Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20190060
Brazilian Journal of Pain
Original Article

Clinical manifestations in patients with musculoskeletal pain post-chikungunya

Manifestações clínicas em pacientes com dores musculoesqueléticas pós-chikungunya

Ben-Hur James Maciel de-Araujo; Patricia Bueno Nestarez Hazime; Francisca Joyce Vasconcelos Galeno; Laís Nascimento Candeira; Mayare Fortes Sampaio; Fuad Ahmad Hazime

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Abstract

BACKGROUND AND OBJECTIVES: Chronic clinical manifestations of the chikungunya virus infection are associated with high rates of disability and worsening of quality of life, representing one of the major challenges for global public health. The objective of this study was to investigate the clinical-psycho-functional presentation of the chikungunya virus-infected individuals with complaints of chronic musculoskeletal pain.

METHODS: Twenty-two individuals with a diagnosis of chikungunya virus infection and a complaint of persistent musculoskeletal pain (≥3 months) participated in the study. The clinical-psycho-functional evaluation was performed through the intensity and affective-emotional aspect of pain, quality of life, kinesophobia, global perception of post-infection pain recovery and emotional functionality. In the end, the pressure pain threshold and the conditioned pain modulation were evaluated.

RESULTS: The clinical presentation of pain revealed long persistence 17.5±7.4 months; predominant in the lower limbs (45.5%); mean intensity (5.5±2.1); mild to moderate affective-emotional changes; moderate kinesophobia (46±6.5) and low overall perception of improvement (1.5±2.5). The Beck Depression Inventory and the visual analog scale for anxiety showed little change. Quality of life presented mild to moderate impairment, and pain modulation showed a slight increase in the pressure pain threshold (6.3%).

CONCLUSION: The chronic phase of the chikungunya virus infection is characterized by persistent moderate-intensity pain, both in sensory and affective levels, with moderate kinesophobia, worsening of quality of life, perception of poor post-infection recovery, and a decrease in the pain descending inhibitory pathways.

Keywords

Chikungunya virus, Chronic pain, Clinical evolution, Signals and symptoms

Resumo

JUSTIFICATIVA E OBJETIVOS: As manifestações clínicas crônicas da infecção pelo vírus chikungunya estão associadas a altos índices de incapacidade e piora da qualidade de vida, representando um dos grandes desafios para a saúde pública mundial. O objetivo deste estudo foi investigar a apresentação clínica-psico-funcional de indivíduos infectados pelo vírus chikungunya com queixas de dores musculoesqueléticas crônicas.

MÉTODOS: Participaram do estudo 22 indivíduos com diagnóstico de infecção pelo vírus chikungunya e queixa de dor musculoesquelética persistente (≥3 meses). A avaliação clínica-psico-funcional foi realizada por meio da intensidade e aspecto afetivo-emocional da dor, qualidade de vida, cinesiofobia, percepção global de recuperação da dor pós-infecção e funcionalidade emocional. Ao final foi avaliado o limiar de dor por pressão e a modulação condicionada da dor.

RESULTADOS: A apresentação clínica da dor revelou longa persistência, 17,5±7,4 meses; predominância nos membros inferiores (45,5%); intensidade média (5,5±2,1); alterações afetiva-emocionais leves a moderadas; moderada cinesiofobia (46±6,5) e baixa percepção global de melhora (1,5±2,5). O Inventário de Depressão de Beck e a escala analógica visual para ansiedade apresentaram pouca alteração. A qualidade de vida apresentou prejuízos leves a moderados, e a modulação da dor revelou pouco aumento do limiar de dor por pressão (6,3%).

CONCLUSÃO: A fase crônica da infecção pelo vírus chikungunya tem como apresentação clínica dor persistente de moderada intensidade, em nível sensorial e afetivo, além de moderada cinesiofobia, piora na qualidade de vida, percepção de pouca recuperação pós-infecção e diminuição da ativação inibitória descendente da dor.

Palavras-chave

Dor crônica, Evolução clínica, Sinais e sintomas, Vírus chikungunya

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Submitted date:
06/03/2019

Accepted date:
09/23/2019

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