Rheumatoid Arthritis

What is rheumatoid arthritis?

In general, arthritis is a common pain condition marked by inflammation of the joints. The inflammation causes pain, swelling, and stiffness. Such inflammation is largely common to all types of arthritis.  

Rheumatoid arthritis is a specific type of arthritis. 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, but can occur in any joint.

Because it involves the immune system reacting to normal tissue, rheumatoid arthritis is considered an autoimmune disorder.  

Central sensitization is a common complication of rheumatoid arthritis.1 Central sensitization is a highly reactive state of the central nervous system, which amplifies pain. It also can cause sensitivity to touch or mild pressure, fatigue, poor sleep, anxiety, and sometimes depression. It can occur with any pain disorder, including rheumatoid arthritis. It is important to address in treatment when it occurs.  

Is there a cure for rheumatoid arthritis?

It is important to know that there is no cure for rheumatoid arthritis. It is considered a chronic condition. Just because there is no cure, patients should not become hopeless.  Persons with chronic health conditions need to redefine what having hope means. Hope in the context of a chronic health condition, like rheumatoid arthritis, means having a realistic plan to get better and “better” is defined by the following:

  • Having less pain and other symptoms
  • Being able to do more activities, like stay at work or return to work
  • Needing less pain medications
  • Being less distressed about pain
  • Needing to seek healthcare less

Therapies and procedures for rheumatoid arthritis

Common treatments for rheumatoid arthritis are anti-inflammatory medications, corticosteroid medications, chemotherapies, physical therapy, cortisone injections, and chronic pain rehabilitation programs. Treatments that address central sensitization are antidepressant medications (which are used for pain), anti-seizure medications (which also are used for pain), and chronic pain rehabilitation programs.  

References

1. 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. 

 

Date of publication: April 27, 2012

Date of last modification: October 23, 2015

Murray J. McAllister, PsyD, is the executive director of the Institute for Chronic Pain (ICP). The ICP is an educational and public policy think tank. Its mission is to lead the field in making pain management more empirically supported. Additionally, the ICP provides Academic quality information on chronic pain that is approachable to patients and their families. Dr. McAllister is also the clinical director of pain services for Courage Kenny Rehabilitation Institute (CKRI), part of Allina Health, in Minneapolis, MN. Among other services, CKRI provides chronic pain rehabilitation services on a residential and outpatient basis.

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