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Pain Management for Women with Rheumatoid and Other Arthritic Conditions


Release date: December 12, 2016
Valid through: December 12, 2019
Re-reviewed December 12, 2019; valid through December 12, 2020. 
Format: Didactic, PowerPoint, Question-&-Answer session

Osteoarthritis (OA) and rheumatoid arthritis (RA) in women cause chronic pain and are incompletely understood. Both involve both nociceptive and non-nociceptive mechanisms, including neuropathic mechanisms due to peripheral inflammation and central sensitization [1, 2]. Managing pain from these chronic conditions in women requires the clinician to balance the need for effective analgesia against safety risks associated with analgesic agents. Not treating pain is not an option since chronic pain itself is associated with considerable mortality [3-5], and effective analgesia is viewed as a fundamental human right [6-8]. Prevailing guidelines for arthritis-related pain do not differentiate between nociceptive and non-nociceptive pain, sometimes leading to recommendations that do not fully address the nature of pain. Despite a wealth of analgesic options, managing moderate to severe chronic pain as a women’s issue remains clinically challenging for several reasons. This webinar will review best practices for effective treatment and management of rheumatoid arthritis conditions in women, and will discuss when combination therapy may be more appropriate to manage the different pain mechanisms involved.

Ellen W. K. Rosenquist, MD
Dr. Rosenquist completed her anesthesiology residency at Beth Israel Deaconess Medical Center/Harvard Medical School and her pain medicine fellowship at the University of Pennsylvania. She is board certified in anesthesiology and pain medicine. She also completed training in medical acupuncture through the Helms Medical Institute and is certified in medical acupuncture. She is currently an assistant professor at the Cleveland Clinic Lerner College of Medicine of Case Western University.

Learning Objectives Following this session, attendees will be better able to:

  • Review best practices for effective treatment and management of rheumatoid arthritis conditions in women.
  • Discuss complementary and alternative treatment options which have been shown to be of therapeutic value for reducing pain in patients with Rheumatoid Arthritis and other arthritic conditions.
  • Describe the characteristics associated with osteoarthritis.
  • Classify disease-modifying anti-rheumatic drugs.

Intended Audience: Members of the primary care team who provide health services and education to women throughout the lifespan, including physicians, nurse practitioners, physician assistants, nurses, and support staff who practice in obstetrics/gynecology, family medicine, pain medicine, rheumatology, internal medicine, and related settings.

Continuing Education: The AAPM will provide an enduring internet activity (webinar) titled “ Pain Management for Women with Rheumatoid and Other Arthritic Conditions ” and will offer continuing medical education (CME) for physicians. Successful completion requires that participants register for the webinar and complete a pre-test, attend and participate, and complete a post-test and an online evaluation. Participants will receive their CME certificates after they submit their evaluations online.

The American Academy of Pain Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation:
The American Academy of Pain Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Funding for this course was made possible by an educational grant from Pfizer via the Association of Reproductive Health Professionals. Funder did not influence nor have control over the development or delivery of educational content.

Disclaimer:The material presented in this activity represents the opinion of the authors/faculty and not necessarily the view of the American Academy of Pain Medicine.

Instructions for Course Participants: This live activity will consist of a didactic presentation accompanied by PowerPoint slides, followed by a question-and-answer session. There is no fee to participate. The learner is required to respond to the pre-test question(s) before beginning the presentation. Since it is not possible to fail a pre-test, upon submission, "passed" will appear on your screen. This is not an indication that questions were answered correctly.
1) You are required to view the entire presentation.
2) Learners must answer all post-test questions to proceed to the activity evaluation. 3) Learners must receive at least an 80% passing score.
4) An evaluation must be completed prior to receipt of your certificate.
5) After completing the post-test and activity evaluation(s), a statement of credit will be generated and printed on your own at your convenience.

For additional assistance, please contact the American Academy of Pain Medicine, 8735 W. Higgins Road, Suite 300, Chicago, IL 60631, 847-375-4731.
If you need further assistance with software requirements please contact

Internet CME Policy
In regard to its CME programming and initiatives, The American Academy of Pain Medicine is committed to protecting the privacy of its members and customers. AAPM maintains its website as an information resource and service for physicians and other health care professionals. AAPM ensures that all personal and credit card information (if applicable) is kept confidential when participating in any Internet CME activity and that personal information will not be shared with any person/entity outside of AAPM. AAPM will ask for only that information necessary to provide the service(s) requested.

Faculty/Planner Disclosures & Policy: It is the policy of AAPM to plan and implement educational activities in accordance with ACCME’s Essential Areas and Elements to ensure balance, independence, objectivity, and scientific rigor. All program faculty and planners are required to disclose all financial relationships they may have or have had within the last 12 months with commercial interests whose products or services are related to the subject matter of the presentation. Any real or apparent conflicts of interest will be resolved prior to the presentation. All confirmed faculty disclosure information will be made available to participants prior to the activity. Faculty will also be expected to disclose this information to the audience both verbally and in print (slide presentation) at the beginning of each presentation.

Disclosure of Unlabeled Use:
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The American Academy of Pain Medicine does not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclosure information appears below.

Planners and Faculty:

Jianguo Cheng, MD, PhD, FIPP
Planner, Course Reviewer
Professor of Anesthesiology
Vice President for Scientific Affairs, American Academy of Pain Medicine
Director, Cleveland Clinic Pain Medicine Fellowship Program
Departments of Pain Management and Neurosciences
Cleveland Clinic Anesthesiology Institute and Lerner Research Institute
*No relevant financial relationships

Larry C. Driver, MD
Course Reviewer
Chair, AAPM Professional Education and CME Oversight Committee
The University of Texas M.D. Anderson Cancer Center
*No relevant financial relationships

Doris Quintanilla
Planner, ARHP Staff
Education Program Manager
Association of Reproductive Health Professionals
*No relevant financial relationships

Ellen W.K. Rosenquist, MD
Planner, Faculty
Assistant Professor of Anesthesiology
The Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
The Cleveland Clinic Foundation
*UpToDate (Author; Royalties); KURE (Board of Directors – Spouse; Stockholder – Spouse)

Jennifer Westlund, MSW
Planner, AAPM Staff
Director of Education, American Academy of Pain Medicine
*No relevant financial relationships

Disclosure Disclaimer:

Please note: The disclosure information stated above were relevant financial relationships based upon the 12-month reporting period prior to the live education activity date of December 6, 2016.