysis of centrally mediated and inflammatory pain experiences amongst patients diagnosed with rheumatoid arthritis: A multimethods study |
| title_full | Comparative analysis of centrally mediated and inflammatory pain experiences amongst patients diagnosed with rheumatoid arthritis: A multimethods study |
| title_fullStr | Comparative analysis of centrally mediated and inflammatory pain experiences amongst patients diagnosed with rheumatoid arthritis: A multimethods study |
| title_full_unstemmed | Comparative analysis of centrally mediated and inflammatory pain experiences amongst patients diagnosed with rheumatoid arthritis: A multimethods study |
| title_short | Comparative analysis of centrally mediated and inflammatory pain experiences amongst patients diagnosed with rheumatoid arthritis: A multimethods study |
| title_sort | comparative analysis of centrally mediated and inflammatory pain experiences amongst patients diagnosed with rheumatoid arthritis a multimethods study |
| topic | chronic pain multiresearch methods patient involvement rheumatology |
| url | https://doi.org/10.1111/hex.14090 |
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