Arthritis And Joint Pain Management
Many professional organizations have guidelines for managing arthritis pain. A common theme across guidelines is that pain management strategies should be flexible, include options that do not involve medication, and be tailored to meetthe needs of the patient. Such guidelines suggestthe following for managing arthritis symptoms such as pain:
- Over-the-counter medications like acetaminophen or ibuprofen and other nonsteroidal anti-inflammatory drugs .
- Physical activity/exercise or community-based physical activity programs.
- Exercise therapy, including physical therapy.
- Self-management education workshops.
- Weight loss, if overweight or obese.
- Cognitive behavioral therapya psychological, goal-directed approach in which patients learn how to modify physical, behavioral, and emotional triggers of pain and stress.
Emerging evidence suggests that these are safer and more effective treatments for managing long-term arthritis pain than opioids.
- A recent study of individuals with knee and hip osteoarthritis, the most common types of arthritis, found that after one year, people who took over-the-counter medications had greater reductions in pain severity than people who took opioids.
Safer options exist to help manage arthritis pain.
Talking About Arthritis Pain
Help guide your arthritis pain treatment by learning how and what to communicate to your doctor.
Talking About Arthritis Pain
When you live with chronic pain, the only one who can know how much it hurts is you. Pain can be hard to describe because its both invisible and personal. If you cant put into words how much pain youre in or how it affects your life, your doctor cant prescribe the right treatment for you.
Use this guide to help you talk to your doctor about your arthritis pain so you can get the relief you need.
What Does the Pain Feel Like?
Be as specific as possible about how your pain feels to help your doctor figure out whats wrong.
Here are a few words you can use to describe the way your pain feels, and how your doctor might interpret them:
Aching, dull: muscle strains, arthritis pain
Shooting, electric, tingling, burning, pins-and-needles: nerve pain
Sharp, stabbing: injuries such as a broken bone, muscle or ligament tear, or penetrating wound
Throbbing: headache, abscess, gout
Tightness: muscle spasm
Where Do You Have Pain?
Describe exactly where you hurt and how that that may or may not change to your doctor.
Here are a few examples:
Deep in your shoulder joint or in the muscles near the surface.
Under the kneecap or in the back of the knee.
The outside of your hip or in your groin.
Is the pain in only one spot, or does it travel?
Does the pain remain steady, come and go, or only flare up when you move in a certain way?
How Much Does it Hurt?
Classes Of Drugs For Treating Ra
DMARDs: DMARDs, like methotrexate, work by altering the underlying processes of RA, particularly those responsible for inflammation. While they are not painkillers, they can reduce pain, swelling, and stiffness by slowing down RAs effects.
Biologics: Other types of DMARDs, called biologics, target specific molecules responsible for inflammation. These drugs work much quicker than standard DMARDs.
NSAIDs: NSAIDs work by targeting an enzyme called cyclooxygenase . They prevent COX from making prostaglandins, which are hormones involved in inflammation.
Analgesics: Analgesics can relieve RA pain because they change the way the brain and body sense and respond to pain.
Corticosteroids: Corticosteroid drugs can relieve pain and inflammation quickly by mimicking the effects of cortisol, a hormone naturally found in the body.
DMARDs and biologics are not used for managing pain, stiffness, and swelling associated with RA flare-ups .
Healthcare providers will instead recommend NSAIDs, analgesics, and corticosteroids for this purpose. These drugs are effective at quickly improving joint pain, stiffness, and other RA symptoms. They are considered short-term treatments because of the dangers and risks associated with their long-term use.
Rheumatoid Arthritis Healthcare Provider Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
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How Can Side Effects Be Avoided
NSAIDs should only be used when needed, and not over a long period of time in other words, only to relieve acute pain. It’s important to use the lowest dose possible, and not to exceed the maximum daily dose. If you’re considering using NSAIDs, it’s best to talk to your doctor about the most suitable medication and dose.
The risk of complications affecting the gastrointestinal tract can be lowered considerably by taking NSAIDs together with medicine designed to protect the lining of the stomach. These include, in particular, proton pump inhibitors like omeprazole or pantoprazole.
Alternatively, diclofenac or ibuprofen can be applied to the painful joint in the form of a cream or gel. The risk of side effects is then much lower than it is if you take tablets.
To Use Topical Diclofenac 2% Topical Solution Follow These Steps:
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What Are The Symptoms Of Osteoarthritis
Symptoms vary depending on how many joints are affected and how severely they are affected. Symptoms also tend to build up gradually over time rather than come on suddenly and include:
- Pain and stiffness in the affected joints, particularly first thing in the morning or after inactivity. This tends to resolve within about 30 minutes of gentle movement
- Limited range of movement in a joint
- Affected joints may swell after extended activity
- Pain may also increase after activity or towards the end of the day.
