How to Distinguish Non-Inflammatory from Inflammatory Pain in RA?

IF 5.7 2区医学 Q1 RHEUMATOLOGY Current Rheumatology Reports Pub Date : 2024-12-01 Epub Date: 2024-08-09 DOI:10.1007/s11926-024-01159-4

Sharmila Khot, George Tackley, Ernest Choy

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Abstract

Purpose of the review: Managing non-inflammatory pain in rheumatoid arthritis (RA) can be a huge burden for the rheumatologist. Pain that persists despite optimal RA treatment is extremely challenging for patient and physician alike. Here, we outline the latest research relevant to distinguishing non-inflammatory from inflammatory RA pain and review the current understanding of its neurobiology and management.

Recent findings: Nociplastic pain is a recently introduced term by the international pain community. Its definition encompasses the non-inflammatory pain of RA and describes pain that is not driven by inflamed joints or compromised nerves, but that is instead driven by a functional reorganisation of the central nervous system (CNS). Insights from all areas of nociplastic pain research, including fibromyalgia, support a personalised pain management approach for non-inflammatory pain of RA, with evidence-based guidelines favouring use of non-pharmacological interventions. Future developments include novel CNS targeting pharmacotherapeutic approaches to treat nociplastic pain.

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如何区分 RA 中的非炎症性疼痛和炎症性疼痛？

综述的目的：治疗类风湿性关节炎（RA）的非炎症性疼痛对风湿病医生来说是一项巨大的负担。对患者和医生而言，在接受最佳 RA 治疗后仍持续存在的疼痛极具挑战性。在此，我们概述了与区分非炎症性和炎症性 RA 疼痛相关的最新研究，并回顾了目前对其神经生物学和管理的理解：非炎症性疼痛是国际疼痛学界最近引入的一个术语。其定义涵盖了 RA 的非炎症性疼痛，描述的疼痛不是由发炎的关节或受损的神经引起的，而是由中枢神经系统（CNS）的功能重组引起的。包括纤维肌痛在内的所有非痉挛性疼痛研究领域的观点都支持针对RA非炎症性疼痛采取个性化的疼痛管理方法，循证指南倾向于使用非药物干预措施。未来的发展包括治疗非运动性疼痛的新型中枢神经系统靶向药物治疗方法。

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来源期刊

Current Rheumatology Reports RHEUMATOLOGY-

CiteScore

11.20

自引率

0.00%

发文量

期刊介绍： This journal aims to review the most important, recently published research in the field of rheumatology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of rheumatologic conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas such as the many forms of arthritis, osteoporosis and metabolic bone disease, and systemic lupus erythematosus. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also occasionally provided.