Flare Up. The two words that can cause fear in a person suffering from rheumatoid arthritis and twist every joint (literally) in their body. Rheumatoid Arthritis (RA) is an auto-immune disease that primarily affects the joints. Causing chronic inflammation, RA results in swollen and painful joints. While inflammation normally works as a defence against bacteria and virus and is supposed to be part of the body’s healing process, people suffering from this disease experience inflammation for no apparent reason. Since this condition is auto-immune, the inflammation caused can damage the affected joints, and induce pain and stiffness, instead of repairing the body.
Although people of all ages can suffer this condition, it is more likely to occur as people get older. Living with rheumatoid arthritis pain leads to a reduced range of motion and might result in a lower quality of life. However, working on a personalised fitness and diet plan with your doctor can help you in coping with rheumatoid arthritis.
Causes And Symptoms Of Rheumatoid Arthritis –
While the exact cause of RA is unknown, there is evidence that your lifestyle choices might increase your chances of developing the condition.
People are more likely to develop RA when they –
- Consume a lot of red meat
- Smoke and drink heavily
- Drink a lot of coffee
Experts have concluded that people consuming high levels of Vitamin C are at a lower risk of developing the disease.
While there are significant chances of RA being genetically passed on from parents to children, genetic factors alone are not responsible for causing the condition. For instance, if you have an identical twin who has RA, there is only a 1 out of 5 chances of you developing the condition, even if you both share the exact same genetic material.
The symptoms of RA start gradually and may flare up with time. The condition may develop rapidly for every 1 out of 5 people, leading to difficulty in performing everyday tasks. The severity of the symptoms differs from one person to another.
The most common ones are –
- Joint pain and swelling
- Joint stiffness in the morning that lasts for more than half an hour
- Flu-like symptoms
- Fatigue, irritability and depression
Other lesser common symptoms include –
- Growth of fleshy lumps on hands, below the elbow, or on the feet (rheumatoid nodules)
- Weight loss
- A very rare occurrence of inflammation of other body parts like the membrane around the heart, lungs, and blood vessels
- Eye inflammation
RA mostly affects the joints in the fingers, wrists or the feet often causing discomfort. Studies have concluded that treatment is more likely to be effective if the condition is diagnosed in the early stages. Hence, it is important to contact your medical advisor immediately if you go through any of these symptoms.
Pain Management For Rheumatoid Arthritis
The pain caused by RA is chronic. While there is no permanent cure for the pain, there are several ways to manage it. Read on to know more –
Understand Your Body And Use Your Joints The Right Way –
RA leads to a life built around immobility due to pain. You can reduce the pain in your joints by lowering the stress on them by doing things in a different way –
- Use the largest and strongest joints and muscles in your body wherever possible for carrying out daily tasks. For instance, using a bag with shoulder straps across the back rather than holding a bag or a case in your hand will reduce the pressure in your hands and fingers
- Try to avoid being in one position for long stretches of time. Do not maintain postures that make your body feel stiff
- Avoid activities that require you to apply too much pressure on your fingers or maintain a tight grip
- Maintaining a healthy body weight helps in reducing the stress on joints that bear your weight
- Balance your physical activities with appropriate amounts of breaks. It is important to remember that too much activity can cause the pain to flare up, but too much rest will lead to muscle and joint stiffness
Relax The Body And Mind –
The pain caused by this condition makes the person irritable. It is, therefore, important to relax the body as well as the mind to manage the pain, and get through day to day activities. Relaxation techniques such as yoga, meditation, deep breathing, and visualisation can alleviate the stress caused by RA.
Here are a few techniques that you can try –
- Take out 10 minutes of your time every day and find a quiet place without distractions
- Sit or lie down in a comfortable position with your eyes closed and a proper headrest
- Inhale deeply and exhale slowly
- Feel your chest and stomach move in and out while focussing on your breathing and the sensations you experience
- Think and focus on things that make you feel calm. This will gradually take your mind away from the pain
Jump Into The Shower
No, don’t jump, that will just flare up the pain. Walk into the shower with the grace of a newborn deer and turn on the faucet (gently)! Research has concluded that warm water loosens the joints and works effectively against stiffness and pain. Patients who have tried this method have reported that the flexibility lasts even after you are out of the shower.
