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RA Pain Biopsychosocial Model — SCE Rheumatology MCQ

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EasyRheumatoid ArthritisRA Pain Biopsychosocial ModelSCE Rheumatology

A 45-year-old woman with rheumatoid arthritis has persistent pain despite assessment and appropriate treatment of inflammatory disease activity. Which overall framework is recommended for ongoing assessment and management of pain associated with inflammatory arthritis?

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Correct answer: A — A patient-centred biopsychosocial model combining disease control with education, exercise, psychological and social interventions, sleep support and carefully reviewed analgesia

The recommended approach is a patient-centred biopsychosocial framework. In RA, pain may arise from active inflammation but also from structural damage, biomechanical problems, altered pain processing, sleep disturbance and psychological or social factors. Disease activity should therefore be optimised when inflammation is present, but management should also include pain education, tailored physical activity or physiotherapy, psychological support where indicated, self-management and sleep interventions. Analgesics may have a limited, reviewed role; long-term opioid treatment should generally be avoided. DMARD escalation alone is inappropriate when pain is not inflammation-driven. Analgesic-led, biomechanical-only and psychological-only approaches each neglect important contributors to persistent pain.

Reference: British Society for Rheumatology. New guideline: Pain management in people with inflammatory arthritis, 21 July 2026. https://www.rheumatology.org.uk/news/details/New-guideline-Pain-management-in-people-with-inflammatory-arthritis?articleId=1067