Rheumatoid Arthritis and Pain Management: Literature Review

Abstract

Background: Rheumatoid arthritis (RA) is a chronic, immune-mediated, systemic inflammatory disease of the synovial joints that influences approximately 0.5-1% of the population global. Degrees of RA vary in different patients and are assessed according to intensity, pain, and disability in daily life. Purpose: The purpose of this literature review is to review RA pain, and mediators primarily cytokines, inflammation mediators, and various RA mechanisms. Method: This is a descriptive review. Relevant literature was identified by searching PubMed using key search terms, including arthritis, cytokines, cytokine signaling, inflammation, Janus kinases, pain, mechanisms, rheumatoid arthritis. Results: Several cytokines that target the treatment of RA, such as TNF-α, IL-1, and IL-6, have been well characterized in the pathogenesis of RA and associated pain through autoimmunity promotion, chronic inflammatory synovitis, and destruction of adjacent joint tissue. The range of epigenetic and other mechanisms by which such variants could disrupt cytokine homeostasis to increase disease risk is only beginning to be understood, along with the recognition that in relevant disease contexts they are best dissected at the cellular level. Another descriptive review talks about the role of the central nervous system. Many studies have explored the mechanisms of CNS pain in fibromyalgia and research on CNS pain mechanisms in osteoarthritis is growing. Conclusions: We conclude that there are different pathways to explain pain in rheumatoid arthritis.   Received: 9 September 2022 / Accepted: 22 November 2022 / Published: 20 December 2022