Abstract
Although biological DMARDs (b-DMARDs) have made remission of rheumatoid arthritis (RA) a realistic treatment goal, there are still patients who remain complaining about pain.
Such cases have been reported to be affected by psycho-emotional problems such as catastrophic thinking, and analysis of data from multicenter studies, including those from our hospital, shows that psycho-emotional problems affecting complaints are not related to the main symptoms, such as disease activity and pain intensity. Furthermore, there was a low association with factors such as duration of illness and age. This seemingly incomprehensible condition is what makes it difficult to understand and interpret the pain complaints of RA patients.
In the era of mainstream b-DMARDs, pain itself is unlikely to limit the functions of daily living. However, there are problems caused by physical functional factors, such as some kind of physical dysfunction and decreased physical activity, and there is an intervening pain that remains even in remission and low disease activity. This paper discusses the relationship between residual pain and functional impairment, psycho-psychological factors, and quality of life, and discusses the role of pain rehabilitation in RA patients in the mainstream era of b-DMARDs from the perspective of a physical therapist.
