Pain in the rheumatic diseases - Practical aspects of diagnosis and treatment

Pain is a pervasive complaint of patients with musculoskeletal disease. Thi s symptom may result from both central and peripheral factors and, in the i ndividual patient, may have individual causes. Because of the interplay of these factors, treatment can entail a variety of pharmacological agents, wi th drugs modulating central pain as a common component even in patients wit h structural and inflammatory disease. In older patients and in patients wi th chronic inflammatory disease, frequent reevaluation may be needed to sta ge disease and detect intercurrent problems leading to pain.