Rheumatoid arthritis is a chronic pain condition with no definite cure. However, it can be managed via various treatments, depending on the nature and severity of a patient’s arthritis. Unlike osteoarthritis, which typically occurs due to age and/or wear-and-tear, or gout, which may cause arthritis due to uric acid crystals in the joints, rheumatoid arthritis is an auto-immune condition wherein the body’s defenses attack and cause inflammation in various tissues, including the joints.
This joint pain can range from manageable to excruciating, depending on the illness’s severity and the patient’s perception. Many factors can lessen or contribute to the pain, such as restlessness, mood, age, and environmental factors such as climate and temperature. Controlling and managing rheumatoid arthritis requires a very individualized approach that uses both pharmacology and lifestyle changes to reduce symptoms and improve life quality.
How Does Rheumatoid Arthritis Cause Pain?
Rheumatoid arthritis is not entirely understood yet, but researchers have found that it involves the immune system and that it is the body itself that causes inflammation in its tissues. While rheumatoid arthritis is characterized by moderate to severe joint pain, the inflammation can occur in other body areas, including the skin and blood vessels and vital organs like the lungs and heart.
The joint pain during rheumatoid arthritis occurs because the body attacks the linings of the joints themselves (known as the synovium), causing them to swell and become sensitive, and eventually leading to joint deformity, as well as bone erosion. This occurs because, as the body attacks these linings, the harden can damage the underlying cartilage and bones. Eventually, the joint becomes unstable and loses its alignment.
Where rheumatoid arthritis comes from is still unknown. There is a genetic component, yet it may be that certain bacterial or viral infections trigger the disease. Women are more likely than men to develop rheumatoid arthritis, and its onset is typically in the middle age (ages 45 to 65), although it can develop at any age, including childhood.
Symptoms will usually flare up and calm down. While it is a lifelong condition, it can be managed, and symptoms can be reduced. This can help patients with moderate symptoms achieve more extended pain-free periods and significantly improve patients’ quality of life with more severe symptoms.
Exploring Treatment Options
Treatments for rheumatoid arthritis will usually play the most significant role in managing the severity of the disease. Make sure you are coordinating with your doctor often, providing feedback on any treatment methods prescribed to find the most effective course of treatment together. There are a variety of different drug therapies for rheumatoid arthritis, as well as other individual drugs per type. The most common treatments are:
Disease-Modifying Anti-Rheumatic Drugs (DMARDs) and Biologic Agents
These are drugs that do not address the pain itself (and therefore are not painkillers) but instead focus on reducing the swelling and stiffness caused by rheumatoid arthritis by suppressing the immune system and slowing down the disease. These drugs are also prescribed in the treatment of psoriatic arthritis and ankylosing spondylitis.
There are a variety of different biologics and DMARDs, with differing side effects and counterindications. Doctors commonly treat rheumatoid arthritis with two or more DMARDs. The best combination for you will depend on your medical history, prior treatments, and other essential factors.
Just like high-dose steroids, DMARDs carry an increased risk of infection. This is why a holistic approach is essential – doctors will advise patients on reducing risks and ensuring that other medications and treatments are not potentially harmful due to the infection risk, such as vaccinations.
These include non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen but may consist of other non-opioid painkillers.
Opioids are typically reserved for extreme and debilitating pain or managing pain after surgeries. Low-dose opioids, either via pills or patches, may also be prescribed in some instances.
Corticosteroids can significantly help in the treatment of rheumatoid arthritis because of their potent anti-inflammatory and pain-killing effects. However, they are not advised for very long-term use due to an increased risk of hypertension, osteoporosis, and infection. They are usually injected into tissue near a swollen or much-inflamed joint to maximize the pain-killing effect and minimize side effects. Corticosteroids can also be used as nerve blocks, temporarily numbing the area during intense flare-ups.
More invasive treatments may become an option if reducing inflammation or addressing the pain through the nervous system is not enough. These options can include surgeries, such as modifying or replacing the joint itself or removing chronically inflamed tissue around the joint (synovectomy).
Treatments, Home Remedies, and Lifestyle Changes
Pain is a complicated and subjective sense and can be modified through lifestyle changes, emotional states, medication, and home remedies. Treatment for rheumatoid arthritis may depend on certain medications to do the heavy lifting. Still, suppose the rest of a patient’s lifestyle does not contribute to symptom management or further exacerbates the problem.
In that case, the effectiveness of any given treatment plan will be limited. Therefore, doctors and pain management specialists place great importance on simple yet effective adjustments for combatting rheumatoid arthritis, including:
- Sleep: If you struggle to get your requisite eight hours a day, consider taking naps. Seek treatment for conditions that may affect sleep quality, such as sleep apnea.
- Physical activity: Brisk walks, water aerobics, short swims, and training with controlled resistance – such as bands or weights – can significantly affect treatment and improve symptoms.
- Diet: An anti-inflammatory diet and making individualized dietary changes based on a professional’s recommendation may affect your flare-ups’ severity and frequency by helping the body reduce inflammation on its own.
- Topicals: Certain creams, oils, and ointments may help reduce minor pain or consistently reduce symptoms depending on their active ingredient. Low-THC (less than 0.03 percent) cannabidiol products, camphor topicals, and menthol may help reduce joint pain.
“Pain-Free” Does Not Mean “In Remission”
Rheumatoid arthritis is a chronic condition, but it is one that can, under the right circumstances, be brought into remission. However, remission does not merely mean “symptom-free” or “pain-free.” There are invisible disease metrics that can only be identified through thorough testing that help a medical professional determine whether a patient’s rheumatoid arthritis is currently in remission or not.
You may now be pain-free but not necessarily in remission if these metrics have not been met. This is important because a patient who has successfully entered remission may benefit from an altered treatment plan that reduces their medication. However, if you stop taking your medication after reaching a pain-free state without first consulting your doctor, you may be harming your treatment.
Be sure to consult a professional whenever you plan on modifying your treatment or want an alternative approach. The pain management process for rheumatoid arthritis requires a holistic view – one that considers several different markers of health and approaches treatment through a combination of lifestyle changes, pharmacology, and potentially more invasive or drastic treatments.