NEW YORK (Reuters Health) May 28 - Patients with rheumatoid arthritis (RA) demonstrate general hyperalgesia to mechanical and thermal stimuli across several body sites, researchers report in the May 4th issue of Arthritis Research & Therapy.
Lead investigator Dr. Robert R. Edwards told Reuters Health, "Treated RA patients remain more pain-sensitive than controls, which may place these patients at greater risk for other sorts of pain problems such as post-surgical pain."
Dr. Edwards of Brigham and Women's Hospital, Chestnut Hill, Massachusetts and colleagues observe that although "it is well-established that RA patients are more behaviorally responsive to noxious stimulation relative to non-arthritic controls, no studies have evaluated whether RA patients show aberrant inflammation-related responses to the experience of acute pain in a controlled laboratory setting."
To investigate further, the team subjected 19 RA patients and 21 healthy controls to standardized noxious stimuli. Serum cortisol levels increased but did not differ between groups at baseline or during testing. However, the RA patients tended to show elevations in serum IL-6 and demonstrated significantly increased levels of TNF-alpha which remained heightened for at least an hour after testing.
Thus, continued Dr. Edwards, "RA patients may be on a medication regimen that effectively manages their inflammation under 'resting' or 'baseline' conditions, but in the context of painful stress -- in this case, pain stimulation applied in the laboratory -- those RA patients may show significant elevations in inflammatory markers."
"This could suggest," he concluded, "that testing of inflammation levels in RA patients might best be done under conditions of stress, and that more aggressive anti-inflammatory treatment could be helpful in preventing stress- or pain-related spikes in inflammatory disease activity."
Arthritis Res Ther. 2009;11.
I definitely can say this was my experience.. When I was in flare.... I wondered about this after my surgery because I felt like I was being such a wuss! I thought with all the crap I went through with RA, surgery would be a piece of cake. Nope... it HURT, dammit! Now that's interesting.