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Treatment of Central Sensitization in Patients With Rheumatoid Arthritis: a Narrative Overview

  • Pain in Rheumatology (W Nielson, Section Editor)
  • Published:
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Abstract

Purpose of review

Central sensitization (CS) is present in a variety of chronic pain conditions including rheumatoid arthritis (RA). An overview of the treatment options for desensitizing the central nervous system in RA patients, with CS as their dominant pain mechanism, is provided.

Recent findings

The treatment of pain in RA patients has mostly focused on treating inflammation to indirectly treat pain. Unfortunately, little research has focused on treating CS, which appears to be present in some patients with RA.

Summary

“Treating the brain without ignoring the joints” should be the leading principle in the management of CS in RA patients. Pain neuroscience education, graded activity, and a time-contingent exercise approach are important interventions to implement in clinical practice. Further research is necessary to evaluate the effectiveness of these promising treatments for diminishing hyperexcitability of the central nervous system in RA patients with CS as their dominant pain mechanism.

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Authors and Affiliations

  1. Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium

    L. Meert PT MSc, I. Baert PT, PhD, M. Mertens PT, MSc & M. Meeus PT, PhD

  2. Pain in Motion International Research Group, Ghent, Belgium

    L. Meert PT MSc, I. Baert PT, PhD, M. Mertens PT, MSc & M. Meeus PT, PhD

  3. Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, CIR Rehabilitation, Eindhoven, The Netherlands

    R. J. E. M. Smeets MD, PhD

  4. Department of Medicine, Maastricht University Medical Center, Division of Rheumatology, Maastricht, The Netherlands

    A. Boonen MD, PhD

  5. Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium

    M. Meeus PT, PhD

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  1. L. Meert PT MSc
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  2. R. J. E. M. Smeets MD, PhD
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Correspondence to M. Meeus PT, PhD.

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L. Meert declares that she has no conflict of interest. R. J. E. M. Smeets declares that he has no conflict of interest. I. Baert declares that she has no conflict of interest. M. Mertens declares that he has no conflict of interest. A. Boonen declares that she has no conflict of interest. M. Meeus declares that she has no conflict of interest.

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Meert, L., Smeets, R.J.E.M., Baert, I. et al. Treatment of Central Sensitization in Patients With Rheumatoid Arthritis: a Narrative Overview. Curr Treat Options in Rheum 5, 179–189 (2019). https://doi.org/10.1007/s40674-019-00125-x

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