Pain Can Vary

Chronic pain is a major health prob­lem and is one of the most weak­en­ing effects of arthri­tis. Pain can vary greatly from per­son to per­son and may come from dif­fer­ent fac­tors. These may include:

• inflam­ma­tion (includ­ing joints, ten­dons and ligaments)
• mus­cle ten­sion and strain
• nerve dam­age (neuralgias)
• fatigue

A com­bi­na­tion of fac­tors can also con­tribute to pain inten­sity. Each per­son has a dif­fer­ent thresh­old and tol­er­ance for pain, often affected by both phys­i­cal and emo­tional factors.

A Vicious Cycle Of Pain

- Health Prob­lems Cause Stress
- Stress Causes Mus­cle Ten­sion
- Mus­cle Ten­sion Increases Pain

Pain man­age­ment tech­niques can sever this stress-tension-pain cycle.

Pain Man­age­ment Tech­niques — Eval­u­at­ing What Works

Bet­ter ways to man­age pain are con­tin­u­ally being sought. With pain relief as the goal, suf­fer­ers often try a vari­ety of pain man­age­ment tech­niques, deter­min­ing which works best. The suc­cess or fail­ure of each type of treat­ment is indi­vid­ual. What works for one per­son may not work for another person.

Pain Med­ica­tions

Med­ica­tions can be used to reduce pain. Com­monly pre­scribed pain med­ica­tions include:

Pain med­ica­tions serve to regain some level of com­fort, but they do lit­tle to change the dis­ease state. The amount of pain med­ica­tion used must be con­trolled since there are known side effects.

Exer­cise

Exer­cise can help main­tain func­tion and lessen pain. Peo­ple with arthri­tis should always dis­cuss exer­cise plans with their doc­tor. Some exer­cises may be off-limits for peo­ple with a par­tic­u­lar type of arthri­tis or when joints are swollen and inflamed.

Hydrother­apy / Warm Water Therapy

Warm water ther­apy can decrease pain and stiff­ness. Exer­cis­ing in a pool, swimspa, or hot tub may be eas­ier because water takes some weight off painful joints. Some also find relief from the heat and move­ment pro­vided by warm water exercise.

Rest

Pain can also be an indi­ca­tor of the need for rest. It is impor­tant to pay atten­tion to the sig­nal and allow the body the required time to recharge. Inflam­ma­tion decreases dur­ing a rest­ful phase, how­ever too much still­ness can lead to mus­cle weak­ness. It is essen­tial to strike a bal­ance between rest and exercise.

Mas­sage

Mas­sage ther­apy can has­ten pain relief, soothe stiff sore mus­cles, and reduce inflam­ma­tion and swelling. As mus­cle ten­sion is relaxed and cir­cu­la­tion is increased, pain is decreased.

TENS Units

TENS (tran­scu­ta­neous elec­tri­cal nerve stim­u­la­tion) uti­lizes low-voltage elec­tri­cal stim­u­la­tion to the nerves to block pain sig­nals to the brain. Elec­trodes are placed on the skin and emit the elec­tri­cal charge. This is used pri­mar­ily for chronic, local­ized pain which is intractable.

Surgery

Often viewed as a last resort option, surgery can be per­formed with the goal of elim­i­nat­ing pain in a spe­cific joint. Joint replace­ment surgery has become more com­mon over the years, and is regarded as a viable option when all else has failed. The dam­aged and painful joint is removed and replaced with a pros­the­sis. Other sur­gi­cal options include:

• arthrode­sis (fusion)
• syn­ovec­tomy
• re-section
• arthroscopy

Med­i­ta­tion / Relaxation

Med­i­ta­tion and relax­ation can ease mus­cle ten­sion and help fight fatigue. Relax­ation tech­niques may reduce:

• stress
• anx­i­ety
• depres­sion
• sleep­ing problems

Deep breath­ing

Deep breath­ing involves clear­ing the mind by breath­ing in and out, slowly, deeply, and rhyth­mi­cally. You inhale through the nose and exhale through the mouth, releas­ing tension.

Pro­gres­sive Relax­ation / Cre­ative Imagery

Pro­gres­sive relax­ation involves lying on your back to sys­tem­at­i­cally tense and relax each part of your body. The relax­ation works toward con­trol­ling pain. Fol­low­ing pro­gres­sive relax­ation, the mind can be engaged into imag­in­ing a pleas­ant and happy scene. As the mind is occu­pied with the scene, stress lev­els dimin­ish, as do pain levels.

Biofeed­back

Biofeed­back uses a com­bi­na­tion of relax­ation, visu­al­iza­tion, and sig­nals from a machine to gain con­trol of pain. As you are attached by elec­trodes to a machine, you are taught to con­trol blood pres­sure, mus­cle ten­sion, heart rate, and temperature.

Occu­pa­tional Therapy

Occu­pa­tional ther­apy is rooted in phys­i­cal med­i­cine, psy­chi­a­try, and behav­ioral psy­chol­ogy. The objec­tives of occu­pa­tional ther­apy are:

• to help the pain suf­ferer deter­mine which activ­i­ties or behav­iors inten­sify pain
• teach meth­ods for decreas­ing the amount of time in pain
• use tech­niques to decrease pain intensity
• help patients become more func­tional in daily activ­i­ties and in the workplace
• intro­duce a lifestyle based on good health habits

Pain man­age­ment tech­niques used can include:

• body mechan­ics (learn­ing to move the body in ways that do not increase pain)
• joint pro­tec­tion
• con­serv­ing energy (often by adapt­ing daily activities)
• exer­cise (can reduce pain by increas­ing strength)
• devel­op­ing a focus on abil­i­ties rather than limitations
• using adap­tive equip­ment and assis­tive devices
• relax­ation techniques

Heat

Morn­ing stiff­ness is often relieved by the use of hot show­ers or baths. The warmth of the water relaxes mus­cles and eases the stiff­ness. Also ben­e­fi­cial are assis­tive devices and equip­ment such as:

• hot packs
• elec­tric blankets
• heat­ing pads
• saunas

Paraf­fin wax baths for the hands, feet, and elbows have also been uti­lized for pain management.

Cold

Cold ther­apy, also known as cryother­apy, is a pre­ferred treat­ment for some peo­ple as opposed to heat ther­apy. The cold works to relieve pain by numb­ing nerve end­ings in affected areas of the body. It also decreases activ­ity of body cells and slows blood flow, result­ing in decreased inflam­ma­tion. Cold com­presses, wrap­ping a plas­tic bag filled with ice cubes, or frozen gel packs can be applied locally. Peo­ple who have Raynaud’s phe­nom­e­non should not use this method.

Pain Clin­ics

The objec­tive of a pain clinic is to offer some pain man­age­ment to peo­ple with pro­longed pain who can­not be helped by med­ical and sur­gi­cal treat­ment options. The goal is to dimin­ish the pain as much as pos­si­ble and max­i­mize the qual­ity of life within the patients lim­i­ta­tions. The approach is usu­ally holis­tic and may encompass:

• drug man­age­ment
• nerve blocks
• phys­i­cal therapy
• relax­ation
• coun­sel­ing

Mutual Sup­port

Mutual sup­port can make an impor­tant con­tri­bu­tion to pain man­age­ment. Those liv­ing with pain can share insight and draw inspi­ra­tion from oth­ers. Peo­ple afflicted with pain expe­ri­ence sim­i­lar dif­fi­cul­ties, chal­lenges, and lim­i­ta­tions. A unique under­stand­ing of what it is like to face these prob­lems con­nect peo­ple to each other.