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(2) Mean or median pain VAS\/VNS score was also 4 to 6 in OA in 1979 and appears unchanged in 2022, similar to RA. (3) RAPID3 (Routine Assessment of Patient Index Data 3), a composite of physical function, pain, and patient global assessment, also appears unchanged in RA and OA from 1985 to 2022. (4) Similar 4 to 6 of 10 VAS\/VNS pain scores were seen in other rheumatic diseases. (5) Pain scores were significantly higher in patients with RA or OA who screened positive versus negative for anxiety, depression, and\/or fibromyalgia on Multidimensional Health Assessment Questionnaire indices, which agree 80% with reference questionnaires. These findings suggest that a traditional view of pain in RA and OA as primarily nociceptive, based on inflammatory activity or structural damage, may be oversimplified. Patients with RA or OA also appear affected by neuropathic pain, based on central\/peripheral nervous system pathology, and nociplastic pain, based on pain sensitization. These findings have been possible only with recent excellent control of inflammation in RA and with feasible screening indices for anxiety, depression, and fibromyalgia in all rheumatic diseases.<\/jats:p>","DOI":"10.1002\/acr2.70133","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T13:02:39Z","timestamp":1769518959000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Similar Pain Scores in Rheumatoid Arthritis and Osteoarthritis Over 45 Years Despite Dramatically Fewer Swollen Joints in Rheumatoid Arthritis: Are Scores Based as Much on Pain Sensitization and Patient Distress as on Inflammation and\/or Structural Damage?"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5708-5971","authenticated-orcid":false,"given":"Juan","family":"Schmukler","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine 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