March 25, 2009 -- Many people with rheumatoid arthritis may have barriers that hinder optimal management of their pain, a study suggests.
Barriers to pain reduction, Canadian researchers say, include fear of medication side effects, fear of drug interactions, worry about drug addiction, concerns that the effects of medication might mask the disease, and aversion to taking too many pills.
McGill University scientists studied 60 patients with rheumatoid arthritis, all of whom were being treated by specialists. Of the rheumatoid arthritis sufferers, 53% described their pain as moderate to severe. Forty-seven percent reported that pain was mild or absent. And 65% of all patients, including about half of those with moderate to severe pain, were satisfied with current methods to control suffering, the researchers report in the March issue of The Journal of Pain.
Although 87% of the patients reported that they expected to have "some" pain to "much" pain from their rheumatoid arthritis, only 13% didn't expect any pain or only slight pain.
The researchers, led by Mary-Ann Fitzcharles, MD, of Montreal General Hospital at McGill University, were interested in the potential barriers to reducing pain that kept some people hurting.
The top barriers to optimal pain management found in the study participants included:
- Worry of medication side effects (80%)
- Not wanting to take "too many pills" (63%)
- Worry about medication interactions (57%)
- Worry of addiction (35%)
The researchers found that more than half of the patients had at least three barriers.
The researchers conclude that people with rheumatoid arthritis should be questioned vigorously about their pain, and that clinicians should explore potential barriers to effective pain control.