Authors: Nessighaoui H.
Objective: Systemic sclerosis (SSc) is one of the most common autoimmune diseases causing disability and chronic pain. Despite the fact that pain remains the major condition impacting quality of life in patients, surprisingly, it is still not well evaluated and often underestimated.
We did a systematic review to assess the effectiveness of the relationship between pain and SSc, the natural history of pain emerging in the disease and to evaluate patterns of pain incriminated in this condition.
Data Sources: A key word literature search was conducted using articles listed the last 5 years starting in 2012 until September 2017 in PubMed, Web of Science and The Cochrane Library. Manual searches were made of all retrieved articles to analyze those that met the review inclusion criteria.
Study Selection: To be included in the review, articles needed to be written in English between 2012 and 2017. Search terms used: Systemic sclerosis and pain or systemic scleroderma and pain. Quality of life in SSc was also used.
387 articles and abstracts were retrieved. All articles or titles who did not include those terms were excluded. All Abstracts with the word pain contain were manually analyzed with their full articles. Only 25 trials were analyzed of which, 9 articles met our inclusion criteria. 2 authors were contacted via emails in order to retrieve their full articles without success. At the end, only 7 articles were finally analyzed.
Data Synthesis: We identified 7 articles including 1956 people with SSc. Pain is a major patients’ complaint. It seems to appear with or without digital ulcers usually at the Raynaud phenomenon stage. Multilevel modeling was estimated in one study to show that pain has emotional, psychological and social components beyond its neuropathic and somatic composition. It is suggested that better comprehensive pain models conducted to a better pain management when several aspects of the SSc still resist to a lonely therapeutic management.
Conclusion: Many people suffer from chronic pain and there is a little agreement on what medications are helpful. One reason for this is that clinical trials remain poor in assessing pain and measuring meaningful improvement. Despite the paucity of literature evaluating pain in SSc, this review tried to awareness clinicians to the importance of evaluating pain at the beginning of the disease and to consider other aspects and patterns of pain for a better care.
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