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Pain Patterns in the Rheumatic Disorders*

Pain patterns vary greatly in the different types of arthritis, from the localized agony without mental overtones in acute gout to the diffuse disorder we call rheumatoid arthritis, where inflammation of many joints, systemic illness, anaemia, anxiety, and depression are usually all present in some degree. Each pain pattern calls for a different therapeutic approach, physical, psychological, and pharmacological. Few patients suffer as much pain and suffering over many years as do chronic arthritics. It is all the more important to instruct them in the essentials of their own treatment. A patient with an occupied and instructed mind usually suffers less than an ignorant and depressed one, fearful of her disease and its complications and of the dark uncertain future that lies ahead.