10 Ways to Find Relief From Chronic Rheumatoid Arthritis Pain

From fatigue to loss of appetite,rheumatoid arthritis (RA)can impact your life in a number of ways, but the most limiting symptom for many people is pain. Because that pain comes in different forms, you may need more than one strategy to relieve it.

“The primary cause of RA pain is inflammation that swells joint capsules," saysYousaf Ali, MBBS, a professor of medicine at the Icahn School of Medicine and chief of the division of rheumatology at Mount Sinai West Hospital in New York City. Joint capsules are thin sacs of fluid that surround a joint, providing lubrication for bone movement. In RA, the body's immune system attacks those capsules.

The first goal of pain relief is the control of inflammation, Dr. Ali explains. “Inflammation can cause acute (short-term) pain or longer-lasting, smoldering pain," he says. "Chronic erosion of joint tissues over time is another cause of chronic pain. But there are many options for pain relief.”

GettingRA painunder control may take some work. You may need to take several drugs — some to slow joint damage and some to alleviate joint pain — as well as experiment with lifestyle adjustments and alternative therapies to find relief. It may take some time, too.

Treatments and Strategies to Help Relieve Chronic RA Pain

Try the following strategies — with your doctor's supervision — to discover which are most effective for you.

1. Inflammation medication"In the case of RA, all other pain-relief strategies are secondary to controlling inflammation," Ali says. That means treating with medications that alter the course of the disease — such as disease-modifying anti-rheumatic drugs (DMARDs), biologics, or janus kinase (JAK) inhibitors. "Steroids may be used to bridge the gap during an acute flare," adds Ali, though they’re typically only used for a short period of time, due to the side effects they’re associated with.

These drugs each work differently to suppress the body's overactive immune system response and are also used to prevent joint damage and slow the progression of the disease. They’re often prescribed shortly after anRA diagnosisin order to prevent as much joint damage as possible — though it may take up to six months or so to fully feel the drug’s benefits. It can also take time to find the right treatment — or combination of treatments — to help you gain control of your RA.

2. Pain medicationThe best drugs for acute pain, Ali says, are nonsteroidal anti-inflammatory drugs, calledNSAIDs. While NSAIDs help treat joint pain, research has shown that they don't prevent joint damage.

"Stronger pain relievers, calledopioids, may be used for severe pain, but we try to avoid them if possible," says Ali. "These drugs must be used cautiously because of the potential to build up tolerance, which can lead to abuse."

3. DietAlthough some diets may be touted to helpRA symptoms, they aren’t backed by the medical community. “There is no evidence that any special diet will reduce RA pain," Ali says. But there is some evidence that omega-3 fatty acids can help reduce inflammation — and the joint pain that results from it. Omega-3s can be found in cold-water fish and in fish oil supplements. According to findings presented at the2019年度会议的美国流值umatology,people with RAwho took omega-3 supplements might have less painful and swollen joints, and lower disease activity scores. However, fish oil supplements aren’t a substitute for following yourRA treatmentplan.

4. Weight managementMaintaining a healthy weight may help alleviate joint pain. A study published in March 2018 in theInternational Journal of Clinical Rheumatologyfound that clinically relevant weight loss — defined as at least 11 pounds — was associated with improved RA symptoms, including less tender and swollen joints.

5. MassageA massage from a therapist (or even a DIY massage) can be a soothingcomplementary therapyto help reduce muscle and joint pain. According to theArthritis Foundation(AF), it’s best to first check with your doctor to get the green light to try massage, as certain techniques apply a lot of pressure to your muscles and joints. Once you have your doctor’s approval, be sure to tell your massage therapist that you have RA. And remember: Massage should make you feel better, not worse.

6.锻炼Although you may not feel like exercising when you have RA, and it might seem that being active could put stress on your joints,gentle exercisescan actually help reduce muscle and joint pain. “Non-impact or low-impact exercise is a proven way to reduce pain," Ali says. "I recommend walking, swimming, and cycling.” In fact, one of the best exercises you can do for RA is wateraerobicsin a warm pool, as the buoyancy of exercising in water reduces stress on your joints.

The AF also recommends yogaas another option to help reduce RA pain, and traditionalyoga posescan be modified to your abilities. Yoga may also help improve the coordination and balance that is sometimes impaired when you have the disease. When it comes to exercise, though, be sure to use caution. Talk with your doctor if any workouts are making your pain worse, and in general, put any exercise plan on hold during an RA flare.

7. OrthosesThese mechanical aids can help support and protect your joints. Examples include padded insoles for your shoes and splints or braces that keep your joints in proper alignment. You can even get special gloves for affected hand and finger joints. A physical therapist can help you determine the best orthoses options for you.

8. Heat and coldHeat helps to relax muscles, while cold helps to dull the sensation of pain. You might find that applying hot packs or ice packs, or alternating between hot and cold, helps reduce your joint pain. Relaxing in a hot bath can also bring relief, as can exercising in a warm pool.

9. AcupunctureThis Eastern medicine practice has been around for centuries and is thought to work by stimulating the body's natural painkillers through the use of fine needles gently placed near nerve endings. “Acupuncture can be helpful for some patients, but the pain relief is usually not long-lasting,” says Ali.

10. Transcutaneous electrical nerve stimulation (TENS)This form of therapy uses low-voltage electric currents to stimulate nerves and interfere with pain pathways. “TENS is usually used for stubborn, chronic pain and not as a first-line treatment for RA,” Ali says. One of the benefits of this treatment is the low occurrence of side effects. If you're interested in trying TENS for pain relief, talk with your physical therapist. If you have a pacemaker, a heart problem, orepilepsy— or you’re pregnant — get your doctor’s approval first before trying TENS.

Remember,you’re not alone— your RA care team can help you find relief from chronic pain. If you’re experiencing more pain than before, or if pain is interfering with your ability to get things done, don’t hesitate to talk to your doctor. Ask yourrheumatologistabout pain relief options, like exercise, massage, yoga, and acupuncture; but remember that your first priority should be to get RA inflammation under control.

Additional reporting by Erica Patino