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Managing Arthritis Pain

Arthritis pain

Key points

  1. Treatments for arthritis pain largely depend on the type of arthritis you have.
  2. Applying cold and heat to inflamed joints may help with arthritis pain.
  3. Prescription medications, physical therapy, and surgery are a few possible treatments.

An estimated one in five American adults have been diagnosed with arthritis according to the Centers for Disease Control and Prevention (CDC). Arthritis is a major cause of disability in the United States. Left untreated, it can cause:

  • chronic pain
  • stiffness
  • swelling
  • limb deformities
  • impaired range of motion

These symptoms can seriously disrupt everyday life. Learning how to live with arthritis can be difficult. However, it’s usually possible to manage the symptoms and improve your quality of life.

Treatments for arthritis will depend on:

  • type of arthritis
  • individual health needs
  • severity of pain
  • symptoms in other body organs (extra-articular symptoms)

How lifestyle affects arthritis pain

Living a healthy life may help reduce your risk of developing certain types of arthritis. It can also reduce the severity of your symptoms.

Being overweight or obese, for example, increases the pressure on your joints. It may also contribute to generalized inflammation that can increase arthritis symptoms. Losing weight in a healthy way may help ease these symptoms.

Healthy lifestyle changes are often the first steps in managing arthritis symptoms. You should try to improve your sleep, exercise regularly, and eat a low-fat, high-fiber diet.

Exercise may be particularly useful in helping with arthritis symptoms. Low-impact exercise has been shown to:

  • improve joint mobility
  • relieve stiffness
  • reduce pain and fatigue
  • strengthen muscles and bones

“Staying in motion actually helps to keep pain away,” says Dr. Moshe Lewis, MD, MPH. Exercise, such as brisk walking, is critical in treating pain and stiffness associated with arthritis. It extends the life of your joints.

Cold/heat treatment for arthritis pain

Applying cold and heat to inflamed joints may help with arthritis pain. Research on the efficacy of cold and heat treatments has been inconsistent.

Ice helps to restrict blood vessels. This reduces fluid in the tissue and decreases swelling and pain. Wrap ice in a towel and apply to the aching area for up to 20 minutes. You can ice your joints several times a day.

Heat treatments can be applied in the same way. Use a hot water bottle or heating pad and apply it to the swelling. Heat opens the blood vessels and increases circulation. This brings in nutrients and proteins that are essential to repairing the compromised tissue.

Heat and ice treatments can be used in combination. Talk to your doctor about what might work best for your needs.

Over-the-counter medications for arthritis pain

Over-the-counter (OTC) medications can help with minor pain and swelling associated with arthritis.

The most common types of OTC pain relievers are acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs). Types of NSAIDs include:

  • aspirin
  • ibuprofen (Advil, Motrin, Nuprin)
  • naproxen (Aleve, Naprosyn)

Acetaminophen only relieves pain. NSAIDs relieve pain and can also reduce the swelling associated with certain types of arthritis.

Topical medications

OTC topical creams can also help treat arthritis symptoms. These creams are applied directly to painful areas. They may contain active ingredients such as menthol (Bengay, Stopain) or capsaicin (Capzasin, Zostrix).

Prescription medications for arthritis pain

Sometimes OTC painkillers are not strong enough to treat your arthritis pain. If this is the case, your doctor may suggest prescription options.

Prescription NSAIDs

Prescription NSAIDs work to reduce swelling and pain. They haven’t, however, been definitively proven to be more effective than OTC NSAIDs for this purpose. This class of drugs includes:

  • celecoxib (Celebrex)
  • piroxicam (Feldene)
  • nabumetone (Relafen)
  • prescription-strength ibuprofen and naproxen

Tramadol

Tramadol (Ultram) is a prescription painkiller. It’s widely used for chronic pain and may cause fewer side effects than NSAIDs. However, it has significant potential for physical drug dependence.

