Understanding Pain Mechanisms in Rheumatology

Pain often complicates medical decision-making in rheumatology, especially in conditions like psoriatic arthritis. Three types of pain mechanisms were discussed: nociceptive pain, which arises from inflammation or mechanical irritation; neuropathic pain, caused by nerve damage; and nociplastic pain, characterized by central sensitization without direct peripheral input, commonly seen in fibromyalgia. Recognizing these mechanisms is crucial for optimizing pain treatment, particularly since fibromyalgia may affect up to 20% of patients with rheumatologic diseases. Effective treatment strategies should include pain management approaches specifically tailored to address fibromyalgia, rather than solely focusing on controlling inflammation.