Pain in myositis: prevalence, assessment, potential mechanisms and considerations for management

Pain is a prevalent symptom experienced by over 80% of patients with idiopathic inflammatory myopathies (IIM). Pain severity ranges between 3 to 4 (out of 10) assessed by various tools in the literature. Myositis-related pain could be affected by underlying disease activity and other biological mechanisms, including muscle and joint inflammation, fasciitis, and central pain sensitisation. Pain is associated with a high disease activity, fatigue and poor functional outcomes among patients with IIM. In this narrative review, we provide an overview of the current knowledge on pain and pain assessment tools in IIM and discuss potential mechanisms underlying myositis-related pain and considerations for management.