Treatment of rheumatic diseases. Different nosologies, common problems

Abstract

A characteristic feature of rheumatic diseases (RD) is a chronic inflammatory process, which contribute to their pathogenesis, and determines the formation of a persistent pain syndrome. Therefore, in current recommendations for the treatment of RD, the main attention is paid to the correction of disorders that induce pain caused by inflammation. Meanwhile, more and more data are accumulating on the participation of noninflammatory mechanisms in the development of pain in RD. In some cases, the clinical picture of RD is determined by the simultaneous participation of several mechanisms. At the same time, the symptoms associated with the inflammatory process can eventually transform into a different pain phenotype, which persists even after the suppression of inflammatory changes. In such a situation, a correct assessment of the patient's status can cause serious difficulties. The results of the studies show that in everyday clinical practice, when assessing the status of a patient, in addition to the disorders characteristic of each disease, it is necessary to take into account the possibility of the presence of symptoms due to the mechanisms of central sensitization common to various joint diseases.