Pain and Arthritis

Address arthritis-associated pain as a disease entity, not as a sensory entity. Attempt to classify chronic pain as nociceptive pain, neuropathic pain, fibromyalgia-type pain, or psychogenic pain (very uncommon); specific treatment approaches are required for these different types of pain. Overcome your negative bias against fibromyalgia and review recent discoveries that have led to classification of fibromyalgia as a biologically-based neurosensory disorder. Use the simple and convenient ways that are available to measure pain and its concomitants (fatigue, poor sleep, depression, anxiety, and impaired physical functioning) both at initial evaluation and in follow-up visits as a guide to therapy. Do not fear use of opioids; just be careful with this class of drug.