Here are a few tips for your next shower –
- Make sure that the water is warm, not hot. Water temperatures between 92 to 100 degrees Fahrenheit are considered to be a healthy range. Water temperature that exceeds 104 degrees Fahrenheit is considered dangerous
- Magnesium is an important mineral that is essential for bone and heart health. Adding bathing salts like Epsom salts that contain magnesium sulfate crystals can lower the pain. However, it is important to understand that this should be done only occasionally
- Warm water helps in stimulating the blood flow to the stiff joints and muscles, making a warm bath the ideal place for gently stretching
- If you are in a bathtub, trap a tennis ball between your lower back and the bathtub and roll it against the knotted muscles
Use Support Aids
While it is advisable to rely as less as you can on support aids, they are helpful when you want to take the pressure off your joints.
Here are some of the aids you can try –
- Shoe insoles designed for people suffering from RA redistribute the body weight evenly and reduces pressure on the sensitive areas of the feet. The cushioning effect eases pressure off the lower body and, hence, reduces foot pain, corrects gait and helps in correcting structural issues
- There are numerous knee braces and knee caps that support the joints and ease pain. These aids enable the patient to walk and even exercise without putting too much stress on the knee joints
- People suffering from RA may be unable to straighten the joints in their fingers as the inflamed tendons cause the fingers to be locked in a permanently bent position. This reduces its function and induces pain. Stabilizing finger joints with the aid of finger joint support helps in loosening the joints and improving their function
Most people diagnosed with RA are prescribed pain relieving drugs. Although these are effective only until the dose wears off, they can lower pain and allow you to go about your daily routine.
However, it is best to consult with a medical practitioner before taking any of them –
- Although they do not cure the disease itself, painkillers may relieve the stiffness and pain caused by RA
- Anti-inflammatory drugs (non-steroidal) help in relieving pain caused by swelling and inflammation
- Steroids, sometimes referred to as corticosteroids are very potent drugs that effectively reduce inflammation. They can be taken both orally and intravenously
- Anti-depressants help in managing and tolerating pain, and improve quality of sleep when taken before bedtime
Eat, Exercise, Rest, Repeat
Maintaining a healthy body weight requires a combination of a good diet and regular exercise and is essential when you have arthritis. Losing even a small amount of weight helps in reducing the strain on your back and in the joints in your legs. It is important to make sure that you are not underweight either, as your body will need the strength to get through an episode of a particularly bad flare-up.
Here’s a bunch of things you can try –
1. Diet –
There is no diet that can cure RA. However, certain foods are known to fight inflammation and strengthen the immune system. When it comes to arthritis, it is not just about what foods you should eat, it is also about what foods you should avoid to reduce risks of a flare-up. The key to achieving good health is to eat a variety of foods in the right proportion and quantities.
Here are some foods you should include in your diet –
1. Fish –
Fish contains omega-3 fatty acids which helps in fighting inflammation. Herring, mackerel, salmon and tuna are some of the richest fish sources of omega-3 fatty acids
2. Soybeans –
Soybeans are the vegetarian substitutes for fighting inflammation. They are also rich in fibre and protein, and low in fat
3. Healthy Oils –
Opt for healthy oils like extra virgin olive oil, that have properties similar to anti-inflammatory drugs. While safflower and avocado oils contain properties that lower cholesterol, walnut oil contains 10 times more omega-3s as compared to olive oil. Take your pick!
