Work

Pain diagnostics in people with hemophilia – pain pressure thresholds and influence of age and joint status

Year: 2025

Type: article

Abstract: BACKGROUND: Pain is a burden for people with hemophilia (PwH) and is often underdiagnosed. Therefore, it is crucial to develop accurate tools for pain assessment. OBJECTIVES: Pain pressure thresholds (PPTs) are valuable in the diagnosis of pain sensitivity. The meaning and influencing factors in PwH were evaluated in this study. METHODS: We investigated PPTs in 327 PwH and 121 healthy controls to compare differences, examine the influence of age on PPT testing, and explore correlations between PPTs and numeric rating scale (NRS) categories or joint status. PPTs were measured bilaterally at hemophilia-specific joints (elbow/knee/ankle) and reference landmarks (sternum/forehead). Joint status was assessed via the Hemophilia Joint Health Score. NRS categories were used to evaluate current, mean, and maximum pain over the last 4 weeks. RESULTS: PPTs varied significantly across hemophilia-specific joints, such as the knees and ankles, compared with controls (P < .001), but showed no significant differences at the elbows (P ≥ .123) or at reference landmarks (P ≥ .621). Age did not influence PPTs in either group. In contrast, age-related effects were observed across nearly all NRS categories (current/mean/maximum) in both groups. Correlations between PPTs and NRS categories were low (r ≤ -.212), indicating that they measure different dimensions of pain. CONCLUSION: This study demonstrates that PPT measurement is an important method of pain assessment in PwH. Joint-specific PPT values are independent of age and correlate with the presence of affected joints, potentially reflecting the local joint condition, while NRS categories likely represent the overall pain status. Therefore, PPT is a useful tool for pain assessment in PwH, particularly for the diagnosis of joint-specific pain sensitivity.

Source: Journal of Thrombosis and Haemostasis

DOI: 10.1016/j.jtha.2025.09.044