oa Editorial [Hot Topic: Pain in the Rheumatic Diseases: Insights from Basic Science, Clinical and Imaging Studies (Guest Editor: Nidhi Sofat)]

In this issue we have three articles discussing features of pain perception in rheumatic diseases. Dr. Inglis et al. review the evidence for activation of peripheral and central pain pathways from basic science using animal models with particular focus on rheumatoid arthritis and osteoarthritis. Drs. Shaikh and Shenker describe the clinical context of pain syndromes in rheumatic diseases and discuss how an initial inflammatory stimulus may lead to ongoing pain and activation of central pathways in the brain. An understanding of pain pathway activation is key to appreciating how pain symptoms impact on disability and loss of function in chronic disease. Dr. Sofat et al. then discuss the contribution that functional neuroimaging studies have made to our understanding of pain perception with specific reference to rheumatoid arthritis, osteoarthritis and fibromyalgia. Several techniques including functional magnetic resonance imaging and positron emission tomography have been used to unravel central brain mechanisms involved in pain perception in these conditions. A deeper understanding of pain mechanisms reviewed in these articles will hopefully provide new insights into the understanding of pain perception in rheumatic diseases which may lead to improved therapies for the future.