Motyl Gabriela, Krupka Wiktoria Maria, Maślińska Maria
Medical University of Warsaw, Poland.
Rheumatology Student Research Group at the National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland.
Reumatologia. 2024;62(3):176-186. doi: 10.5114/reum/189779. Epub 2024 Jul 12.
Residual pain is a major unmet medical need observed in patients suffering from rheumatoid arthritis (RA), which decreases their quality of life, even after achieving remission or low disease activity. The article has two aims: 1) to present mechanisms involved in the pathophysiology of residual pain, both inflammatory and non-inflammatory, i.e. neuropathic and nociplastic pain, as well as secondary pain syndromes, i.e. osteoarthritis and fibromyalgia, which can contribute to residual pain; 2) to show the limitations of current disease activity measures recommended by European Alliance of Associations for Rheumatology (EULAR) and American College of Rheumatology (ACR), which raise the need for a separate assessment of pain, and examples of methods that could be used by medical professionals to assess the pain and make a differential diagnosis. In conclusion, establishing a valid method to assess pain is essential to identify the pathomechanism of residual pain and to create treatments tailored specifically to individual RA patients.
残留疼痛是类风湿关节炎（RA）患者中一种尚未得到满足的主要医疗需求，即使在病情缓解或疾病活动度较低时，残留疼痛也会降低患者的生活质量。本文有两个目的：1）介绍参与残留疼痛病理生理学的机制，包括炎症性和非炎症性机制，即神经性疼痛和伤害感受性疼痛，以及继发性疼痛综合征，即骨关节炎和纤维肌痛，这些都可能导致残留疼痛；2）展示欧洲风湿病联盟（EULAR）和美国风湿病学会（ACR）推荐的当前疾病活动度测量方法的局限性，这凸显了单独评估疼痛的必要性，并列举医疗专业人员可用于评估疼痛和进行鉴别诊断的方法实例。总之，建立一种有效的疼痛评估方法对于识别残留疼痛的发病机制以及为个体RA患者制定专门的治疗方案至关重要。
