Heel pain in spondyloarthritis: results of a cross-sectional study of 275 patients

• Published in: Clinical and experimental rheumatology Vol. 30; no. 4; pp. 487 - 491
• Main Authors: KOUMAKIS, E, GOSSEC, L, DOUGADOS, M, ELHAI, M, BURKI, V, DURNEZ, A, FABREGUET, I, MEYER, M, PAYET, J, ROURE, F, PATERNOTTE, S
• Format: Journal Article
• Language: English
• Published: Pisa Clinical and Experimental Rheumatology 01.07.2012
• Subjects: Adult; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Antirheumatic Agents - therapeutic use; Arthralgia - drug therapy; Arthralgia - epidemiology; Arthralgia - pathology; Biological and medical sciences; Cohort Studies; Diseases of the osteoarticular system; Diseases of the spine; Female; Heel - pathology; Humans; Male; Medical sciences; Middle Aged; Prevalence; Retrospective Studies; Spondylarthritis - drug therapy; Spondylarthritis - epidemiology; Spondylarthritis - pathology; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Human; Heel; Diseases of the osteoarticular system; Rheumatology; heel pain; Spine disease; Epidemiology; clinical characteristics; Foot; Symptomatology; enthesitis; spondyloarthritis; Pain; Cross sectional study; Spondylarthritis
• ISSN: 0392-856X; 1593-098X

Heel pain is a common but poorly studied feature of spondyloarthritis (SpA). The aims of this study were to assess the prevalence and clinical features of heel pain in a cohort of patients with SpA. This was a retrolective single centre observational study in 2010. Patients with SpA as defined by Amor's criteria were recruited. The data collected were: demographic and disease characteristics, history of heel pain, age at first heel pain, localisation, nature and intensity of pain and treatments. The analyses were descriptive. A total of 275 SpA patients (mean age 44.6±13.5 yrs, mean disease duration 16.7±11.8 yrs, 61.5% men) were assessed. A history of heel pain was reported in 130 patients (47.1%), and was the first symptom of SpA in 15.7% of all patients. Heel pain was frequent in both axial (89/201, 44.3%) and peripheral disease (27/56, 48.2%). Distribution was more frequently inferior (88, 69.3%) than posterior (61, 48.0%) (p<0.0001), and frequently bilateral: simultaneously (41.9%) rather than alternatively (29.1%) (p=0.03). Main clinical symptoms were: morning pain on weight bearing (83.6%), but also night pain (34.4%), and/or patient-described swelling (24.2%). Heel pain was frequently recurrent (74.2%), intense (70.3%), source of a limp (71.6%), and often resistant to non-steroidal anti-inflammatory drugs (NSAIDs) (54/108, 50%). Tumour necrosis factor blockers were efficacious on heel pain in 72/94 (76.6%) of cases. This study confirmed heel pain as a frequent symptom in both axial and peripheral SpA. It occurred early in the disease course and it was frequently recurrent and resistant to NSAIDs.