Symptoms can differ depending on which joint is affected.
- Knee joints: moving the knee causes a grating or scraping sensation
- Hip joints: Pain may radiate down the inside of the knee or thigh or be felt in the groin or buttock area
- Fingers: Bony growths may occur inside the joint causing the joints to become swollen, tender and red
- Inflammatory arthritis of the hand: All day stiffness may be noticed early in the disease
- Feet: Swelling and pain may be felt at the base of the big toe or around the ankles.
Gene Therapy: Getting Joint Cells To Make Their Own Drugs
Although doctors can give drugssuch as the biological response modifier anakinrato block the action of interleukin-1 and shut down the release of cartilage-destroying enzymes, researchers may soon teach joint cells to make their own protective drugs.
Investigators have inserted genes into the joint cells of animals that make a harmless protein that parks itself on the outer surface of key immune system cells, thus preventing them from switching on and releasing their destructive enzymes. Research on gene therapy for arthritis continues.
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Spinal Cord Stimulation: An Alternative Or Adjunct To Medication For Spinal Osteoarthritis
If youve taken several medications for your spinal osteoarthritis with little relief, your doctor may recommend , also known as neuromodulation to help relieve your chronic back or neck pain.
Spinal cord stimulation generates mild electrical impulses that block pain signals from reaching your brain. Pain is perceived in the brain. Neuromodulation involves implanting a small generator either in your abdominal or buttock area and thin wires called leads into the spinal canal. Some patients are not candidates for SCS, such as people who are pregnant, have a heart condition, epilepsy or have an existing implanted device such as a pacemaker. If your doctor recommends SCS, the first step is a trial period where the system is temporarily worn outside your body. If your pain improves using the stimulator, the device may be implanted surgically.
For some patients, spinal cord stimulation also helps them reduce their dependence on opioids or other pain medications. If youre concerned about tapering or weaning off your pain medication, talk to your doctor about strategies that may ease this process.
Understanding The Types Appropriate Use And Possible Risks
Angela Underwood’s extensive local, state, and federal healthcare and environmental news coverage includes 911 first-responder compensation policy to the Ciba-Geigy water contamination case in Toms River, NJ. Her additional health-related coverage includes death and dying, skin care, and autism spectrum disorder.
Muscle relaxers are a group of drugs used to treat musculoskeletal pain, meaning pain involving muscles, bones, joints, and connective tissues like ligaments and tendons. Muscle relaxers are sometimes prescribed to people with osteoarthritis as well as those with lower back pain, neck pain, and other musculoskeletal pain.
This article explains how muscle relaxers work, when they are used, and which types are available for people with osteoarthritis and other types of musculoskeletal pain. It also describes the possible risks and side effects of muscle relaxers, including when they should not be used.
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Common Rheumatoid Arthritis Drugs
Your doctor has choices to make within each class of RA medicine. Finding the right treatment for you, that is effective with the least RA medication side effects, may involve some trial and error. Here are 10 drugs commonly prescribed for RA:
Adalimumab is a biologic medication for injection under the skin. You will get the first dose in your doctors office. After that, the typical dose is self-administered once a week or every other week.
Celecoxib is an NSAID, specifically a type called a COX-2 inhibitor. It is a capsule you take once or twice a day, usually with food.
Etanercept is a self-administered biologic for once- or twice-weekly injection under the skin. Like Humira, you will get the first dose in your doctors office.
Hydroxychloroquine is a DMARD. It comes as a tablet you usually take once a day with food. For higher doses, your doctor may recommend splitting the dose to twice daily.
Indomethacin is an NSAID. It is available as a capsule, extended-release capsule, and a suspension. The ER capsule offers the most convenient dosing at once or twice daily with food.
Leflunomide is another DMARD you usually take once daily. Your doctor may have you take it more often during the first several days of treatment.
Methotrexate is a DMARD that is very effective for RA. It is available as either a tablet or injection under the skin. Doctors usually prescribe a weekly dose to decrease side effects.
Can Arthritis In The Hand Be Prevented
Arthritis cant be prevented. However, you can watch for symptoms of arthritis as you age and see your healthcare provider if you notice changes in your joints. You can also take steps to control factors that you can control. Eat healthy to nourish your body and maintain a healthy weight. Being overweight puts more stress on your joints. Dont smoke. Smoking increases your risk of arthritis.