Narcotics

Strong painkillers can provide relief from severe pain. These include:

  • codeine
  • meperidine (Demerol)
  • morphine
  • oxycodone (OxyContin)
  • propoxyphene (Darvon)

These medications will reduce the pain symptoms of arthritis, but they won’t modify the course of the disease. They can also be addictive and should be used with caution.

Disease-modifying drugs

A class of medications known as disease-modifying anti-rheumatic drugs (DMARDs) can be used to treat rheumatoid arthritis and other inflammatory forms of arthritis.

These drugs can actually change the course of your disease unlike NSAIDs and painkillers. But, DMARDS work more slowly than painkillers. It can take weeks or months to see an improvement.

Examples of DMARDs include:

  • azathioprine (Imuran)
  • biologics (Actemra)
  • cyclophosphamide (Cytoxan)
  • cyclosporine (Neoral)
  • hydroxychloroquine (Plaquenil)
  • methotrexate (Rheumatrex)

TNF-alpha inhibitors are a subtype of DMARDs. They also can modify the course of rheumatoid arthritis. These include:

  • etanercept (Enbrel)
  • infliximab (Remicade)
  • adalimumab (Humira)
  • certolizumab pegol (Cimzia)

Each DMARD has its own set of side effects. Discuss them with your doctor before deciding on a treatment.

Cortisone shots

Cortisone injections are used to decrease inflammation and reduce swelling. They can relieve pain in arthritic joints, but they can also accelerate bone loss if used repeatedly.

Trigger point injections

Injections can be used to relieve pain in areas of muscle that contain “trigger points.” These are points occur where muscles bind together and don’t relax. Trigger point injections can be used to treat muscle pain in the arms, legs, or back.

Trigger point injections contain an anesthetic and sometimes a steroid as well. They often provide relief for several weeks or months at a time. Some research, however, suggests that these injections may be no more effective than simply sticking a needle into the trigger point.

Physical therapy for arthritis pain

Physical therapy can help to improve muscle strength, increase the range of motion of joints, and reduce pain. A physical therapist can also help you develop an exercise regimen that will fit your needs.

Physical therapists can also help you find supportive devices such as splints, braces, or shoe inserts. These devices can provide support to inflamed joints. They can also take pressure off weakened joints and bones, reducing pain overall.

Surgery for arthritis pain

Severe cases of arthritis may require surgery to replace or repair damaged joints. Types of surgery used to treat arthritis include:

  • joint replacement
  • bone realignment
  • bone fusion
  • arthroscopic surgery

Alternative treatments for arthritis

Several types of complementary therapy may help with arthritis pain. The efficacy of these treatments varies among individual patients. Consult your primary care physician before starting any new treatment. It’s important to find out whether the treatment will be safe for you.

Acupuncture

Acupuncture and acupressure are traditional Chinese medicine techniques. They relieve pain by stimulating the skin at key points. This stimulation prompts the body to release endorphins. It may also block messages of pain from being delivered to the brain.

Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve stimulation (TENS) is a treatment in which a small electric current is applied to specific nerves. This current is believed to interrupt pain signals and lead to endorphin release.

Herbs and supplements

There are many herbal supplements that have purported anti-inflammatory properties. Capsaicin may help fight arthritic pain, according to the Arthritis Foundation. This is the natural chemical that gives chili peppers their heat. It’s used in several topical arthritis treatments.

Turmeric is another healthy spice that has been used to reduce inflammation for hundreds of years.

There is also some evidence that some other natural remedies may help with arthritis pain, including:

  • vitamin C
  • fish oil
  • glucosamine and chondroitin
  • cat’s claw (Uncaria tomentosa)
  • avocado soybean unsaponifiables (vegetable extract)

Clinical evidence to support benefit from these supplements is mixed. Some people with arthritis do find them helpful. Additionally, some of these supplements, such as fish oil and vitamin C, provide other health benefits unrelated to arthritis.

It’s important to exercise caution when taking supplements. Just because a product is natural does not mean it’s safe. The contents of supplements are not verified by the U.S. Food and Drug Administration.

You should always consult your doctor before taking any supplement. Some supplements can interact with medications or cause health problems.

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