Neuropathic pain and central sensitization in patients with rheumatoid arthritis attending a tertiary hospital

A substantial proportion of RA patients presented with CS-related pain, even in the absence of FM, suggesting a mixed ("top-down and bottom-up") nociplastic pain profile. Both CS and NP were associated with higher pain levels and increased disease activity. This is the first Brazilian study to characterize the coexistence of CS-related pain (with or without FM) and NP in RA, offering relevant insights for the clinical management of chronic pain in this population. These findings reinforce that routine screening and assessment of CS and NP should be an integral and continuous component of RA management, preceding therapeutic adjustments and extending throughout follow-up.