The pain doesn't cause the inflammation - the inflammation causes the pain! And causes the joint damage. My joints are still in good shape but I haven't had RA for all that long - approx three years. Also I've got the inflammation under control now with methotrexate, prednisone and celebrex. So I'm hoping to avoid joint damage.
My grandmother's hands and feet were horrifically deformed - that's what I'm trying to avoid.
I still puzzle about why inflammation doesn't show up in blood tests for some people. It's very odd I think.