Defined by the International Association for the Study of Pain (IASP), pain is characterized as an undesirable experience that is sensory and emotional in nature, linked to real or potential damage to tissues, or expressed in relation to such damage. The perception of pain within rheumatic diseases has historically been classified as nociceptive, suggesting it arises from inflammation or structural changes indicative of tissue injury, omitting the influence of additional elements. This interpretation suggests inflammation management as a direct route to pain relief. Nonetheless, chronic pain remains a significant concern for individuals with rheumatic diseases, even with the progressive control of inflammation through therapeutic innovations.
Tracing back to the theories of Descartes, pain has been described as a consequence of either physical or psychological harm, without interaction between the two types that could potentially exacerbate the experience of pain, thus considering pain to be an entity that is mutually exclusive. Today's understanding, however, acknowledges the complexity of rheumatic pain, which involves interactions between nociceptive and neuropathic pain pathways, the possibility of pain sensitization in the dorsal horn and higher brain centers identified as nociplastic pain, and the role of various psychosocial factors.
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