Thread by @ERheumat

#EULAR2022
Pain in rheumatic and musculoskeletal diseases
😩Pathophysiology of pain in patients with RMDs is not always Nociceptive and can be nociplastic
😩Differentiation between inflammation-related and unrelated pain is important

#EULAR2022
Pain in rheumatic and musculoskeletal diseases
😩Pain can be Nociceptive, Neuropathic and Nociplastic
😩Or can be primary/Secondary
😩Pain sensitisation, processing and response are important for proper assimilation of pain

#EULAR2022
😩No standard method to measure central pain
😩FMS can be present in upto 50% of patients
😩Asso with Higher disease activity and higher biologic use/change
😩A no. of central mechanisms contribute to pain

#EULAR2022
😩FMS co-exists with other RMDs
😩The newer classification is more exclusive
😩 ⬆️ sensitivity or ⬇️ inhibitory control of pain can happen
😩 The concept of fibromyalgianess is new and interesting
😩Pharmacological management is available and can be effective

#EULAR2022
Pain in rheumatic and musculoskeletal diseases
😩Nociplastic pain in RA
😩In 20-30% pts
😩Older
😩⬆️ pain scores / DAS28s
😩Worse Physical functions
😩Mental health issues
😩⬆️ Comorbidities
😩More freq Rx changes
😩Poor Response to bDMARDs

#EULAR2022
Pain in rheumatic and musculoskeletal diseases
😩Management requires effective screening and holistic multidimensional, multimodal management
😩Education
😩Physical Activity + wt. ⬇️
😩Psychosocial interventions
😩Occupational therapy
😩Sleep Rx
😩Pain control meds

#EULAR2022
Pain in rheumatic and musculoskeletal diseases
Conclusions of understanding Nociceptive pain in RA and SpA
Don't Stigmatize Fibromyalgia