Are People With RA More Sensitive to Pain?

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When you have rheumatoid arthritis (RA), there's no question that you're in pain. To make matters worse, people with RA may be even more sensitive to pain than those without the disease.

For instance, in one study, researchers applied heat and cold to various points on the bodies of people with RA and people without it. What they found: RA patients experienced greater pain intensity when exposed to heat and a lower pain tolerance when exposed to cold compared to non-RA participants.

What could be behind this decreased pain threshold? Here are three possible explanations based on some of the latest research.

3 Potential Reasons for Increased Pain Sensitivity

1. Stress

Living with RA everyday can be a stressful experience. But feeling stressed isn't only an emotional issue. Daily stress in people with RA is associated with an increase in muscle tenderness as well as higher levels of interleukin-6, a substance that increases inflammation and is associated with increased pain. It's a vicious cycle: You may feel stressed because of your pain, and the increase in stress can result in even more pain.

2. Catastrophizing

Catastrophizing is a word used to describe a particular response to pain: feeling pessimistic and helpless, resulting in an even greater sensation of pain. People who catastrophize have a tougher time coping with pain and are more sensitive to pain than others. Studies involving people with RA have found that those who catastrophize experience greater disease activity and inflammation. Why? One study found that, when exposed to painful stimuli, people who tend to catastrophize experienced a greater boost in levels of interleukin-6, the inflammatory molecule that can increase pain.

3. Sleep Problems

RA not only affects your joints, it also disrupts your sleep patterns. Many people with RA have a tough time falling asleep and don't find sleep restful. One recent study found that poor sleep quality and increased fatigue are associated with more severe pain in people with RA. In other words, when you're not well rested, your symptoms may seem more severe than they otherwise would.

Take Steps to Conquer Pain

Whatever the cause of your RA pain, one thing is for sure: You need to get your pain under control so you can enjoy life again. Here are three steps you can take today:

  • Seek out ways to reduce stress. For instance, try learning visualization techniques. To do this, relax your body and picture something that brings you calm and joy, such as lying on a warm beach or swaying in a hammock. Maintaining good communication with your doctors can also help fight stress.

  • Try heat and cold. They work in different ways to make your body feel better. Experiment with taking hot showers and applying ice packs to see which provides more relief.

  • Exercise when you feel well. Not only will it help control pain, it can also reduce stress. Your doctor can advise you on what types of exercise are best.

Key Takeaways

  • People with RA may be more sensitive to pain than those without the disease.

  • There are three potential reasons: stress; catastrophizing, or having a tougher time coping with pain; and poor sleep.

  • There are ways to take control of your pain, such as working to reduce stress and exercising when you feel well.
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 May 6

  1. Sleep Quality and Functional Disability in Patients with Rheumatoid Arthritis. F. Luyster et al. Journal of Clinical Sleep Medicine. Vol. 7, no. 1, pp. 49-55.

  2. Rheumatoid Arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

  3. Managing Stress. National Library of Medicine, National Institutes of Health.

  4. Rheumatoid Arthritis. National Library of Medicine, National Institutes of Health.

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