Neuropathic and Nociplastic Pain Profiles are Common in Adult Chronic Nonbacterial Osteitis (CNO)

Chronic nonbacterial osteitis (CNO) is a rare musculoskeletal disease causing chronic bone pain. It is known that chronic musculoskeletal pain may involve other mechanisms than nociceptive pain only. We investigate the prevalence of neuropathic and nociplastic pain in adult CNO and their association...

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Bibliographic Details
Published in:Calcified tissue international 2024-06, Vol.114 (6), p.603-613
Main Authors: Leerling, Anne T., Niesters, Marieke, Flendrie, Marcel, Tel, Marije, Appelman-Dijkstra, Natasha M., Dekkers, Olaf M., Winter, Elizabeth M.
Format: Article
Language:English
Subjects:
Adult
Aged
Biochemistry
Biomedical and Life Sciences
Cell Biology
Chronic Disease
Chronic pain
Chronic Pain - diagnosis
Chronic Pain - epidemiology
Endocrinology
Female
Fibromyalgia
Humans
Life Sciences
Male
Middle Aged
Musculoskeletal diseases
Netherlands - epidemiology
Neuralgia
Neuralgia - diagnosis
Neuralgia - epidemiology
Nociceptive Pain - diagnosis
Nociceptive Pain - epidemiology
Original Research
Orthopedics
Osteitis
Osteitis - complications
Osteitis - diagnosis
Osteitis - epidemiology
Pain
Pain Measurement - methods
Pain perception
Patients
Prevalence
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Summary:Chronic nonbacterial osteitis (CNO) is a rare musculoskeletal disease causing chronic bone pain. It is known that chronic musculoskeletal pain may involve other mechanisms than nociceptive pain only. We investigate the prevalence of neuropathic and nociplastic pain in adult CNO and their association with clinical characteristics and treatment outcomes. Survey study among the Dutch adult CNO cohort ( n  = 84/195 participated), including PAIN-detect for neuropathic pain, and the Central Sensitization Inventory (CSI), Fibromyalgia Rapid Screening Tool (FiRST), and ACTTION-APS Pain Taxonomy (AAPT) for nociplastic pain. Clinical characteristics and CNO-related bone pain scores were compared between patients with exclusive nociceptive pain and those with nociceptive pain plus neuropathic and/or nociplastic pain (mixed pain). 31% (95% CI 21–41) of patients classified as likely having neuropathic pain according to PAIN-detect. 53% (41–64) of patients displayed central sensitization on CSI, 61% (50–72) screened positive for fibromyalgia on FiRST and 14% (7–23) of patients fulfilled the AAPT criteria, all indicative of nociplastic pain. Mixed pain was associated with longer diagnostic delay (mean difference 2.8 years, 95% CI 0.4–5.2, p  = 0.023), lower educational level (72% versus 20%, p  
ISSN:1432-0827
0171-967X
1432-0827
DOI:10.1007/s00223-024-01214-3