Living with rheumatoid arthritis (RA) can feel overwhelming. The pain is often hot, stinging, and achy, making everyday tasks difficult. Standing or walking exacerbates the pain in my feet, ankles, and knees, while overusing my hands and arms results in joint discomfort. I can’t always avoid pain, so it is important for me to understand my pain and its triggers to manage it effectively.
RA commonly affects small joints, like those in the fingers, hands, and feet, but it can also spread to larger joints such as the wrists, knees, ankles, elbows, hips, and shoulders. Typically, symptoms appear symmetrically, affecting the same joints on both sides of the body.
I often experience swelling and tenderness in the joints of my hands, wrists, shoulders, knees, ankles and feet. RA can also affect the neck. The inflammation is primarily located in the upper cervical spine, particularly the first and second vertebrae, causing pain, stiffness, and potential spinal instability.
How I Feel Rheumatoid Arthritis All Over
Beyond the joints, RA can affect other body systems. When the immune system attacks the joints, it can cause chronic inflammation, which may spread to areas like the skin, eyes, lungs, heart, and blood vessels. This can result in symptoms such as skin rashes, vision problems, lung issues, and even heart issues.
Here are a few more ways RA can affect the body, and how I manage these widespread symptoms.
Muscles
Rheumatoid arthritis (RA) can lead to a condition called rheumatoid cachexia, where chronic inflammation and reduced physical activity cause muscle wasting. As a result, RA often brings muscle tenderness, stiffness, and pain, leading to a decrease in muscle mass and strength. This weakness can limit joint movement and reduce range of motion.
As the disease progresses, RA can cause joint damage and deformities, further complicating muscle movement. Though RA usually affects joints symmetrically, it’s common for the dominant hand or one leg to experience more pain due to overcompensating for discomfort elsewhere. A physical therapist can help you pinpoint the causes of your specific pain and recommend tailored exercises to maintain strength.
Because rheumatoid arthritis leads to irreversible joint damage, some level of pain may always be present, but managing it is possible.
The Gut
People with RA are also more prone to gastrointestinal (GI) issues like nausea, indigestion, and abdominal pain. While medication side effects often play a role, unchecked inflammation and infection risks can contribute to GI symptoms such as bleeding, ulcers, and esophagitis (inflammation of the esophagus).
Maintaining gut health is essential, especially when managing RA pain. I prioritize anti-inflammatory foods, listen to my body’s signals, and avoid junk food to support my gut health and overall well-being.
Comorbidities
Along with RA, I also live with osteoarthritis (OA) and fibromyalgia — both of which are common alongside RA. Since these conditions can share overlapping symptoms, it’s important to distinguish which is causing your current pain. Sometimes, it can be challenging to figure out whether RA, OA, or fibromyalgia is behind my discomfort.
That’s why regular blood tests to monitor inflammation levels are essential in understanding whether RA is the main culprit. Thankfully, the treatments and strategies I use for RA often benefit my OA and fibromyalgia as well..
Anxiety and Depression
Living with chronic pain can affect more than just your body — it can take a toll on your mental health too. Anxiety and depression contribute to chronic pain by increasing pain perception and sensitivity, muscle tension, and inflammation. That’s why addressing mental health alongside physical pain management is essential for overall well-being.
Vitamin and Mineral Deficiencies
Certain vitamin and mineral deficiencies can lead to increased fatigue and pain. It’s important to talk to your rheumatologist about which supplements are right for you since some may interact with your medications or health conditions. Keeping your body nutritionally supported can play a key role in managing RA symptoms.
Weight
Managing your weight is especially important when living with RA. Excess body fat can increase inflammation and add extra stress to already painful joints, which may accelerate joint damage.
Being overweight can also make some RA medications, like tumor necrosis factor (TNF) blockers, less effective. Additionally, obesity increases the risk of other health issues, such as cardiovascular disease and type 2 diabetes, which can complicate the management of RA.
Injuries and Conditions
Although RA doesn’t directly increase the risk of injuries, certain RA-related factors can elevate that risk. Conditions like carpal tunnel syndrome, bursitis, or injuries to tendons and ligaments often add to the discomfort. RA’s inflammation can cause pain, stiffness, and decreased mobility, impairing balance and coordination, which may increase the likelihood of falls or accidents.
