Managing The Pain Of Rheumatoid Arthritis

Rheumatoid arthritis is a systemic, chronic disease in which the synovial joints of the body, most commonly in the fingers, and the knees and hips, become inflamed. Over time, erosion of the bone occurs and nodules form under the skin, resulting in painful swelling and joint deformity. Rheumatoid arthritis has no cure. Treatment is focused on alleviating symptoms and heading off damage to the joints.

What Causes Rheumatoid Arthritis?

The exact cause of rheumatoid arthritis is unknown, but it is an autoimmune disorder.

When something happens to this tolerance, your body can stop recognizing its own cells and will begin to attack them, resulting in inflammation and destruction of the tissue it no longer recognizes.

Although, there isn't a clear genetic link for rheumatoid arthritis, your genes do seem to have some role in your chances of developing the disease. Native Americans, among other ethnic groups, have a higher rate of rheumatoid arthritis than the general population. Women of all ethnic groups are three times more likely to have the condition than men. And while rheumatoid arthritis can develop at any age, most people experience their first symptoms between the ages of 40 and 60.

The Symptoms

The most obvious symptom is joint pain, especially in the morning or after periods of rest.

Rheumatoid arthritis is a systemic disease, though, so symptoms can develop throughout the body. Those living with the disease may also have fluid buildup in the lungs and within the heart. The disease can progress gradually over several months or symptoms can arise abruptly.

How to Treat Rheumatoid Arthritis

As a chronic condition, there is no cure for rheumatoid arthritis. Treatment is focused on managing the pain and trying to prevent or slow down the destruction of the joints.

The first line of defense is usually over-the-counter medication. NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (Motrin or Advil) and naproxen sodium (Aleve) help to relieve both pain and inflammation. Long-term use can lead to serious side effects such as inflammation of the upper gastrointestinal tract and bleeding, especially in the elderly.

During flare-ups, your doctor may prescribe a corticosteroid to relieve the worst of the symptoms before gradually tapering the medication off to avoid the serious possible side effects of osteoporosis, diabetes, and cataracts.

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Medications in the disease-modifying antirheumatic drugs class (DMARDs) include hydroxychloroquine (Plaquenil) and methotrexate (Trexall) and must be taken for several months before their full effects are apparent.

Medications such as etanercept, infliximab, and adalimumab are particularly effective when combined with traditional DMARDs. They are administered through injections or infusions and require close monitoring for infections and other serious side effects.

Powerful immunosuppressive drugs such as Cyclosporine and mycophenolate may be used in conjunction with DMARDs or other drugs to battle the systemic effects of rheumatoid arthritis, but these drugs can increase your risk of infection since they work by suppressing your immune system.

Most radically, joint replacement surgery may be most helpful for some patients. Surgical options for chronic arthritis include joint repair to realign or mend joints, often using minimally invasive techniques for quicker recovery. Joint replacement, especially for hips and knees, replaces damaged joints with artificial ones, significantly reducing pain and improving mobility. Joint fusion, used in smaller joints, fuses bones to form a rigid unit.

A Chronic Condition Without A Cure

Those who live with rheumatoid arthritis do so with the knowledge that there is no cure for the condition. Existing treatments serve only to minimize the symptoms or slow down the disease's progression. It can be overwhelming for those who are newly diagnosed to face that idea. Rheumatoid arthritis can be managed, though. It takes a consistent approach in two main areas; pain management and mobility.

Chronic Pain

Unlike osteoarthritis, where loss of protective cushioning between the joints makes movement increasingly intolerable, rheumatoid arthritis is more painful after bouts of inactivity.

Gentle exercise can help relieve the gelling or stiffness and allow you to ease into a more active day. Moist heat is especially effective with rheumatoid arthritis, so make good use of warm baths and soaks.

It is extremely important to take your pain medication exactly as prescribed. Many times, those with chronic conditions will try to put off taking pain medication as long as possible for fear of becoming addicted or dependent. However, it is much more difficult to bring intense pain down to tolerable levels than it is to maintain a tolerable level in the first place.

Medications work more effectively when you maintain a consistent level in your system.

Impaired Mobility

As the joints degenerate, those living with rheumatoid arthritis begin to experience a limited range of motion and a decrease in their ability to perform self-care skills and activities of daily life. This can be even more discouraging than the pain of rheumatoid arthritis because it involves a loss of independence and can lead to feelings of despair as patients must rely more on family member, friends, or other caregivers for assistance with basic needs.

As with pain management, exercise can help. Gentle range-of-motion exercises can help to preserve mobility. These can be active (done individually) or passive(completed with assistance), depending on whether the patient is enduring a flare-up or not.

With activities of daily life, such as eating, dressing, and bathing, occupational therapists can help in many ways. They can instruct patients in adaptive techniques for completing these tasks, as well as provide training on assistive devices that can be used by the patient at home to successfully complete self-care tasks.

When it comes to assistive devices, great strides are being made in the area of universal design. Universal design is a method of creating homes and buildings that are accessible to the widest range of people possible, including those who are disabled in any way. Universal design has also resulted in an enormous array of new products that encourage independent living. Instead of clumsy, medical-style products, universal design products are stylishly crafted in order to be seamlessly integrated into homes. They allow people with chronic conditions greater independence without feeling as if they are living in a hospital setting.

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With a good plan for pain management and self-care skills, those with rheumatoid arthritis can maintain an independent lifestyle for far longer than those diagnosed in the past. By working carefully and consistently with their doctors, pharmacists, and therapists, rheumatoid arthritis sufferers can effectively manage their condition and remain in control of their lives.