10 Strategies to Help Relieve
Chronic RA Pain
Getting RA pain under control may
take some work. Try the following strategies 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," says Ali.
The No. 1 option in the pain relief arsenal is to control inflammation with
disease-modifying anti-rheumatic drugs, called DMARDs. "The most commonly
used is the drug methotrexate," explains Ali.
"Steroids may be used to bridge the gap during an acute flare. If flares
continue, we can go to triple-drug therapy, using newer drugs that are more
expensive but also effective.”
The next tier of pain relief
includes these additional approaches:
2. Pain medication. The best drugs for acute pain are nonsteroidal
anti-inflammatory drugs, called NSAIDs, according to Ali.
"Stronger pain relievers, called opioids, may be used for severe pain, but
we try to avoid them if possible. These drugs must be used cautiously because
of the potential to build up tolerance, which can lead to abuse."
3. Diet. Although some diets may be touted to help RA symptoms, they
aren’t backed by the medical community. “There is no evidence that any special
diet will reduce RA pain," says Ali.
However, there is some evidence that omega-3 fatty acids can help reduce
inflammation — and that could ultimately help you find relief. Omega-3s can be
found in coldwater fish and in fish oil supplements. A 2013 study published in
the Annals of the Rheumatic Diseases also found that people newly
diagnosed with RA who took a high-dose fish oil supplement had significantly
better responses to DMARD treatment than did people who took a low-dose fish
oil supplement.
4. Weight management. Maintaining a healthy weight may help you better manage pain.
A study presented at the 2013 annual meeting of the European League Against
Rheumatism found that being overweight increases the amount of medication
people need to control inflammation and decreases the chances of symptom
relief.
5. Massage. A massage from a therapist (or even one you give yourself)
can be a soothing complementary treatment to help reduce rheumatoid arthritis
pain. A 2013 study published in the journal Complementary Therapies in
Clinical Practice involved 42 people with RA in their arms who received
either light massage or medium massage from a massage therapist once a week for
a month. The participants were also taught to do self-massage at home. After a
month of treatment, the moderate-pressure massage group had less pain and greater
range of motion than the others.
6. Exercise. Although you may not feel like being active when you have
RA, gentle exercises can actually help reduce pain.
“Non-impact or low-impact exercise is a proven way to reduce pain," says Ali. "We recommend walking, swimming, and
cycling.” In fact, one of the best exercises you can do for RA is water
aerobics in a warm pool because the water buoys your body. The Arthritis
Foundation also notes that yoga is another option to help reduce RA pain, and
traditional yoga poses can be modified to your abilities. But when it comes to
exercise, it’s also wise to exercise caution: Talk with your doctor if any
workouts are making your pain worse, and, in general, put any exercise plan on
hold during an acute flare.
7. Orthoses. These are mechanical aids that 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 hand and finger RA. A physical therapist can help you determine the
best orthoses options for you.
8. Heat and cold. Heat 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 pain. Relaxing in a hot bath
can also bring pain relief, as well as exercising in a warm pool.
9. Acupuncture. This Eastern medicine practice, which has been around for
centuries, is thought to work by stimulating the body's natural painkillers
through the use of fine needles gently placed near nerve endings. Some studies
have shown that acupuncture can help chronic pain, but there is not much
evidence for its use in RA. “I have found acupuncture to be helpful for some
patients, but the pain relief is usually not long-lasting,” says Ali.
10. Trans
coetaneous electrical nerve stimulation (TENS). TENS is a form of therapy that 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
rheumatoid arthritis,” says Ali. If
you're interested in trying it for pain relief, talk with your physical
therapist.
Remember, you’re not alone — your
doctor and specialists 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 your rheumatologist about pain relief options like exercise, massage, yoga,
and acupuncture, but remember that the first priority on your pain relief list
should be to get RA inflammation under control.
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