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Feature Article

Managing pain in patients with rheumatoid arthritis

Milton Cohen

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© SPL MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY
© SPL MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY

Abstract

Patients with rheumatoid arthritis who are responding to disease-modifying drug therapy but continue to complain of pain – in joints and elsewhere – present a management challenge. Although biomedical factors may play the major role in the pain experienced by such patients, consideration of the psychological and social dimensions is essential. A sociopsychobiomedical framework is useful for patient assessment and for identifying other, nondrug, therapeutic pathways.

Key Points

  • Perhaps every second patient with rheumatoid arthritis will experience ongoing pain and disability despite optimal control of inflammation.
  • The sociopsychobiomedical framework for chronic pain is not only useful for assessing such patients but also provides a template for identifying other, nondrug, therapeutic pathways.
  • Biomedical factors other than inflammation need to be considered, including the new concept of nociplastic pain.
  • Symptom control is important, as an adjunct to nondrug treatment approaches. Australian prescribers have access to a variety of medicines that should be used judiciously.

Figures

© SPL MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY
© SPL MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY