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Pain in the joints and beyond; the challenge of rheumatoid arthritis

Abstract:
Pain is a common and often debilitating symptom for people living with rheumatoid arthritis. Although pain is a generic feature of inflammation and often improves with successful treatment that targets inflammatory pathways, pain experience can persist. Emerging data suggest that the magnitude of pain relief might vary according to the therapeutic target of pharmacological intervention within the inflammatory cascade. Both inflammatory and non-inflammatory causes contribute to the pain experience, which depends on tissue origin, peripheral sensory mechanisms and their transmission, integration, and interpretation within the nervous system. Contemporary neuroimaging is transforming our understanding of these mechanisms and the role of sensory, emotional, and cognitive contributions to the experience of pain. This understanding paves the way for therapeutic approaches that recognise the existence of multiple, cognitively driven, supraspinal mechanisms for pain modulation and could complement pharmacological inflammation suppression. Such approaches include neuropsychological interventions that have the potential to modify human brain cortical structure and reduce suffering that is often associated with pain experience.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1016/S2665-9913(23)00094-2

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
NDORMS
Sub department:
Botnar Research Centre
Oxford college:
St Peter's College
Role:
Author
ORCID:
0000-0001-7766-6167


Publisher:
Elsevier
Journal:
Lancet Rheumatology More from this journal
Volume:
5
Issue:
6
Pages:
E351-E360
Publication date:
2023-05-04
Acceptance date:
2023-03-21
DOI:
EISSN:
2665-9913


Language:
English
Keywords:
Pubs id:
1333641
Local pid:
pubs:1333641
Deposit date:
2023-03-21
ARK identifier:

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