Arthritis Pain: An Introduction

Arthritis is a painful condition involving one or more joints as well as periarticular structures. In addition to pain the condition is characterized by swelling, stiffness and deformity. In moderate to severe cases there is associated muscle weakness and atrophy as well as systemic symptoms of fatigue and depression. It is a major cause of disability which is sometimes pain related and sometimes not.


The most important part of treating arthritis pain as in so many other conditions is making an accurate diagnosis. There are many different types of arthritis and the treatments can vary considerably. The most common type of arthritis is osteoarthritis, which is felt to be a degenerative condition in which the affected joints simply wear out and for which there is currently no specific treatment. This must be differentiated from infectious arthritis and the so-called sero-positive arthritides such as rheumatoid arthritis and ankylosing spondylitis for which there are more specific and hopefully more effective treatment.


Another important way of grouping arthritides is by the number of joints involved. Monoarthritis is defined as arthritis affecting a single joint and therefore is easily amenable to both systemic and local therapy. Polyarthritis by contrast involves more than one joint and can be further subdivided into a limited form involving a small number of joints and a generalized form involving a large number of joints. The distinction may be more useful in developing treatment strategies than in differentiating between distinct pathophysiologic mechanisms. When a relatively small number of joints are involved local treatment options may be effective while in any generalized arthritis.


In the following pages we will look at the different forms of arthritis in detail as well as the major treatment strategies. We will look at the progression of the disease from its preclinical phases to more advance stages of the disease constantly returning to the questions of not only pain but function as well.


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