Highlights
- •77% of PAH patients experience musculoskeletal pain.
- •PAH drugs seem to increase musculoskeletal pain prevalence.
- •Pain prevalence is highest at low back, followed by knees and neck regions.
- •Knee pain has the strongest impact on quality of life and functional status.
- •Examining and addressing musculoskeletal pain complaints may improve PAH management.
Abstract
Background
In pulmonary arterial hypertension (PAH), pathophysiological consequences of the disease
and the drugs used to treat PAH may adversely affect musculoskeletal system. Aim of
the study was to evaluate musculoskeletal pain prevalence and its impact on quality
of life (QoL) and exercise capacity in PAH patients.
Methods
61 PAH patients were evaluated with Nordic Musculoskeletal Questionnaire (NMQ) for
musculoskeletal pain presence, EmPHasis-10 and Minnesota Living with Heart Failure
Questionnaire (MLHFQ) for QoL, 6-min walk test (6MWT) for functional exercise capacity
and International Physical Activity Questionnaire- Short Form (IPAQ-SF) for physical
activity participation.
Results
77% of PAH patients reported musculoskeletal pain. Pain prevalence was highest at
low back (38%), followed by knees (36%), shoulders (36%) and neck (33%). Hemodynamic
indicators of PAH severity were associated with pain presence in various parts of
the body. Patients receiving any PAH-specific drug were more likely to experience
pain compared to the patients whose drug therapy has not yet been initiated (RR = 1.6–2.0).
Pain presence in neck, shoulder, low back and knees significantly correlated to worse
QoL scores in both EmPHasis-10 and MLHFQ (p < 0.05). Pain presence in knees had the
strongest influence on QoL, and it was the only significant correlate of 6MWT (r = −0.424)
and IPAQ-SF (r = −0.264) (p < 0.05).
Conclusions
Musculoskeletal pain is a common complaint in PAH patients, which significantly impairs
QoL and physical functioning. Treatment strategies should include a more comprehensive
assessment for musculoskeletal pain complaints of these patients and address pain
presence accordingly, which may help providing a better management for PAH.
Keywords
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Article info
Publication history
Published online: February 02, 2022
Accepted:
January 29,
2022
Received in revised form:
January 28,
2022
Received:
October 2,
2021
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
