title: Pain in rheumatoid arthritis: a critical review.
abstract: Patients with rheumatoid arthritis (RA) are frequently afflicted by pain, which may be caused by joint inflammation (leading to structural joint damage) or secondary osteoarthritis, and may be increased by central sensitisation. Non-inflammatory pain may also confuse the assessment of disease activity, and so the aim of treatment is not only to combat inflammatory disease, but also relieve painful symptoms. In order to ensure effective treatment stratification, it is necessary to record a patients medical history in detail, perform a physical examination, and objectively assess synovitis and joint damage. The management of pain requires various approaches that include pharmacological analgesia and biological and non-biological treatments. Although joint replacement surgery can significantly improve RA-related pain, it may only be available to patients with the most severe advanced disease.
authors.affiliation: Rheumatology Unit, L. Sacco University Hospital, Milan. piercarlo.sarziputtini@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Sarzi-Puttini
authors.forename: F
authors.initials: F
authors.lastname: Salaffi
authors.forename: M
authors.initials: M
authors.lastname: Di Franco
authors.forename: L
authors.initials: L
authors.lastname: Bazzichi
authors.forename: G
authors.initials: G
authors.lastname: Cassisi
authors.forename: R
authors.initials: R
authors.lastname: Casale
authors.forename: M
authors.initials: M
authors.lastname: Cazzola
authors.forename: S
authors.initials: S
authors.lastname: Stisi
authors.forename: M
authors.initials: M
authors.lastname: Battellino
authors.forename: F
authors.initials: F
authors.lastname: Atzeni
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000503:physiopathology; D059333:Central Nervous System Sensitization; D059350:Chronic Pain / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005081:Exercise Therapy; D005356:Fibromyalgia / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007249:Inflammation; D059352:Musculoskeletal Pain / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D018377:Neurotransmitter Agents / Q000502:physiology; D010003:Osteoarthritis / Q000150:complications / Q000503:physiopathology; D059408:Pain Management; D010147:Pain Measurement; D058748:Pain Perception; D017288:Pain Threshold / Q000502:physiology
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D018377:Neurotransmitter Agents