RESEARCH - RA patients show increased pain sensitivity

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Rheumatoid Arthritis Patients Show Increased Pain Sensitivity

NEW YORK (Reuters Health) May 28 - Patients with rheumatoid arthritis

(RA) demonstrate general hyperalgesia to mechanical and thermal

stimuli across several body sites, researchers report in the May 4th

issue of Arthritis Research & Therapy.

Lead investigator Dr. R. told Reuters Health, " Treated

RA patients remain more pain-sensitive than controls, which may place

these patients at greater risk for other sorts of pain problems such

as post-surgical pain. "

Dr. of Brigham and Women's Hospital, Chestnut Hill,

Massachusetts and colleagues observe that although " it is

well-established that RA patients are more behaviorally responsive to

noxious stimulation relative to non-arthritic controls, no studies

have evaluated whether RA patients show aberrant inflammation-related

responses to the experience of acute pain in a controlled laboratory

setting. "

To investigate further, the team subjected 19 RA patients and 21

healthy controls to standardized noxious stimuli. Serum cortisol

levels increased but did not differ between groups at baseline or

during testing. However, the RA patients tended to show elevations in

serum IL-6 and demonstrated significantly increased levels of

TNF-alpha which remained heightened for at least an hour after

testing.

Thus, continued Dr. , " RA patients may be on a medication

regimen that effectively manages their inflammation under 'resting' or

'baseline' conditions, but in the context of painful stress -- in this

case, pain stimulation applied in the laboratory -- those RA patients

may show significant elevations in inflammatory markers. "

" This could suggest, " he concluded, " that testing of inflammation

levels in RA patients might best be done under conditions of stress,

and that more aggressive anti-inflammatory treatment could be helpful

in preventing stress- or pain-related spikes in inflammatory disease

activity. "

Arthritis Res Ther. 2009;11.

http://www.medscape.com/viewarticle/703534

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