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. 2025 Aug 22;45(9):205.
doi: 10.1007/s00296-025-05948-7.

Risk factors of nociplastic pain in patients with autoimmune arthritis: web-based cross-sectional survey of patients

Grzegorz Mirocha  1 , Joanna Makowska  2 , Olga Brzezińska  3
Affiliations

Risk factors of nociplastic pain in patients with autoimmune arthritis: web-based cross-sectional survey of patients

Grzegorz Mirocha et al. Rheumatol Int. .

Abstract

This study aimed to identify risk factors of nociplastic pain in patients with autoimmune arthritis. Patients suffering from chronic pain and autoimmune arthritis were invited to participate in a study via moderated support groups on social media. Each invitation included a brief description of nociplastic pain. The study cohort comprised 185 patients, primarily those with rheumatoid arthritis (64%) and spondyloarthropathies (27%). 82% of patients scored positively (≥ 40 points) on the Central Sensitization Inventory (CSI), while 57% showed a neuropathic component as indicated by the PainDetect Questionnaire (PDQ). Of the participants with a positive CSI score, 86% achieved at least a borderline grade on the PDQ. More frequent use of painkillers (> once a day) correlated with higher CSI scores (mean difference (MD) = 7.1, p = 0.039, and MD = 8, p = 0.005 compared to daily and less frequent use, respectively). In a multivariable linear regression model, factors such as depression (β = 8.7, p < 0.001), nocturnal pain (β = 4.5, p = 0.013), need for painkillers (β = 5.3, p = 0.032), disease duration > 2 years (β = 3.3, p = 0.036), Chronic Pain Grade Scale (β = 2.8, from I to IV grade, p < 0.001), and worse mood (β = -0.9, on a 0-10 scale, p = 0.031) were independently associated with higher CSI scores. Nocturnal pain and pain-related disability may serve as clinical risk factors of nociplastic pain. The PDQ may lose its reliability in detecting neuropathic pain in patients with a high nociplastic component.

Keywords: Central sensitization; Chronic pain; Nociplastic pain; Non-inflammatory pain; Psoriatic arthritis; Rheumatoid arthritis; Spondyloarthropathy; Surveys and questionnaires.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
The figure shows the distribution of CSI, PDQ, and CPGS in relation to each other. CPGS Chronic Pain Grade Scale, CSI central sensitization inventory, PDQ PainDetect Questionnaire
Fig. 2
Fig. 2
Violin plots represent differences in CSI score according to specified comorbidities or lifestyle factors; Dashed lines represent medians with IQR. The gold points represent means with 95% CI. The p-values are marked as follows: * for p < 0.05, ** for p < 0.01, *** for p < 0.001, and **** for p < 0.0001. CSI Central Sensitization Inventory, PDQ PainDetect Questionnaire
Fig. 3
Fig. 3
Violin plots represent differences in CSI score according to specific clinical features; dashed lines represent medians with IQR. The gold points represent means with 95% CI. The p-values are marked as follows: * for p < 0.05, ** for p < 0.01, *** for p < 0.001, and **** for p < 0.0001. CSI Central Sensitization Inventory, NSAIDs non-steroidal anti-inflammatory drugs, PK painkillers, PDQ PainDetect Questionnaire, W/O Without
See this image and copyright information in PMC

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