Additionally, medications like corticosteroids can weaken bones, making fractures more likely. Immunosuppressive drugs can also interfere with wound healing.
Over time, joint deformities caused by RA can change the way you move, further increasing the risk of injury. Fatigue and muscle weakness related to RA may also affect your physical performance, which could lead to accidents.
Poor Posture
Poor posture is common among people with arthritis-affected joints and can lead to significant pain. Weak muscles, which are often unable to fully support the body, contribute to this problem. Over time, RA can cause joint damage and deformities, which alter body alignment, making it difficult to maintain a straight posture.
Chronic fatigue, another frequent symptom of RA, often leads people to slump or hunch over, worsening the issue. Additionally, RA may impact a person’s gait, causing them to develop an abnormal walking pattern to avoid pain, which can further lead to compensatory changes in posture.
How I Choose My Pain Relief
When I was first diagnosed, I was desperate to alleviate the pain and willing to try anything that promised relief from inflammation or an energy boost. Unfortunately, this approach was both costly and time-consuming. I also fell prey to companies that target vulnerable people with chronic illnesses.
What I eventually learned is that evidence-based research is critical. The 2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis is an excellent place to start. As a patient partner involved in creating these guidelines, I know that each therapy is backed by the most accurate, research-supported data while incorporating patient perspectives.
Over the years, I have discovered and honed a variety of strategies to manage my symptoms and improve my quality of life. It’s important to ask yourself:
- Are the benefits worth the cost and effort?
- Is it too energy-draining or time-consuming for the results you need?
Here are my top strategies for relieving rheumatoid arthritis pain, all of which have become key parts of my wellness routine. Keep in mind: What works for one person might not work for another.
When I was first diagnosed, I was desperate to alleviate the pain so I was willing to spend money on anything that made claims to reduce inflammation and pain or increase my energy. This was costly and time consuming, I also fell victim to those preying on my vulnerabilities as someone with a chronic illness.
Ice or Heat
One of the easiest, most affordable, and highly effective ways to relieve RA pain is by using ice or heat. Alternating between ice packs and heat pads can help, depending on the type of pain and inflammation you’re dealing with. Ice is great for reducing swelling and numbing the area during flare-ups.
In contrast, heat therapy, such as warm baths, saunas, or heating pads, helps to loosen stiff joints and relax muscles. The key is to find the right balance between ice and heat and knowing when to use each. However, be cautious — applying too much heat to inflamed joints may make inflammation worse.
Movement
Physical Activity
Keeping your joints flexible and reducing stiffness is key when managing RA. Gentle exercises like walking, swimming, or cycling are excellent ways to maintain joint function without putting too much strain on your body. Personally, I find the elliptical and gardening to be effective ways to get exercise.
By incorporating regular movement into my daily routine, I’ve not only managed my RA symptoms but also improved my mood and energy levels, which makes coping with the challenges of RA a little easier.
Stretching
In addition to movement, stretching is a cornerstone of my pain relief strategy. Regular stretching exercises help keep both my joints and muscles flexible. I make sure to stretch major muscle groups and focus on areas that tend to feel stiff. Stretching doesn’t just relieve pain; it also helps prevent further issues by keeping my joints limber and ready for everyday activities.
Strength Training
Strengthening the muscles around my joints has been another essential part of managing my RA. When guided by a physical therapist, strength training has helped me stabilize my joints and ease the load on them. This approach has made a noticeable difference in my functional abilities, while also reducing the frequency and intensity of my pain episodes.
Sleep, Rest, and Elevation
Listening to my body and getting enough rest is essential for managing my RA. During flare-ups, taking the time to rest and elevate the affected joints helps reduce swelling and alleviate pain.
It’s all about finding the right balance between activity and rest — overexerting myself can make symptoms worse. Elevating my legs during rest periods has been particularly effective for reducing inflammation and promoting better circulation, allowing my body to recover more efficiently.
