Mechanisms for Joint Pain in Rheumatoid Arthritis (RA): from Cytokines to Central Sensitization

Angela Zhang, Yvonne C. Lee*

*Corresponding author for this work

Research output: Contribution to journalReview article

13 Scopus citations


Purpose of Review: Pain in rheumatoid arthritis (RA) may be due to different etiologies, ranging from peripheral inflammation to dysregulation of central nervous system (CNS) processing. This review evaluates relevant literature published on RA pain mechanisms in recent years. Recent Findings: Despite successes of disease-modifying antirheumatic drugs (DMARDs), pain persists for many RA patients. Studies involving patient-reported outcomes, quantitative sensory testing, and neuroimaging indicate that, in addition to joint inflammation, abnormalities in CNS pain processing may contribute to pain. Some DMARDs (e.g., janus kinus inhibitors) may work via multiple pathways to decrease pain. Adjunctive treatments (e.g., antidepressants, antiepileptics) may also be useful in managing pain in RA patients with well-controlled disease. Summary: Both peripheral and central mechanisms play key roles in the expression of pain in RA. To effectively manage pain, physicians need accurate assessment tools to identify the pathways involved in each patient so that treatments may be appropriately targeted.

Original languageEnglish (US)
Pages (from-to)603-610
Number of pages8
JournalCurrent Osteoporosis Reports
Issue number5
StatePublished - Oct 1 2018


  • Disease activity
  • Inflammation
  • Pain
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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