How joint pain and the destruction of cartilage are related is not yet fully understood. Cartilage itself does not cause pain because there are no nerve structures in cartilage to transmit pain signals. Most likely, the pain of rheumatoid arthritis is caused by the irritation of other tissues in and around the affected joints. This irritation may be caused by chemical-messenger substances, such as prostaglandin E2, that are associated with the disease process. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain because they inhibit the production of prostaglandins.

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