Abstract
Central sensitization (CS) is present in a variety of chronic pain conditions including rheumatoid arthritis (RA). An overview of the treatment options for desensitizing the central nervous system in RA patients, with CS as their dominant pain mechanism, is provided. The treatment of pain in RA patients has mostly focused on treating inflammation to indirectly treat pain. Unfortunately, little research has focused on treating CS, which appears to be present in some patients with RA. “Treating the brain without ignoring the joints” should be the leading principle in the management of CS in RA patients. Pain neuroscience education, graded activity, and a time-contingent exercise approach are important interventions to implement in clinical practice. Further research is necessary to evaluate the effectiveness of these promising treatments for diminishing hyperexcitability of the central nervous system in RA patients with CS as their dominant pain mechanism.
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