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Current Osteoporosis Reports
Published in: Current Osteoporosis Reports 5/2018

01-10-2018 | Bone and Joint Pain (T King and S Amin, Section Editors)

Mechanisms for Joint Pain in Rheumatoid Arthritis (RA): from Cytokines to Central Sensitization

Authors: Angela Zhang, Yvonne C. Lee

Published in: Current Osteoporosis Reports | Issue 5/2018

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Abstract

Purpose of Review

Pain in rheumatoid arthritis (RA) may be due to different etiologies, ranging from peripheral inflammation to dysregulation of central nervous system (CNS) processing. This review evaluates relevant literature published on RA pain mechanisms in recent years.

Recent Findings

Despite successes of disease-modifying antirheumatic drugs (DMARDs), pain persists for many RA patients. Studies involving patient-reported outcomes, quantitative sensory testing, and neuroimaging indicate that, in addition to joint inflammation, abnormalities in CNS pain processing may contribute to pain. Some DMARDs (e.g., janus kinus inhibitors) may work via multiple pathways to decrease pain. Adjunctive treatments (e.g., antidepressants, antiepileptics) may also be useful in managing pain in RA patients with well-controlled disease.

Summary

Both peripheral and central mechanisms play key roles in the expression of pain in RA. To effectively manage pain, physicians need accurate assessment tools to identify the pathways involved in each patient so that treatments may be appropriately targeted.
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Metadata
Title
Mechanisms for Joint Pain in Rheumatoid Arthritis (RA): from Cytokines to Central Sensitization
Authors
Angela Zhang
Yvonne C. Lee
Publication date
01-10-2018
Publisher
Springer US
Published in
Current Osteoporosis Reports / Issue 5/2018
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI
https://doi.org/10.1007/s11914-018-0473-5

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