Neuropathic symptoms and central sensitization negatively impact functional capacity in individuals after Chikungunya fever

Abstract

Introduction: The main consequence of Chikungunya Fever is arthralgia, which can last for years. The investigation of other aspects of pain, such as the presence of neuropathic symptoms and central sensitization, as well as their relationship with functional limitation in patients with Chikungunya Fever, has not yet been explored. Objective: To evaluate the relationship between pain characteristics and functional capacity in individuals affected by Chikungunya Fever who are in the chronic phase of this disease. Methods: This is a cross-sectional observational study with 36 individuals in the chronic phase of Chikungunya Fever. Participants completed a sociodemographic questionnaire, an instrument to assess the impact of pain on functionality (Brief Pain Inventory, BPI), the presence of neuropathic symptoms (PainDETECT), the presence of signs and symptoms of central sensitization (Central Sensitization Inventory) and functional capacity (Health Assessment Questionnaire, HAQ). Results: 36 questionnaires were valid for research, with individuals of both sexes with an average age of 43.5 years, 77.7% being female. Chikungunya Fever was clinically diagnosed in most participants (55.6%). Mean pain intensity was moderate (mean = 3.3, SD=2.0). painDETECT identified 27 (77.7%) participants with nociceptive pain, 7 (19.4%) as indeterminate and 2 (5.5%) as probable neuropathic pain. In the Central Sensitization Inventory there was a mean score of 31.5 (SD=18.5) with subclinical pain in 16 (44.4%) participants, mild in 9 (25%), moderate in 6 (16.6 %), severe in 2 (5.5%), extreme in 3 (8.3%) participants. The Health Assessment Questionnaire (HAQ) evaluating the interference of pain on functionality had a mean total score of 0.7 indicating mild to moderate disability. There was a strong and positive correlation between functional capacity and the presence of neuropathic symptoms (r=0.663/p=0.001) and pain intensity (r=0.653 / p=0.001). There was a moderate and positive correlation between the presence of signs and symptoms of central sensitization and functional capacity (r=0.486 p=0.001). Finally, there was a weak correlation between the interference of pain in the individual's life and functional capacity (r=0.366/p=0.028). Conclusion: Chronic pain after Chikungunya Fever has a prevalent characteristic of nociceptive pain and moderate intensity. The presence of neuropathic signs and symptoms and central sensitization negatively impacts the functional capacity of affected individuals.