Topicals
Topical treatments, such as creams, sprays and gels containing anti-inflammatory or analgesic properties, provide direct relief to the affected areas. I have found that applying these topicals, can offer immediate and localized pain relief on the surface level.
These treatments are a valuable addition to my pain management arsenal, providing a non-invasive option for managing day-to-day discomfort.
When I search for topical pain relief products, I consider several key ingredients:
- Menthol: Provides a cooling sensation that can help divert attention from pain.
- Methyl salicylate: Commonly found in products like Bengay, it offers a warming sensation and alleviates pain by acting as a counterirritant.
- Capsaicin: Extracted from chili peppers, it creates a warming sensation
- Lidocaine: A local anesthetic that numbs the targeted area to reduce pain.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Such as diclofenac, these ingredients help to reduce inflammation and alleviate pain.
Nourish Your Body
A well-balanced diet plays a pivotal role in managing RA symptoms. Consuming anti-inflammatory foods, such as fatty fish, leafy greens, nuts, and seeds, can help reduce overall inflammation in the body. Staying hydrated and avoiding processed foods, sugars, and excessive caffeine also contribute to better joint health.
By nourishing my body with the right nutrients, I support my immune system and enhance my body’s natural ability to combat inflammation and pain.
More Tips for RA Pain
Managing RA often involves adopting a variety of strategies to help reduce pain and improve your overall quality of life. Below are some additional tips that make a difference in my day-to-day management of RA pain.
Understand Your Triggers
Identifying your triggers can help manage and reduce the frequency and severity of flare-ups, including pain, swelling, and stiffness. Understanding these triggers allows for a tailored treatment plan, including medication adjustments and lifestyle changes, which can improve symptom control.
Avoiding triggers also helps prevent long-term joint damage, preserve joint function, and enhance your quality of life by reducing symptom unpredictability. By staying aware of what triggers your symptoms, you can make informed decisions about your health and lifestyle, giving you a sense of control over your condition.
Pace Yourself
Learning to pace yourself is crucial in managing RA. Recognizing your personal limits and avoiding overexertion can prevent increased pain and fatigue. Breaking tasks into smaller, more manageable steps and taking frequent breaks can help you maintain a balance between activity and rest.
Adhere to Your Medications
Following your prescribed medication regimen is essential for managing RA effectively. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologics are often necessary to control symptoms.
Regular consultations with a rheumatologist ensure that my medication regimen is optimized for my condition.
Try Massage
Therapeutic massage can help alleviate muscle tension and improve circulation. Regular sessions with a trained massage therapist may reduce pain and promote relaxation, contributing to your overall well-being.
Dabble in Dry Needling
Dry needling, performed by a skilled practitioner like a physiotherapist, targets trigger points to reduce muscle tension. This technique has provided significant pain relief and improved mobility, especially in areas affected by RA like my shoulders and neck.
Get Joint Support
To maintain good posture and reduce joint strain, ensure that your workspace is ergonomically set up. Use a chair that supports your lower back, keep your feet flat on the floor, and position your computer screen at eye level. Wearing supportive shoes can also improve your posture and alleviate joint discomfort. Additionally, splints, braces, or compression gloves can provide extra joint support, helping to reduce pain, swelling, and stiffness.
Practice Prevention
Taking pain medication or anti-inflammatories before engaging in a big activity can help manage discomfort and inflammation. Planning ahead can make strenuous activities more manageable.
Talk To Your Rheumatologist
If you notice increasing pain or find that your current treatments is not working, it’s important to reach out to your rheumatologist for further evaluation and management.
Living with rheumatoid arthritis requires a multifaceted approach to pain management. By incorporating these strategies into my daily routine, I have been able to manage my symptoms more effectively and maintain a better quality of life. Each person’s RA journey is unique, and finding the right combination of strategies is key to achieving optimal pain relief.
Check Out Remission Possible
Our Remission Possible podcast is dedicated to guiding and supporting you on your mission to take back your life and control symptoms. In each episode, we’ll share inspiring stories from patients who are succeeding in their mission and discuss how patients and doctors can work together to better understand the optimal course of treatment for different chronic conditions while keeping personal goals and lifestyle choices in mind. Listen now.
