Many people with inflammatory arthritis continue to experience high levels of pain even when receiving effective treatments. Chronic pain is a complex biological process that cannot be easily remedied with a single pill. A multimodal approach is required.
Inflammatory arthritis (IA) affects up to 3% of the population and is characterised by pain, stiffness, loss of function and impaired quality of life. It comprises diseases such as rheumatoid arthritis (Figure 1), psoriatic arthritis, reactive arthritis and spondyloarthropathies, and when treatment is successful IA is a satisfying condition to treat. There are many examples of the debilitated patient with polyarthritis who is revived with a pulse of steroid. Instant trust and often a smile can follow. Unfortunately, this is not always the case and for doctors and patients it can be frustrating when treatment fails to live up to the high expectations.