Management of pain in arthritis

Introduction The negative impact of arthritis on virtually every aspect of society is so great as to be almost inestimable. In addition to direct costs of care, the indirect costs resulting from arthritis-related work disability, absences, and decreased productivity, are monumental. Thus, arthritic conditions not only generate pain and suffering, but contribute to financial hardship, decreased quality of life, and life dissatisfaction. The resulting social and psychological impact of arthritic conditions can be staggering. According to the National Health Interview Survey over 46 million adults in the USA have some form of arthritis. Almost half of these adults, i.e., 18.9 million patients, have limitations in daily activities attributable to the arthritis. Arthritis prevalence increases with age and is higher among women in every age group in the USA. Prevalence rates are expected to rise; by the year 2030 an estimated 67 million adults in the United States will have diagnosable arthritis. The adverse impact of arthritic conditions is therefore expected to rise significantly. Despite these and other problems and challenges faced by arthritis sufferers, there are now more and varied treatment options available to them than in the past. The first portion of this chapter will examine current diagnostic and treatment approaches to osteoarthritis, rheumatoid arthritis, and systemic lupus erythematosus. The second portion of this chapter will address psychological and psychopharmacological treatment approaches, particularly for pain management, in arthritic conditions.