Pain avoidance in rheumatoid arthritis

Forty-eight patients with rheumatoid arthritis were compared to 52 pain-free controls in terms of tolerance/avoidance and rated intensity of cold pressor pain. The patients had lower thresholds and tolerated the cold pressor pain for a shorter period, although not significantly so. However, the patients rated the novel nociceptive cold stimulus as significantly more painful. The results demonstrate that arthritis patients report novel pain experiences as being more painful, which necessitates special attention to their post-operative analgesic demands needs. Tolerance/avoidance of the cold pressor pain had different correlates in the more and less chronic patient groups, and was respectively related to the affective and sensory qualities of the pain stimulus. The results confirmed qualitative similarities between different chronic pain populations, suggesting that chronicity of the pain problem may be a more important factor in determining pain experience and pain-related behaviours than the specific locus of the pain.