Open Access Highly Accessed Open Badges Research article

Enhanced reactivity to pain in patients with rheumatoid arthritis

Robert R Edwards*, Ajay D Wasan, Clifton O Bingham, Joan Bathon, Jennifer A Haythornthwaite, Michael T Smith and Gayle G Page

Arthritis Research & Therapy 2009, 11:R61  doi:10.1186/ar2684

See related editorial by Straub and Kalden,

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A patient's response

Kelly Young   (2010-02-24 14:25)  Rheumatoid Arthritis Warrior email

I disagree with the premises and conclusions of this article. My full reply is here. In addition to living with Rheumatoid Arthritis personally, I have compared the responses of thousands of RA patients' statements about pain.

Your theory does not offer explanation for this key fact: Onset of RA pain tends to be sudden in nature and extremely severe. If maladaptation to chronic pain were the reason for perception of its severity, then what explains sudden extreme pain during disease onset?

Have you considered the possibiity that rather than "amplified responses to pain," RA actually causes severe pain? You would have no way to objectively measure this, but RA patients are able describe it.

What of RA patients who have decades of living with various pains in life such as broken bones and childbirth prior to diagnosis? They indicate that, objectively compared, RA pain is worse than any other pain ever experienced.

Is it so difficult to believe that a disease that is as destructive as RA is to human tissue can cause extreme pain in that destructive process? We are obviously in our infancy of the understanding of this disease. Hearing the patient's viewpoint of what the disease actually entails would be the best way to progress.

Note:. Regarding the conclusion that RA patients would benefit from more studies of this kind: Rheumatoid arthritis patients would benefit more from having their disease treated than from having their claims of pain diminished. We ought to put our resources toward curing RA and reducing its mortality gap.

Thank you for reading.
Kelly Young
Rheumatoid Arthritis Warrior

Competing interests

I have no competing interests. I have no monetary gain from either having Rheumatoid Arthritis pain or writing about it at this time.


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