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Arthritis Pain; Rheumatoid Arthritis, Osteoarthritis, and Fibromyalgia

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Chronic Pain Management in General and Hospital Practice

Abstract

Rheumatoid arthritis (RA), osteoarthritis (OA), and fibromyalgia (FM) are common disabling and distressing conditions illustrating the production, amplification, and maintenance of pain by inflammation, altered joint structure, and central pain mechanisms. Addressing joint pathology might not alone resolve pain, and analgesia should complement treatments that might retard structural progression. Multimodal approaches deliver interventions within an optimised therapeutic context. Systemic or locally administered pharmaceuticals might reduce nociceptive transmission, inflammation, sensitisation, or future structural damage. Non-pharmacological interventions include exercise, orthotics, psychological and surgical approaches. Addressing comorbidities can improve pain and remove barriers to effective treatment. Musculoskeletal pain prognosis is highly variable and difficult to predict, but, with optimal treatment, pain progression is not inevitable. In this chapter we discuss RA, OA, and FM as representative of diagnoses associated with inflammatory, structural, or central pain mechanisms. Pain mechanisms explain clinical characteristics and inform optimal management of people presenting with musculoskeletal pain.

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Authors and Affiliations

  1. Department of Rheumatology and Back Pain Unit, Sherwood Forest Hospitals NHS Foundation Trust, Kings Mill Hospital, Sutton in Ashfield, UK

    Afsha Khan, João Calinas Correia & David Andrew Walsh

  2. Pain Centre Versus Arthritis and NIHR Nottingham Biomedical Research Centre, Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham Clinical Science Building, City Hospital, Nottingham, UK

    David Andrew Walsh

  3. Academic Rheumatology, Clinical Sciences Building, City Hospital, Nottingham, UK

    David Andrew Walsh

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  1. Afsha Khan
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  3. David Andrew Walsh
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Correspondence to David Andrew Walsh .

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  1. Pain Control Institute, Shinjyuku, Tokyo, Japan

    Koki Shimoji

  2. Feinberg School of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Antoun Nader

  3. Guy’s and St Thomas’ Hospital, Pain Management Centre, London, UK

    Wolfgang Hamann

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Khan, A., Calinas Correia, J., Walsh, D.A. (2021). Arthritis Pain; Rheumatoid Arthritis, Osteoarthritis, and Fibromyalgia. In: Shimoji, K., Nader, A., Hamann, W. (eds) Chronic Pain Management in General and Hospital Practice. Springer, Singapore. https://doi.org/10.1007/978-981-15-2933-7_27

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