Rheumatism: When the pain doesn't go away

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.

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Many patients with rheumatoid arthritis still suffer from severe pain even after the joint therapy has worked well. Then what can help?

Rheumatoid arthritis is an inflammatory joint disease caused by an autoimmune reaction. The inflammation can usually be contained well with medication. But the disease also affects the joints - in the surrounding soft tissues, but also in more distant parts of the body. A Swedish study shows that pain often persists over the long term.

Pain despite contained inflammation

According to the study, 32 percent of patients still complained of unacceptable pain after one year, even though they were treated with effective drugs in the early stages of the disease. In two-thirds of these patients, the drugs had largely stopped the inflammatory reactions in the body by this point.

"The unacceptable pain a year after the diagnosis is therefore not related to the current disease activity," explains Prof. Christoph Baerwald, head of the rheumatology department at Leipzig University Hospital. "As a result of the severe inflammation at the beginning of the disease, the nerves may be sensitized, which then continue to react with pain to lighter stimuli."

Take pain patients seriously

Particularly affected were patients who had reported a greater limitation in everyday life at the beginning of the disease. In addition, women in the study were 2.5 times more likely to experience greater pain than men.

"The connection between female gender and persistent unacceptable pain could indicate gender differences in the severity of the disease or in the tendency to chronic pain," says Baerwald, summarizing the study results. The rheumatologist emphasizes that it is important to take patients with pain beyond the joints seriously and to treat them consistently.

Nerve pain medication

Increasing the dose of rheumatoid drugs would rarely help in such cases. Medicines for treating nerve pain were more likely to have an effect. If necessary, those affected must be treated in an interdisciplinary manner in cooperation with a pain therapist.

"Just looking at the joints is not enough," explains Professor Hendrik Schulze-Koops from the Ludwig Maximilians University in Munich, President of the German Society for Rheumatology. "Rheumatism is a systemic disease affecting the entire body, the treatment must therefore also consider symptoms throughout the body."

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