10 Ways You Can Manage Your Rheumatoid Arthritis Pain

Rheumatoid arthritis (RA) can affect your life in a variety of ways, from fatigue to loss of appetite, but the most limiting symptom for many people is pain. Because pain can manifest itself in a variety of ways, you may require more than one method to alleviate it.

Inflammation that swells joint capsules is the primary cause of RA pain. Joint capsules are fluid-filled sacs that surround a joint and provide lubrication for bone movement. Your body’s immune system attacks those capsules in RA.

Controlling the underlying inflammation is the first step toward pain relief. Inflammation can cause both acute and long-lasting pain. Another cause of chronic pain is the gradual deterioration of joint tissues. However, there are numerous options for pain relief.

Managing RA pain may require some effort. To find relief, you may need to take several medications, some to slow joint damage and others to relieve joint pain, as well as experiment with lifestyle changes and alternative therapies which may also take some time. 

1. Medication to Control Inflammation 

In the case of RA, all other pain-relief strategies are secondary to inflammation control. This includes using medications to change the course of the disease, such as disease-modifying anti-rheumatic drugs (DMARDs), biologics, or Janus kinase (JAK) inhibitors.

These medications each work differently to suppress the body's overactive immune system response and are also used to prevent joint damage and slow disease progression. They're frequently prescribed soon after a RA diagnosis to prevent as much joint damage as possible — though it can take up to six months to fully reap the benefits. Finding the right treatment — or combination of treatments — to help you gain control of your RA can also take time.

2. Pain Relievers 

Nonsteroidal anti-inflammatory drugs, or NSAIDs, are the most effective treatments for acute pain. While NSAIDs can help with joint pain, studies have shown that they do not prevent joint damage.

Opioids, which are stronger pain relievers, may be used for severe pain, but we try to avoid them whenever possible. Because of the potential for tolerance, which can lead to abuse, these drugs should be used with caution.

3. Diet

Although some diets claim to help with RA symptoms, they are not supported by the medical community. There is no evidence that any particular diet can alleviate RA pain. However, there is some evidence that omega-3 fatty acids can help reduce inflammation and  associated joint pain. Cold-water fish and fish oil supplements contain omega-3 fatty acids.

People with RA who took omega-3 supplements may have less painful and swollen joints, as well as lower disease activity scores, according to an analysis of previously published data in the May 2022 issue of the journal Arthritis Research & Therapy. However, fish oil supplements are not a replacement for adhering to your RA treatment plan.

4. Exercise

Although you may not feel like exercising if you have RA, and it may appear that being active will put stress on your joints, gentle exercises can help reduce muscle and joint pain. Non-impact or low-impact exercise has been shown to help with pain relief. Water aerobics in a warm pool is one of the best exercises for RA because the buoyancy of the water reduces stress on your joints.

Yoga is another option recommended by the Arthritis Foundation to help reduce RA pain, and traditional yoga poses can be modified to your abilities. Yoga may also help improve coordination and balance, which can be affected by the disease.

When it comes to exercise, however, be cautious. Consult your pain doctor if any workouts are exacerbating your pain, and put any exercise plan on hold during a RA flare.

5. Weight Management 

Getting and keeping a healthy weight can help with joint pain. A study published in the Journal of Clinical Rheumatology in January 2022 discovered that people with RA and obesity who lost an average of five pounds saw improvements, including less joint swelling and pain.

6. Heat and Cold 

Heat relaxes muscles, whereas cold dulls the sensation of pain. Applying hot or ice packs, or alternating between hot and cold packs, may help relieve joint pain. Relaxing in a hot bath or exercising in a warm pool can also provide relief.

7. Orthoses 

These mechanical aids can assist in the support and protection of your joints. Padded shoe insoles and splints or braces that keep your joints in proper alignment are two examples. Special gloves for affected hand and finger joints are even available. A physical therapist can assist you in determining the best orthoses for you.

8. Massage 

A therapist's massage can be a relaxing complementary therapy that helps relieve muscle and joint pain. Because certain massage techniques apply a lot of pressure to your muscles and joints, it's best to check with your doctor first.

Once you have received your doctor's approval, inform your massage therapist that you have RA. Keep in mind that massage should make you feel better, not worse.

9. Acupuncture 

This centuries-old Eastern medicine practice is thought to work by stimulating the body's natural painkillers through the use of fine needles gently placed near nerve endings.

10. Transcutaneous electrical nerve stimulation (TENS) 

This type of therapy employs low-voltage electric currents to stimulate nerves and disrupt pain pathways. TENS is typically used to treat persistent, chronic pain rather than as a first-line treatment for RA. The low occurrence of side effects is one of the treatment's advantages. Speak with your physical therapist if you want to try TENS for pain relief. If you have a pacemaker, a heart condition, epilepsy, or are pregnant, consult your doctor before using TENS.