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Poster presentations: Clinical: Therapy and Observation 2020

P715 The prevalence of chronic musculoskeletal pain in patients with ulcerative colitis in comparison to control subjects: A cross-sectional study

N. Pettersson1, F. Kragsbjerg1, A. Hamrin2, H. Forsblad-D′elia3, P. Karling1

1Department of Public Health and Clinical Medicine- Umeå University, Medicine, Umeå, Sweden, 2Region Västernorrland, Medicine, Sundsvall, Sweden, 3Department of Public Health and Clinical medicine- Umeå University, Reumatology and Medicine, Umeå, Sweden

Background

Musculoskeletal symptoms are common in patients with ulcerative colitis (UC) but there is no data on the prevalence of chronic regional pain (CRP) and chronic widespread pain (CWP) in patients with UC compared with control subjects.

Methods

From a national IBD Register (SWIBREG), all living patients with a confirmed UC diagnosis, aged 20–74 years, who were residents of two counties in Northern Sweden (n = 1164) were posted a validated questionnaire. Subjects (n = 3867) from a previous study using the same questionnaires was used as Controls (Bergman et al). The questionnaire comprises demography, history of pain and body localisation of pain. The disease activity of UC was measured by Patient- Simple Clinical Colitis Activity Index (P-SCCAI). CRP and CWP was defined as having pain for at least three months the last year. CWP was defined as having pain on both left and right side of the body and both above and below the waist, and in the axial skeleton.

Results

The response rate for the patients with UC was 43.6% and for the control subjects 62.7%. The patients were older than the control subjects (mean age 53.1 vs. 46.5 years; p < 0.001) but there was no difference in gender (men 50.7% vs. 46.7%; p = 0.108). The reported prevalence of any chronic pain, CRP and CWP was higher in patients with UC vs. controls (53.9% vs. 39.5%; p < 0.001; 33.5% vs. 24.2%; p < 0.001 and 19.7% vs. 12.5%; p < 0.001). The differences for reported chronic pain (any pain) was seen in all age groups. The patients with UC reported significant more pain in the regions ‘lower back’, ‘hip/upper leg’ and ‘lower leg/foot compared with controls (Table). The patients with P-SSCAI >5 (n = 110) reported more CWP than patients with P-SSCAI <5 (n = 411) (48.2% vs. 12.1%; p < 0.001) and controls (48.2% vs. 12.5%; p < 0.001) with significant differences for all body regions but there was no difference in CWP between patients with P-SSCAI <5 and controls (12.1% vs. 12.5%; p = 0.852). There was a slightly higher prevalence of reported ‘any chronic pain’ between patients with P-SSCAI <5 and controls (46.8% vs. 39.5%; p = 0.007).

Reported chronic musculoskeletal pain for different body regionsUC patients (n = 507)Controls (n = 2425)p-value
Anterior chest32 (6.3%)115 (4.7%)0.141
Neck111 (21.9%)460 (19.0%)0.130
Dorsal chest58 (11.4%)236 (9.7%)0.242
Lower back155 (30.5%)557 (23.0%)<0.001
Shoulder/upper arm115 (22.6%)482 (20.0%)0.154
Elbow/lower arm/hand92 (18.1%)405 (16.7%)0.430
Hip/upper leg128 (25.2%)319 (13.1%)<0.001
Knee87 (17.1%)335 (13.8%)0.050
Lower leg/foot92 (18.1%)300 (12.4%)<0.001

Conclusion

Patients with UC reported more chronic pain than control subjects, especially from the lower back and hip region. Disease activity was associated with more pain included all body regions.