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Pain mechanisms for the practicing rheumatologist.
1Department of Internal Medicine, Division of Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA.
Best Practice & Research. Clinical Rheumatology
|March 23, 2024
Summary
Chronic pain in rheumatic diseases involves complex biological, psychological, and social factors, moving beyond simple nociception. Effective management requires integrated medical, psychological, and social interventions for a holistic approach.
Area of Science:
- Rheumatology
- Pain Medicine
- Neuroscience
Background:
- Rheumatic disease pain extends beyond nociception.
- Chronic pain involves peripheral and central sensitization.
- Nociplastic pain arises from altered central nervous system processing.
Purpose of the Study:
- To explore the multifaceted nature of pain in rheumatic diseases.
- To highlight the role of biological, psychological, and social factors.
- To emphasize comprehensive treatment strategies.
Main Methods:
- Review of current understanding of pain mechanisms in rheumatic diseases.
- Analysis of the interplay between biological and psychosocial factors.
- Synthesis of research on central nervous system processing in pain.
Main Results:
- Pain in rheumatic diseases is influenced by nociceptive, neuropathic, and nociplastic mechanisms.
- Psychosocial factors like mood disorders and catastrophizing significantly impact pain perception.
- The brain plays a central role in the experience of chronic pain.
Conclusions:
- A modern understanding of rheumatic disease pain integrates neurobiological and psychosocial elements.
- Comprehensive management requires a combination of medical, psychological, and social interventions.
- Addressing the intricate interplay of factors is crucial for effective pain management.
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