Principles & Practice of Pain Medicine > Part IV. Pain by Anatomic Location > C. Extremities and Joints > Chapter 31. Pain Management in Rheumatologic Disorders Matthew Lefkovitz, Daniel Ricciardi

Pain Management in Rheumatologic Disorders: Introduction

"Pain resulting from various bone and joint disorders, whether noninflammatory (e.g., degenerative joint disease, osteoarthritis [OA]) or inflammatory (e.g., rheumatoid arthritis [RA]), significantly reduces the quality of life in affected patients. Individuals with chronic pain often become depressed and socially isolated and experience functional decline and disability as well as morbidity and mortality associated with pain. Data on undertreatment of pain in patients with arthritis do not appear to be available. However, as many as 20% of patients with cancer may have inadequate pain relief even when World Health Organization (WHO) guidelines (the analgesic ladder)² are used.³ Pain is frequently underassessed and undertreated in patients with arthritis⁴ and in elderly patients. A review of 15 studies of chronic pain in the elderly found a median point prevalence of 15% (range from 2% to 40%) and noted that there were no clearcut differences between estimates based on self-assessment and those made by physicians after clinical examination.⁵..."