Section 2: The importance of improving function in patients with pain

When evaluating pain in the rheumatic diseases, assessment of adequate therapy has expanded from purely biochemical measures and joint counts to determining the degree of function. Because pain is an important predictor of function, instruments have been developed that attempt to measure how disease and pain affect parameters such as activities of daily living, quality of life, ability to work, and emotional well-being. Some measures, such as visual analogue scales, measure only the intensity of pain; multidimensional scales assess a variety of factors related to the patient's overall ability to function. The Short Form-36 measures the impact of disease on overall quality of life; adaptations have been made to some specific diseases. The Health Assessment Questionnaire was one of the first multidimensional questionnaires developed for rheumatic diseases, and this has been further refined for rheumatoid arthritis with the Multidimensional Health Assessment Questionnaire.