Clinical Entities and Characteristics of Pain in Patients With Rheumatic Diseases

Mišićno-koštana bol najčešći je simptom prisutan u gotovo svim reumatskim bolestima. Reumatske bolesti obuhvaćaju više od 150 kliničkih entiteta. Nema jedinstvene klasifikacije reumatskih bolesti. Općenito ih dijelimo na upalne reumatske bolesti, neupalne bolesti zglobova degenerativnog karaktera, sustavne bolesti vezivnog tkiva, metaboličke poremećaje s manifestacijom na zglobovima, regionalne i proširene bolne sindrome. Bol je prema Međunarodnom udruženju za proučavanje boli (IASP) definirana kao neugodan osjećaj povezan s oštećenjem tkiva ili opisan u vrijeme takvog oštećenja. Ona ima svoju tjelesnu, duševnu i socijalnu komponentu. Najčešće se u reumatskim bolestima radi o kroničnoj boli koja može narušiti opće stanje organizma, traje duže od 3 ili 6 mjeseci, a prema nekim definicijama, već i ako postoji duže od 6 tjedana. Uglavnom je nociceptivna, a rjeđe neuropatska. Mišićno-koštana bol, osobito kronična, globalni je javnozdravstveni problem zbog svoje učestalosti, nerijetko oštećenja funkcije i razvoja kroničnoga bolnog sindroma koji se može smatrati zasebnim kliničkim entitetom i zahtijeva biopsihosocijalni pristup u liječenju bolesnika.Musculoskeletal pain is the most common symptom present in almost all rheumatic diseases. Rheumatic diseases include more than 150 clinical entities. There is no uniform classification of rheumatic diseases. In general, we distinguish inflammatory rheumatic diseases, non-infl ammatory degenerative articular diseases, systemic connective tissue diseases, metabolic disorders with articular manifestations, and regional and extended pain syndromes. According to the International Association for the Study of Pain (IASP), pain is defined as an unpleasant sensation associated with tissue damage or reported simultaneously with such damage. Pain has a physical, mental, and social component. In rheumatic diseases the pain is mostly chronic and may severely impair the patient’s general condition. The defining criteria involve a period of more than 3 or 6 months, and according to some definitions more than 6 weeks. In most cases the pain is nociceptive rather than neuropathic. Musculoskeletal pain, especially chronic pain, is a global public health problem because of its prevalence, as well as the frequently associated muslculoskeletal function impairment and development of chronic pain syndrome, which can be considered as a separate clinical entity and requires a biopsychosocial treatment approach