Assessment of pain threshold in haemophilic patients

Many patients with haemophilia (PWH) live with persistent end-stage arthritis, as a result of multiple joint haemarthrosis, and experience daily pain. For these people, pain becomes a central aspect of life. The aim of this study was to use mechanical pain thresholds (MPT) to characterize pain perception in different PWH groups. The groups tested were characterized by age, previous bleeding into joints, Hemophilia Joint Health Score (HJHS) and PAIN perception score in the HJHS scoring. A total of 23 PWH (haemophilia A) were included in this study (10 children, 13 adults). A total of 12 PWH suffered from repeated bleeding into some of the tested joints. Data were compared to those collected from 15 age-matched control subjects. The most significant differences in MPTs were found when the PWH were compared to the controls, based on the differences in PAIN score (PAIN score 1 and 2) in all the tested joints, except for the right knee. Similarly, the difference in MPT in ankle joints was confirmed when PWH with and without bleeding were compared to controls. Summarizing the outcomes, we can emphasize the potential usefulness of MPT as an objective tool in evaluating the pain of PWH. © 2013 John Wiley & Sons Ltd.