Arthritis Pain

How Many Americans Have Arthritis Pain?

Chronic pain is a major health problem in the United States and is one of the most weakening effects of arthritis. More than 40 million Americans are affected by some form of arthritis, and many have chronic pain that limits daily activity. Osteoarthritis is by far the most common form of arthritis, affecting over 20 million Americans, while rheumatoid arthritis, which affects about 2.1 million Americans, is the most disabling form of the disease.

What Causes Arthritis Pain? Why Is It So Variable?

The pain of arthritis may come from different sources. These may include inflammation of the synovial membrane (tissue that lines the joints), the tendons, or the ligaments; muscle strain; and fatigue. A combination of these factors contributes to the intensity of the pain.

The pain of arthritis varies greatly from person to person, for reasons that doctors do not yet understand completely. Factors that contribute to the pain include swelling within the joint, the amount of heat or redness present, or damage that has occurred within the joint. In addition, activities affect pain differently so that some patients note pain in their joints after first getting out of bed in the morning, whereas others develop pain after prolonged use of the joint. Each individual has a different threshold and tolerance for pain, often affected by both physical and emotional factors. These can include depression, anxiety, and even hypersensitivity at the affected sites due to inflammation and tissue injury. This increased sensitivity appears to affect the amount of pain perceived by the individual. Social support networks can make an important contribution to pain management.

How Do Doctors Measure Arthritis Pain?

Pain is a private, unique experience that cannot be seen. The most common way to measure pain is for the doctor to ask you, the patient, about your difficulties. For example, the doctor may ask you to describe the level of pain you feel on a scale of 1 to 10. You may use words like aching, burning, stinging, or throbbing. These words will give the doctor a clearer picture of the pain you are experiencing.

Since doctors rely on your description of pain to help guide treatment, you may want to keep a pain diary to record your pain sensations. You can begin a week or two before your visit to the doctor. On a daily basis, you can describe the situations that cause or alter the intensity of your pain, the sensations and severity of your pain, and your reactions to the pain. For example: "On Monday night, sharp pains in my knees produced by housework interfered with my sleep; on Tuesday morning, because of the pain, I had a hard time getting out bed. However, I coped with the pain by taking my medication and applying ice to my knees." The diary will give the doctor some insight into your pain and may play a critical role in the management of your disease.

What Will Happen When You First Visit a Doctor for Your Arthritis Pain?

The doctor will usually do the following:

• Take your medical history and ask questions such as, How long have you been experiencing pain? How intense is the pain? How often does it occur? What causes it to get worse? What causes it to get better?
  
  
• Review the medications you are using
  
  
• Conduct a physical examination to determine causes of pain and how this pain is affecting your ability to function
  
  
• Take blood and/or urine samples and request necessary laboratory work
  
  
• Ask you to get x rays taken or undergo other imaging procedures such as a CAT scan (computerized axial tomography) or MRI (magnetic resonance imaging) to see how much joint damage has been done.
  
  

Once the doctor has done these things and reviewed the results of any tests or procedures, he or she will discuss the findings with you and design a comprehensive management approach for the pain caused by your osteoarthritis or rheumatoid arthritis.

Who Can Treat Arthritis Pain?