Rethinking Pain Management in Inflammatory Arthritis: A Shift Toward Better Care

For millions of individuals living with inflammatory arthritis—such as rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis—pain is more than an occasional symptom. It’s a daily reality. From morning stiffness and disrupted sleep to the emotional burden of persistent discomfort, arthritis-related pain can significantly impact every aspect of life.

Yet despite medical advances, many people continue to struggle with pain that is poorly understood and inadequately treated. Fortunately, a new guideline from the British Society for Rheumatology (BSR) is challenging the status quo—and reshaping how pain is assessed and managed.

Understanding the Full Impact of Inflammatory Arthritis Pain

Inflammatory arthritis causes the immune system to attack the joints, leading to chronic inflammation, stiffness, and swelling. But the experience of pain is complex—driven not only by joint damage, but also by the nervous system, emotional well-being, sleep quality, and personal coping mechanisms.

Common challenges reported by people living with inflammatory arthritis include:

• Morning stiffness that makes it difficult to start the day

• Pain during simple tasks like walking or lifting objects

• Interrupted sleep due to discomfort

• Frustration from trying multiple treatments with limited relief

These symptoms aren’t just physical—they can affect mood, relationships, and quality of life. In fact, research has shown that chronic pain is strongly associated with increased risk of anxiety and depression in individuals with inflammatory arthritis.

A New, Patient-Centered Guideline from the BSR

In response to the ongoing burden of pain in arthritis, the British Society for Rheumatology released a comprehensive guideline in 2024 that emphasizes a more holistic, patient-focused approach. Developed by a multidisciplinary team—including rheumatologists, psychologists, physiotherapists, and patient representatives—the guideline aims to improve outcomes by addressing the many dimensions of pain.

Key Highlights of the New Guideline:

✅ Personalized Pain Assessments
Rather than relying solely on a 1-to-10 pain scale, the new guideline encourages clinicians to assess how pain impacts sleep, daily activities, emotional well-being, and overall function.

✅ Integrated, Multi-Disciplinary Care
Effective pain management should involve more than medications. The guideline promotes collaboration across specialties, including physical therapy, mental health support, pain education, and lifestyle interventions.

✅ Focus on the Patient Experience
Patient input is central. Understanding the lived experiences of those with arthritis helps providers tailor treatments that align with individual needs and preferences.

✅ Evidence-Based Non-Pharmacological Options
The guideline highlights the value of exercise therapy, cognitive behavioral therapy (CBT), pacing techniques, mindfulness, and other non-drug approaches—alongside appropriate medication use.

Why This Matters for Patients

Many individuals with arthritis have experienced trial-and-error treatment plans that leave them feeling discouraged. The BSR’s guideline represents a step toward more compassionate, comprehensive care that validates the patient experience and addresses pain as a whole-body, whole-person issue.

This shift aligns with broader global efforts—including those led by the American Arthritis Foundation—to ensure that pain is not minimized or overlooked in arthritis care.

What You Can Do

If you’re living with inflammatory arthritis and struggling with pain, consider the following steps:

• Speak openly with your care team about how pain is affecting your daily life—not just physically, but emotionally and socially.

• Ask about integrative treatment options, such as physical therapy, counseling, or guided exercise programs.

• Track your symptoms with a journal or app to identify patterns and improve communication with your providers.

• Seek support through patient communities or local arthritis organizations. Shared experiences can be a powerful source of insight and encouragement.

Looking Ahead: A More Empowered Approach to Pain

Inflammatory arthritis pain is real, complex, and deeply personal. With the release of the BSR guideline, the healthcare community is beginning to embrace more empathetic, multidisciplinary strategies that reflect what patients have long known—effective arthritis care must go beyond treating joints.

At the American Arthritis Foundation, we are committed to supporting this change by educating patients, advocating for improved care standards, and connecting individuals to providers who understand the full impact of arthritis.

📣 Have you struggled to find effective pain relief for your arthritis? You’re not alone—and better care is possible.