Hot baths or showers can ease stiff joints, while the pain of hot, inflamed joints can sometimes be relieved with the application of a cold pack, such as a gel pack or bag of frozen peas, wrapped in a tea towel. But these benefits are often short-lived. Strong muscles take weight off painful joints. How do you know if your muscles are weak? Simple forearm exercises such as sustained squeezing of a rolled-up sock while resting the arm on a cushion will reduce hand pain, and straight leg raising quadriceps exercises will reduce knee pain.
Some patients with RA will, of course, find it difficult to exercise because of fatigue, which is a common symptom of rheumatoid arthritis. However, for many patients, gentle exercise will be beneficial; for example, walking laps in a swimming pool allows for leg muscle strengthening while reducing load through an inflamed or damaged joint. Aim to get strong before taking up more aerobic activities like brisk walking or exercise bike. If joint damage is severe, then sometimes the only therapy that will help relieve pain significantly is to surgically replace the joint.
Joint replacement is a successful treatment for severe arthritis involving the knee and hip, but can also sometimes be used in the shoulder, elbow and small joints of the hand. Depending on the source of the pain, other members of the multi-disciplinary team at your hospital may be able to help, for example, occupational therapists can provide splints, podiatrists can help you with foot, and footwear problems and physiotherapists can help you with muscle strengthening.
You may also be able to get access to a pain clinic, but availability of all of these services will vary between hospitals. For more information on the multi-disciplinary team, please click here. It is uncommon to find one drug that relieves all arthritis pain for any one person. The medications commonly used to treat musculoskeletal pain, including that associated with RA, are:. This is commonly used for joint pains, although it seems to have only mild joint pain-relieving effects.
It is generally safe in doses up to 2 grams daily. Very high doses or high regular use together with heavy alcohol intake can lead to liver damage. These agents may be used orally or as topical preparations i.
They typically have a quick onset of action, need to be taken at least once a day and their analgesic effect lasts for a number of hours, depending on the particular drug used. The major side effects of NSAIDs include dyspepsia upper abdominal burning or bloating sensation, often described as indigestion and very uncommonly stomach ulcers and bleeding.
All NSAIDs and COX-2 drugs may cause aggravation of blood pressure and ankle swelling by causing fluid retention and importantly they may increase risk of angina and stroke, so they should not be used in people with or at high risk of heart problems or stroke.
However, their long-term use is associated with greater risk of osteoporosis, diabetes, hypertension and infection. Therefore, corticosteroids are often administered when your doctor thinks inflammation is playing a big role in your pain. No new concepts emerged after 11 transcripts data saturation. All patients gave informed consent. Fourteen focus groups comprised 67 participants with a range of characteristics Table 2. Analysis identified flare codes, which could be grouped into 21 concepts and 6 overarching themes.
There were no major differences between the countries. Patients used the word flare to convey multiple situations. Flare as a single symptomatic joint, increased symptoms within normal variation, increased symptoms from external causes e. The fifth use of flare is characterized by unprovoked, increased symptoms that are unmanageable, persistent and lead to seeking help. Values are represented as mean range , unless otherwise mentioned. Patients describe a depth and breadth of symptom intensity and consequences that extend beyond a count of painful, swollen joints.
The concept of pain in multiple joints was raised in every group, differentiated from normal RA pain by its intensity, quality and constancy: Ear piercing. Ear-shattering pain.
It goes from just aching, a dull background ache to an ear-shattering pain Group D, Patient I just feel that all my body, my feet, my knees, my hands, even sometimes my hips and my shoulders, in my neck, you know, like everything O The joints, they were not warm, they were not swollen either, but I had the pain N I needed 2 hours in the early mornings to get going.
All I do when I have a flare-up is lie down, and get up to go to the toilet, and it takes me half an hour to get to the toilet A5. The simple little things, just trying to pick up something, I tend to drop things a lot more. It takes me a lot longer to get ready in the morning, to shower, to get ready, because I work full-time, and it is just the amount of time that everything takes.
So it really affects you and your day J You get very tired D You can sleep all day and night and never feel refreshed D Yes D Never feel refreshed D The shivering, feverish feeling.
I just felt ill. I just felt as if all my glands throughout my body were up, plus the pain […] I just talk about it as making me feel bodily ill C A really terrible day is when I get up early and feel like a tractor has run over me L Trouble with concentrating!
I wake up in the night and have infernal pain and then take an Ibuprofen and then put a cooling-bag on it N Most of the time it starts in my elbows and goes through the body. I call it my duvet and chocolate day E She gives them to me and then leaves me in peace L I increase the prednisone, and take Panadol for the pain.
Once I feel better I then decrease the prednisone slowly, every two days. Cycles of self-managing flare symptoms on the patient journey to seeking help. This occurs with clusters of unprovoked, persistent symptoms that are not normal for their RA Fig. I would describe it as an attack [flare], the sudden, unexpected occurrence. Without having exerted myself, for no reason N It hurt. Everything just ached F The tipping point for seeking professional help is reached when multiple symptoms cannot be controlled by even increased self-management strategies, and patients cannot run their normal lives Fig.
Do you think that reflects how active your arthritis is? What would be the words be at the beginning and end of that scale? Controlled, uncontrolled A6. Patients use flare to describe five situations: four that are usually contained by self-management, and one that relates to uncontrollable flare that prompts a request for medical help. These multiple uses of the word flare highlights the need for clinicians and patients to clarify a common language concerning flare. Patients and professionals may be describing different entities or simply prioritizing different facets e.
People living with RA do not have to deal with their symptoms alone. There are many helpful resources available. Ways to get support include having a positive relationship with a rheumatologist and joining support groups.
For example, the Arthritis Foundation has both online and in-person support networks. RA is a chronic, life-long condition. People with RA should work with their doctor to establish a treatment routine that helps them maintain disease remission.
If a person experiences more frequent or worsening flares, they should talk to their doctor about treatment adjustments. A person with RA may feel intense pain in their joints during flares. This may feel like sustained pressure, a burning sensation, or a sharp pain.
However, people with RA may also experience periods of remission when they feel few to no symptoms. In addition to causing pain in the joints, RA can affect the whole body. A person living with the condition may experience fatigue, depression, anxiety, and may lose weight unintentionally. RA is a life-long condition. As a result, the key treatment outcome for RA is the management of the condition.
While researchers do not know exactly what causes rheumatoid arthritis RA , they do know that heredity plays a role. Learn more about RA and genetics…. Rheumatoid arthritis causes pain, swelling, and inflammation in the joints and can affect organs throughout the body. Here, find out more. Rheumatoid arthritis is a condition that causes inflammation and pain in the joints, but it may also affect the lungs.
Rheumatoid arthritis is one of the few diseases where subjective measures of how a patient feels are among the best predictors of how well a person will respond to treatment and how much the disease will progress. By subscribing you agree to the Terms of Use and Privacy Policy.
Health Topics. Health Tools. Rheumatoid Arthritis. Reviewed: March 12, Medically Reviewed. Here are five important things to note about disease progression: 1.
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