Pain in rheumatoid arthritis: a critical review

  • P. Sarzi-Puttini | Rheumatology Unit, L. Sacco University Hospital, Milan, Italy.
  • F. Salaffi Reumatology Department, Polytechnic University of Marche, Italy.
  • M. Di Franco Reumatology Department, La Sapienza University, Rome, Italy.
  • L. Bazzichi Department of Internal Medicine, Division of Rheumatology, S. Chiara Hospital, University of Pisa, Italy.
  • G. Cassisi Rheumatology Branch, Specialist Outpatients’ Department, Belluno, Italy.
  • R. Casale Department of Clinical Neurophysiology and Pain Rehabilitation Unit, IRCCS Foundation Salvatore Maugeri, Scientific Institute of Montescano (PV), Italy.
  • M. Cazzola U.O.C. Rehabilitative Medicine, A.O. “Ospedale di Circolo”, Saronno (VA), Italy.
  • S. Stisi A.O. r.n. “G. Rummo” Benevento, Italy.
  • M. Battellino Rheumatology Unit, L. Sacco University Hospital, Milan, Italy.
  • F. Atzeni Rheumatology Unit, L. Sacco University Hospital, Milan, Italy.


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.



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Rheumatoid arthritis, Pain, Central sensitization, Analgesics.
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How to Cite
Sarzi-Puttini, P., Salaffi, F., Di Franco, M., Bazzichi, L., Cassisi, G., Casale, R., Cazzola, M., Stisi, S., Battellino, M., & Atzeni, F. (2014). Pain in rheumatoid arthritis: a critical review. Reumatismo, 66(1), 18-27.

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