Background Pain in Rheumatoid arthritis (RA) is more prevalent in women than men. Hand involvement in RA is associated with hand pain, low grip force and reduced grip ability. Hand pain related to hand activity and possible differences between sexes have not yet been reported in early RA.
Objectives To analyze hand pain during activity, hand pain at rest and general pain during the first year of RA for women and men.
Methods 454 patients were recruited into the Swedish early RA project “TIRA” during 2006-2009. The 373 patients (67 % women) that remained at 12 months follow up are reported here. Data for disease activity (DAS-28), general pain (VAS), hand pain during rest (VAS) and hand pain during activity (VAS) was registered at inclusion and at the follow-ups after 3 (M3), 6 (M6), and 12 (M12) months respectively. Hand pain during activity was related to test of grip force as measured by Grippitä. Prescribed disease-modifying anti-inflammatory drugs (DMARDs) and hand dominance was registered. Differences in mean values were analysed using ANOVA and differences in medication were analysed using chi-square tests.
Results Women had slightly higher proportions of DMARDs than men throughout the study (84% to 93 % vs 75% to 92%) although the differences were significant only at M3 (p=.022; 85% vs 75%). Disease activity was high at inclusion (mean=5.12) and decreased significantly (p<.001) at M3 and M6, but not between M6 and M12. Women had higher DAS than men at all follow-ups but the difference were not significant. 86% reported right-hand dominance. Women reported higher overall pain than men (p=.007) and overall pain was higher at inclusion than at the follow-ups (p<.001). The paintypes were significantly different (p<.001), general pain was highest and hand pain at rest was lowest. A significant interaction between pain-type and follow-up (p<.001) showed that the three paintypes differed at each follow-up but for general pain and hand pain during activity at M3. There were no significant differences in hand pain between dominant and nondominant hand or between right and left hand.
Conclusions Women had higher DAS and pain than men despite somewhat more women than men prescribed DMARD:s. Hand pain in activity was higher than pain during rest, strongly indicating that hand pain is closely related to performing hand activities in general in early RA.
Disclosure of Interest None Declared