A recent study suggests that fears about possible addiction, the belief that pain relief could mask active disease and further deteriorate joint health, cultural attitudes, and concerns about drug side effects are among the self-imposed barriers to arthritis pain relief. Published in the March 2009 issue of The Journal of Pain, the study showed that these barriers may play an important role in ineffective pain management. The findings are not surprising, says Judith Scheman, PhD, program director of the Chronic Pain Rehabilitation Program in the Pain Medicine section at Cleveland Clinics Neurological Institute. "Patients resist treating pain for a number of reasons. Many say they dont want to feel dependent on a drug. But if pain persists, and instead of treating it, you start limiting activities to the extent that you become deconditioned, then any time you try to do something, its going to hurt. You get caught in a downward spiral, because with each iteration, the pain-and your ability to function-gets worse."