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Some Facts About Pain
- Most people don’t have to live with pain. There are pain treatments. While not all pain can be cured, most pain can be managed. If your doctor has not been able to help you, ask to see a pain specialist.
- The side effects from pain medicine are often manageable. Side effects from pain medicine like constipation, dry mouth, and drowsiness may be a problem when you first begin taking the medicine. These problems can often be treated and may go away as your body gets used to the medicine.
- Your doctor will not think you’re a sissy if you talk about your pain. If you’re in pain, tell your doctor so you can get help.
- If you use pain medicine now, it will still work when you need it later. Using medicine at the first sign of pain may help control your pain later.
- Pain is not “all in your head.” No one but you knows how your pain feels. If you’re in pain, talk with your doctor.
What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and keep it from freezing or excess heat.
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
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When Does It Make Sense To Use Steroids
Steroid medications such as prednisolone help to reduce pain and swelling in the affected joints. They start working fast and have a stronger effect than NSAIDs do. They can help to cover the stretch of time until the basic therapy with disease-modifying drugs starts working. They can also be used for the temporary treatment of rheumatoid arthritis flare-ups. But people are advised not to use steroids for longer than 3 to 6 months. One reason for this is because the medication might become less effective over time.
Steroids can also have a number of serious side effects when taken over longer periods of time. These include an increased risk of bone fractures and infections. People who have osteoporosis can combine steroids with things like and vitamin D supplements to help protect their bones. If treatment with steroids is stopped too suddenly, the symptoms might actually get worse. So it’s important to gradually reduce the dose instead.
Steroids can be injected directly into individual joints to target the worst affected joints. This reduces the risk of side effects that affect the whole body. But local side effects, such as an infection in the joint, are still possible. Unfortunately there’s a lack of good-quality research on the advantages and disadvantages of these steroid injections.
I Was Prescribed Gabapentin For Arthritis Pain Is This Normal
Question posted by Windixi60 on 23 Jan 2017
Last updated on 25 January 2017 by chuck1957
Windixi I have seen this and just checked with one of the pharmacists that I used to work with and he told me that it has been being used OFF LABEL for arthritis pain, And what that means is it has not been approved by the FDA for arthritis pain but using it for all the other things they use it for like Nerve pain, drowsy seizures, Restless leg syndrome and more they have had good results with it helping other with general pain like arthritis. In the lower dose. Just know that it can make you drowsy at first, Be slow getting up and down just to make sure until you know it is not making you dizzy where you might fall. And a good benefit is this is not a narcotic and it is easier to get off of and the doctor tries something else never stop this medication abruptly sometimes it needs to be tapered. Give it a try just know that it is not going to work right off you have to give it some time as you reach a blood level if your still not sure call your doctor and ask how long before you well notice the pain relief we are all different some within a week may notice help from it. Have a great day and please let me know how this works out for you.
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Pain And Other Symptoms Of Spinal Osteoarthritis
The intensity and type of pain people experience as a result of arthritis in the spine varies from mild to severe, and occasional to episodic to chronic. Each type of pain is treated differently. Of course, it is not uncommon for arthritic neck or back pain to be accompanied by other symptoms, such as tingling sensations, numbness, or muscle spasms. Learn more about the range of osteoarthritis symptoms.
Make Sure Your Doctor Knows About All Medications Vitamins And Supplements
Talk to your doctor about which pain medications are best for you. Be sure to let your doctor know what other medications you are taking, even for other health problems. Besides other drugs you take, tell your doctor about any vitamins, supplements or herbal products you use. This can help you to avoid drug interactions. Here are other .
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What Other Treatments Help With Pain
In addition to drugs, there are a variety of complementary and alternative approaches that may provide relief. Talk to your doctor about these treatments. It may take both medicine and other treatments to feel better.
- Acupuncture uses hair-thin needles to stimulate specific points on the body to relieve pain.
- Biofeedback helps you learn to control your heart rate, blood pressure, muscle tension, and other body functions. This may help reduce your pain and stress level.
- Cognitive behavioral therapy is a form of short-term counseling that may help reduce your reaction to pain.
- Distraction can help you cope with acute pain, taking your mind off your discomfort.
- Electrical nerve stimulation uses electrical impulses to relieve pain.
- Guided imagery uses directed thoughts to create mental pictures that may help you relax, manage anxiety, sleep better, and have less pain.
- Hypnosis uses focused attention to help manage pain.
- Massage therapy can release tension in tight muscles.
- Mind-body stress reduction combines mindfulness meditation, body awareness, and yoga to increase relaxation and reduce pain.
- Physical therapy uses a variety of techniques to help manage everyday activities with less pain and teaches you ways to improve flexibility and strength.