Established rheumatoid arthritis (RA) pain, a severe arthritic condition is conventionally associated with peripheral inflammation of the joints. However, it is related to early RA as well. The answer to this question is explained in the following study.

Neuropathic pain (NeP) shows significant association with established rheumatoid arthritis (RA) and affects the disease remission. However, during early RA stage, the effects of NeP was not investigated and therefore to evaluate the association between both, this study was conducted.

The patients with slightly or highly active early RA with the >11score on the Simplified Disease Activity Index were selected. Patients were analysed for 36-item Short Form Health Survey, EuroQoL-5 dimensions (EQ-5D) and painDETECT questionnaire (PDQ). Modified Rheumatic Disease Comorbidity Index (mRDCI) was used to assess the co-morbidity data associated with early RA stage. The presence NeP in every individual was noticed after the six months follow-up. Boolean remission criteria were also fulfilled.

A total of 115 patients whose PDQ scores showed 13% NeP probability had completed the analysis. Twenty-five patients until the end of the follow-up met the Boolean remission criteria. Baseline mRDCI (p=0.0054) and PDQ scores (p=0.0023) were the strongest predictors according to the logistic regression analysis. The ratio of patients who achieved Boolean remission was only one in fifteen patients with concomitant NeP.

The remission of early RA can be affected by the presence of NeP. The perfect tool to measure central pain sensitisation among these patients was found to be PDQ.