[NON-PHARMACOLOGICAL PAIN MANAGEMENT OF RHEUMATIC DISEASES]

Rheumatic diseases are a leading cause of chronic painful conditions, which, if not recognized and treated in a timely manner, cause inability and consequently reduce the quality of life of individuals. Chronic pain in rheumatic patients has a multifactorial background. Therefore, it is oft en accompanied by sleep and mood disturbances, fatigue, and reduced functional capacity of joints and the spine. Recent studies suggest that rheumatic pain is not exclusively nociceptive, and that in a large number of patients it may have the characteristics of neuropathic and central pain. Thus, the current approach to the treatment of rheumatic pain oft en had very modest results. For these reasons, rheumatic pain can no longer be treated only as a symptom, but should rather be viewed as a separate disease. Effective treatment of rheumatic pain requires a multidisciplinary, biopsychosocial approach taking into account the cause and nature of the pain, the disease characteristics, lifestyle, and psychological ability of an individual to deal with painful conditions. Careful selection of different modes of non-pharmacological treatment should be the fi rst step in the treatment of rheumatic pain with the use of available pharmacological interventions. A small number of systematic reviews, which included only a small number of causes and treatments for rheumatic pain with questionable quality of evidence, indicates the need to develop new high-quality randomized controlled trials, in order to enable real insight into the effectiveness of non-pharmacological methods for the treatment of rheumatic pain.