Fighting Rheumatoid Arthritis Pain on Many Fronts

Experts delve deep into the origins and treatment of pain linked to rheumatoid arthritis in an article in the December issue of Arthritis & Rheumatism.

"Rheumatologists are increasingly required to address pain as a specific symptom. Pain management is no longer simply a quick fix with a single pill, but rather an approach to the patient as a whole biophysical being," lead author Dr. Mary-Ann Fitzcharles of Montreal General Hospital, McGill University, said in a prepared statement.

"There is no gold standard regarding the ideal management of chronic pain in rheumatic disease. Ideal pain management should encompass a wide range of both pharmacological and nonpharmacological interventions," she said.

The article offers a review of complementary treatments for pain in people with RA:

• Exercise. Regular activity maintains muscle tone, improves function and induces production of natural painkillers in the body.
• Herbal and dietary supplements. For example, RA patients recorded decreased pain after taking supplementation with an omega-3 enriched diet for 12 months. This approach reduced the need for anti-rheumatic drugs.
• Topical medications. Healing ointments have been used as home remedies for centuries, and have shown clinical promise in treating rheumatic conditions.
• Opioid analgesics. Widely used for treating pain in cancer patients, opioids are increasingly being prescribed for people with musculoskeletal pain. However, there is only limited data on the long-term effects of opioids in people with rheumatic pain, and it isn't clear whether opioids provide sufficient benefit to possible harmful effects.

"Rheumatologists will need to become familiar and comfortable with the use of newly developed strategies for pain management to ensure optimal treatment. Improved function and rehabilitation, and not simply palliation, should be the main goal of pain management in rheumatologic practice," Fitzcharles concluded.