Pain interference, neuropathic-like symptoms, pain intensity, and symptoms of central sensitization negatively impact individual’s disability after Chikungunya fever: cross-sectional study

Dias, Paula Renata Conceição de Oliveira; Bittencourt, Juliana Valentim; Rio, Jéssica Pinto Martins do; Reis, Felipe José Jandre dos; Oliveira, Laura Alice Santos de; Nogueira, Leandro Alberto Calazans

doi:10.5935/2595-0118.20230032-en

Brasil

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ORIGINAL ARTICLE • BrJP 6 (2) • Apr-Jun 2023 • https://doi.org/10.5935/2595-0118.20230032-en linkcopy

Pain interference, neuropathic-like symptoms, pain intensity, and symptoms of central sensitization negatively impact individual’s disability after Chikungunya fever: cross-sectional study

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HIGHLIGHTS

Chikungunya fever patients had mild pain intensity and disability.
One in three patients showed signs and symptoms of central sensitization.
The level of disability was associated with the interference of pain and neuropathic or central symptoms.

ABSTRACT

BACKGROUND AND OBJECTIVES: Particular pain features, such as pain interference, neuropathic-like symptoms, and central sensitization (CS) symptoms may be present in patients with Chikungunya fever and lead to functional limitations. The present study aimed to assess the association between pain characteristics and the disability in participants affected by Chikungunya fever in the chronic phase.

METHODS: A cross-sectional study was conducted with 36 participants who filled out a sociodemographic, pain characteristics (pain interference - Brief Pain Inventory, neuropathic-like symptoms - PainDETECT Questionnaire, and CS-related signs and symptoms - Central Sensitization Inventory) and disability (Health Assessment Questionnaire) questionnaires. The Spearman correlation test (rho) verified the relationship between the outcomes.

RESULTS: Most of the participants were female (77%), with a mean age of 43 years. Twenty-seven (75%) participants presented nociceptive pain and 11 (30%) had central sensitization symptoms. There was a high positive correlation between the presence of neuropathic-like symptoms and disability (rho=0.71; p<0.001) and pain intensity and disability (rho=0.76; p<0.001). A moderate positive correlation was found between the central sensitization symptoms and disability (rho=0.51; p=0.002). Moreover, there is a low positive correlation between pain interference in an individual’s life and disability (rho=0.34; p=0.041).

CONCLUSION: Patients in chronic phase of Chikungunya fever revealed mild pain intensity and predominance of nociceptive pain. Pain interference, neuropathic-like symptoms, and central sensitization symptoms negatively impact individual’s disability after Chikungunya fever.

Keywords: Chikungunya virus; Chronic pain; Correlation study; Disability; Pain measurement

	Value (n= 36)
Gender (female), n (%)	28 (77.7%)
Age (years), mean (SD)	43.5±12.5
Weight (kg), mean (SD)	71.1±21.8
Height (meters), mean (SD)	1.64±0.1
Body mass index (kg/m²), mean (SD)	26.01±7.3
Physical activity practice, yes, n (%)	19±52.7
Clinical diagnosis n (%)	25 (69.4%)
Laboratorial diagnosis n (%)	11 (30.5%)

Characteristics	Value (n= 36)
Pain intensity, median (IQR)	3.0 (4.0)
Pain interference (0-70), median (IQR)	24.0 (31.8)
General activities	3.0 (4.0)
Mood	3.0 (4.3)
Walking ability	3.0 (5.0)
Normal work	3.5 (5.3)
Relations with other people	3.0 (4.0)
Sleep	3.0 (5.0)
Enjoyment of life	2.0 (6.0)
Pain location, n (%)
Head	9 (25.0%)
Neck	8 (22.2%)
Upper back	6 (16.6%)
Low back	5 (13.8%)
PainDETECT, median (IQR)	7.5 (9.5)
Central Sensitization Inventory (CSI), median (IQR)	30.5 (25.0)
Health Assessment Questionnaire (HAQ), median (IQR)	0.3 (1.2)
Dressing, median (IQR)	0.0 (1.0)
Getting up, median (IQR)	0.0 (2.0)
Eating, median (IQR)	0.0 (0.0)
Walking, median (IQR)	0.0 (1.0)
Hygiene, median (IQR)	0.0 (1.0)
Reaching, median (IQR)	0.5 (2.0)
Gripping, median (IQR)	0.0 (2.0)
Other activities, median (IQR)	0.5 (1.3)

Variables	HAQ
	rho (95% CI)	p-value
Pain intensity (BPI)	0.76 (0.57-0.87)	<0.001
Pain interference (BPI)	0.34 (0.02-0.60)	0.041
Neuropathic-like symptoms (PainDETECT)	0.71 (0.50-0.84)	<0.001
Central Sensitization Inventory (CSI)	0.51 (0.22-0.72)	0.002

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