Investigation of Central Sensitization Frequency and Related Factors in Axial Spondyloarthritis Patients

25 somatic and psychosocial symptoms, which are frequently found in patients with central sensitization in part A, are questioned. In part B, the presence of diseases whose relationship with central sensitization is well defined is questioned in the patient without participating in scoring. Central sensitization is assumed in patients who score 40 or more over 100 points.

The spinal hyperalgesia will be evaluated from C3 and C7 (cervical); T6 and T2 (thoracic); L3 and L5 (lumbar) levels. The PPT assessments of these levels were performed over the spinous process and 2 cm right and left side of the corresponding spinous process. The sacroiliac PPT scores were obtained from four measurement points [1]. Trapezius muscle will be used to evaluate distant control point

TS scores will be evaluated over the trapezius muscle, sacroiliac joints, C7, T6, and L3 spine. TS scores will be calculated for each spine as the sum of three values which measured over the spinous process and 2 cm right and left side of corresponding level. In the evaluation of TS, a pressure as much the PPT value of each point will be applied with pain pressure algometer ten times with a 1-second interstimulus interval. Patients will ve asked to rate their pain using visual analogue scale (VAS) at 0, 5, and 10 seconds. TS will be calculated by subtracting the rating at 0 seconds from the rating at 10 seconds

For the assessment of conditioned pain modulation (CPM), first stimulus will be applied to trapezius with the pressure that induced a pain intensity of 4 point on a 10 point VAS. After that the right hand of the patient will be immersed in 7 degrees Celcius water for 20 seconds to create a conditioning stimulus. Second stimulus with the same intensity of first one was applied to trapezius after the conditioning stimulus and patients asked to rate their pain. The ratio between the first and second VAS values will be defined as CPM

The patients pain severity will be evaluated with a 10-cm horizontal visual analogue scale (VAS) ranging from "0 cm" (no discomfort) to "10 cm" (worst imaginable)

BASDAI is one of the most frequently used scales for determining disease activity in axSpA patients and includes questions to evaluate the patient's axial and peripheral symptoms, fatigue and morning stiffness. The questionnaire consists of 10 questions in total and is interpreted in favor of disease activity of 4 points or more.

This scale was developed by Doward et.al in 2003 and consists of 18 questions in total. Each question is answered as yes or no, and the total score is calculated by evaluating the yes answer as 1 and no as 0. It is frequently used in clinical practice because it helps to evaluate the effects of the disease and determine treatment strategies in patients diagnosed with AxSpa.

This scale was developed for assessing the severity of disability in chronic low back pain patients by Duruöz et.al in 2013. This scale consists of 18 questions in the form of a Likert scale that evaluates the limitation of daily life activities of patients in the last month.

This questionnaire consists of 21 questions, each with four options. Scoring is interpreted as 0-9 normal, 10-18 mild depression, 19-29 moderate depression and 30-63 points as severe depression.

The FSS includes 9 questions included in order to determine the negative effects of fatigue intensity and fatigue on daily life activities in the last week. İf the score more than 6.1, this is interpreted in favor of chronic fatigue syndrome.

This scale is designed for quantitative measurement of sleep quality and consists of 24 questions in total. The questions are divided into 7 sections those included sleep disturbance-related symptoms. High scores are associated with poor sleep quality.

This questionnaire is consisted of 6 questions in which fibromyalgia-related clinical parameters are investigated. The patient scoring at least 5 points is considered has fibromyalgia.