MECHANISMS OF NOCICEPTIVE PAIN IN PEOPLE WITH RHEUMATOID ARTHRITIS: A SYSTEMATIC REVIEW

Abstract

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology, characterized by joint inflammation, pain and functional deficit. As implications of the disease, individuals may experience fatigue, decreased range of motion and pain. The pain seems to be the most important symptom for most patients and is considered the main goal of most rheumatic treatments. Objective: To identify the mechanisms in the literature of nociceptive pain in patients with rheumatoid arthritis. Methods: We accessed the databases: Medline, SciELO and Cochrane in the period from 10 to 30 April 2011. According to the keywords found in titles and abstracts of the studies included were those who made reference to the causes and mechanisms of nociceptive pain in RA and were published in Portuguese, English and Spanish. We excluded studies that reported only to the treatment ofRA and those who did not describe the methodology and / or did not present the results and discussion session. Results: We selected 32 articles to read in full, 22 being excluded by the methodology or content inconsistent with the theme. It was shown that factors such as TNF-?, chemokines, cytokines, prostanoids, COX-2, PKC, neutrophils and TRPV1 channels are the main substances related to nociceptive algic clinical manifestation of RA.  Conclusion: In this study it was observed that several substances play an important role for the potentiation of nociceptive pain in RA through different mechanisms. Thus it became clear the importance of a multidisciplinary approach, addressing the various aspects of pain, minimizing or delaying the amplification of pain in the CNS.