Residual joint pain in patients with rheumatoid arthritis in clinical remission

If a patient with well-controlled RA (ie in clinical remission) experiences residual joint pain, it is likely to be noninflammatory in nature, rather than a disease flare. If there are no signs or symptoms of joint inflammation, systemic corticosteroids are not recommended for the management of residual joint pain.

Note: If there are no signs or symptoms of joint inflammation, systemic corticosteroids are not recommended for the management of residual joint pain in patients with RA.

If coexisting osteoarthritis is thought to be contributing to the residual joint pain, see Essential features of osteoarthritis management for advice.

Management for noninflammatory residual joint pain associated with RA follows the same principles as for other types of noninflammatory chronic pain; see General principles of chronic pain management in the Pain and Analgesia guideline. Individualise pain management using a combination of nonpharmacological and pharmacological strategies. Factors that may influence analgesic choice include comorbidities, adverse effects to drugs, potential for dependence, patient preference, likelihood of adherence to treatment, and cost.