Why Some People With Rheumatoid Arthritis Have Pain Without Inflammation

BOSTON, MA (ANI) – For about 20% of rheumatoid arthritis (RA) patients, conventional treatments offer little to no relief. Despite having swollen, painful joints, these patients do not respond to even the strongest anti-inflammatory drugs. Recent research explains this frustrating disconnect: their pain is not caused by inflammation but by abnormal tissue growth.

A study published in Science Translational Medicine examined RA patients who experience pain without visible inflammation. Researchers found that these patients have a set of 815 genes activating abnormal growth of sensory neurons in their joints. This rewiring of nerves explains why anti-inflammatory drugs, which work for most RA patients, fail to alleviate their pain.

For these individuals, the issue isn’t infiltrating immune cells but the overgrowth of tissue and nerves around the joints. Despite the lack of inflammation, the joints feel swollen and tender. Patients are often subjected to multiple rounds of ineffective medications, many of which suppress the immune system, yet do not address the root cause of their pain.

The research offers hope for new treatments that target the sensory nerves driving pain in these outlier patients. By understanding the genetic factors and specific nerve growth involved, scientists hope to develop therapies that can offer relief without the heavy side effects of immune-suppressing drugs.