21 July 2026
Despite major advances in disease‑modifying therapy, pain remains one of the biggest unmet needs for people living with inflammatory arthritis. Today, we publish a new clinical guideline focused specifically on the assessment and management of pain in adults, children and young people with inflammatory arthritis.
This is the first UK guideline to comprehensively address pain in inflammatory arthritis across pharmacological and non‑pharmacological treatments, with a strong emphasis on person‑centred, multidisciplinary care.
Guideline Working Group Co-Chair, Dr Nicholas Shenker, said:
“Pain remains an unacceptable problem for many people with inflammatory arthritis. This first UK guideline brings together the latest evidence to help clinicians manage that pain more effectively. We think there’s a great need for this guideline.”
The guideline was developed by a large, multiprofessional guideline working group including rheumatologists, GPs, specialist nurses, physiotherapists, occupational therapists, psychologists, pharmacists and experts by experience. It covers pain assessment, drug treatments, exercise and physical activity, psychological support, education, weight management, sleep, fatigue and signposting to peer and third‑sector support.
Yeliz Prior, Guideline Working Group member, Consultant Occupational Therapist and Professor of Clinical Rehabilitation, said:
"Pain in inflammatory arthritis is not solely a biomedical issue and cannot be managed effectively through medication alone. High-quality pain care must incorporate evidence-based, non-pharmacological interventions as a core component, not an optional extra."
Key messages from the guideline include:
- Pain should be assessed at every inflammatory arthritis‑related appointment.
- Optimising disease control is essential, but pain often has multiple drivers.
- Non‑pharmacological approaches such as exercise, education and psychological support are central to effective pain management.
- Long‑term use of opioids and neuromodulators for inflammatory arthritis pain should be avoided, where possible.
To support implementation, the guideline is accompanied by a handy one-page summary sheet and an audit tool to help teams review and improve local practice. You can also listen to our latest podcast episode, with exclusive insights from the guideline authors.
Don’t miss our latest Guideline Collection – all the resources for this guideline in one place and free to access via our eLearning site.
All BSR guidelines are published open access in Rheumatology and are available free of charge via the BSR website.