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What is arthritis?

Arthritis is a common pain condition marked by inflammation of the joints. The inflammation causes pain, swelling, and stiffness. Arthritis can occur at any joint of the body.


There are different types of arthritis. The two most common are osteoarthritis and rheumatoid arthritis


Osteoarthritis might best be considered the result of general wear and tear. It can occur from traumatic injuries, overuse, and age. It results from a loss of cartilage. Cartilage provides cushioning for the bones in the joints. The loss of cartilage causes inflammation when the joint is used. In turn, the inflammation leads to pain, tenderness, swelling, and stiffness. While it can occur any joint, osteoarthritis most commonly occurs in the hips, knees, ankles and feet. 


Rheumatoid arthritis is the result of the immune system mistaking healthy cartilage for being diseased, and consequently it attacks the cartilage of the joints. Over time, the immune system erodes the cartilage. The subsequent loss of cartilage causes inflammation when the joints are used. In turn, the inflammation causes pain, joint stiffness, and swelling. In advanced stages, the joints become deformed. Rheumatoid arthritis most commonly occurs in the hands and fingers. 


Central sensitization can occur in both types of arthritis. Arendt-Nielsen, L., Nie, H., Laursen M. B., Laursen, B. S., Madeleine P., Simonson O. H., & Graven-Nielsen, T. (2010). Sensitization in patients with painful knee osteoarthritis. Pain, 149, 573-581. Meeus M., Vervisch, S., De Clerck, L. S., Moorkens, G., Hans, G., & Nijs, J. (2012). Central sensitization in patients with rheumatoid arthritis: A systematic literature review. Seminars in Arthritis & Rheumatism, 41, 556-567. Central sensitization is a highly reactive state of the central nervous system, which amplifies pain. It also can cause sensitivity to touch, fatigue, poor sleep, anxiety, and sometimes depression. It can occur with any pain disorder, including arthritis. Central sensitization is a complication of the pain associated with arthritis. It is important to address in treatment. 


Is there a cure for arthritis?

Arthritis is a chronic condition. Typically, chronic health conditions are also conditions that have no cure and last indefinitely.


Therapies & Procedures for arthritis

Common treatments for osteoarthritis are anti-inflammatory medications, physical therapy, cortisone injections, arthroscopic and joint replacement surgeries, and chronic pain rehabilitation programs. 


Common treatments for rheumatoid arthritis are anti-inflammatory medications, chemotherapies, physical therapy, and chronic pain rehabilitation programs. 


Chronic pain rehabilitation programs focus on reducing the central sensitization associated with any type of chronic pain condition, including arthritis. It is an intensive, interdisciplinary approach that combines lifestyle changes, coping skills training, and medication management. The overall goal of these treatment approaches is to reduce central sensitization by down-regulating the nervous system. The arthritic changes to the joints remain the same. However, by reducing central sensitization, pain is reduced to tolerable levels. Additionally, with less central sensitization, patients also have less fatigue, sleep problems and emotional distress.  As a result, they are more able to cope with the pain that remains. They are also more able to engage in the activities of life. 


Murray J. McAllister, PsyD, is the executive director of the Institute for Chronic Pain. The Institute for Chronic Pain is an educational and public policy think tank. Its purpose is to bring together thought leaders from around the world in the field of chronic pain rehabilitation and provide academic-quality information that is also approachable to all the stakeholders in the field: patients, their families, generalist healthcare providers, third party payers, and public policy analysts. Its aim is to change the culture of how chronic pain is managed through education and consultation efforts that advocate for the use of empirically supported conceptualizations and treatments of chronic pain. He also blogs at the Institute for Chronic Pain Blog.



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