4. Berries –
Red and purple berries like cherries, blueberries, blackberries, raspberries and strawberries contain anthocyanins that have an anti-inflammatory effect
5. Dairy –
Dairy products like milk, cheese, and yogurt are rich sources of Vitamin D and calcium. Both nutrients increase bone strength and boost immunity. People who are lactose intolerant can consume green leafy vegetables as a substitute
6. Broccoli –
Broccoli is packed with Vitamins C and K. Study has shown that people who consume high levels of Vitamin C are at lower risks of developing RA
7. Citrus Fruits –
Fruits like oranges, sweet limes, and grapefruits are also rich sources of Vitamin C and aid in maintaining healthy joints
8. Green Tea –
Rich in antioxidants, green tea contains polyphenols that reduces inflammation and slows down cartilage destruction. It also contains epigallocatechin-3-gallate (EGCG) that blocks molecular production causing joint damage in people suffering from RA
9. Whole Grains And Beans –
Foods like beans, whole-grain cereals, brown rice and oatmeal reduce the C-reactive protein (CRP) in the blood. CRP is the marker that indicates inflammation associated with RA
10. Nuts –
Not only are they delicious, nuts also promote a healthy heart and helps in weight loss. Walnuts, pistachios, almonds, and pine nuts are the richest sources of nutrients like calcium, magnesium, Vitamin E, zinc, protein and alpha-linolenic acid (ALA)
Avoid foods that are high in saturated fat, salt or sugar.
2. Exercise –
Studies have concluded that people suffering from RA can ease their pain with just a few minutes of exercise every day. The three main types of exercise suitable for people suffering from this condition are –
1. Strengthening –
Exercises like Pilates help in strengthening the muscles which move, support and protect your joints. People tend to become less active post developing RA for fear of pain and causing damage. Immobility leads to weaker joints and muscle wastage. Strengthening exercises help in developing stronger muscles. This provides stability to the joints and tasks such as climbing stairs and walking become easier.
2. Range of movement –
These exercises improve flexibility and help in maintaining good posture and strength. It involves stretching your joints to their comfortable range of movement and then pushing them just a bit further. These can even be performed during a flare-up. It should be performed twice day, every day.
3. Cardio –
Cardio exercises increase your heart rate. They help in building control and stamina, reducing weight, improving sleep, and strengthening bones. The best form of cardio for people suffering from RA are walking, cycling and swimming. Performing household chores daily also helps.
The type of exercise you choose depends on the type of arthritis you have and the severity of your condition. It is advisable to consult a physiotherapist or a doctor before starting a new work out routine. If you are planning on going to a fitness club or gym, inform the fitness instructor about your condition. This will help them in developing an appropriate workout plan for you. If any particular exercise causes your joints discomfort or pain, stop immediately and find an alternative. If not, you should continue.
Daily Precautions And Tips
You can manage RA better if you are proactively involved in maintaining a heathy lifestyle.
Here’s a bunch of precautions you can take while going about your day to day activities –
- Make sure that your prescription medicines are regularly refilled. Always keep some over-the-counter pain relief medication handy
- Wear comfortable shoes that have good support and traction
- Maintain a healthy balance between physical activity and rest
- Apart from warm baths, try cold compress for acute pain which numbs pain and reduces inflammation
- Getting enough sleep is essential for the physical and mental well-being. Your body regenerates and repairs itself when you are sleeping
Existing And Experimental Treatment Options For Rheumatoid Arthritis
Apart from conventional medicines for pain and stiffness, complementary therapies can work wonders for RA. Here are a few treatment options you can try –
1. Acupuncture –
It is an ancient Chinese therapy whereby tiny needles are placed along the meridians in the body to increase the production of endorphins. Endorphins are natural pain relievers and release the trapped energy in the body. If you are afraid of needles, you can try acupressure which involves application of pressure using palms, fingers, and knuckles instead of needles
2. Topical Treatments –
This involves application of ointments or patches to the skin directly over the painful joints, which may contain capsaicin, salicylates, or nonsteroidal anti-inflammatory drugs (NSAIDs), which reduce pain
3. Transcutaneous Electrical Nerve Stimulation (TENS) –
It involves fastening a portable pocket-size machine to painful spots. The machine generates electrical current to the affected area via wires connected to the electrodes placed on the skin and is effective in treating any kind of arthritis pain
4. Peripheral Nerve Stimulation –
This therapy is similar to TENS, however, instead of fastening a machine to the affected area, trial electrodes are implanted just beneath the skin. If the pain is relieved post a week-long trial, the electrodes are permanently placed
5. Facet Joint Denervation –
In this therapy, physicians apply radiofrequency heat energy to affected areas and destroy painful nerves in the facet joints at the back of the spine
You make one of the healthiest decisions in life when you understand the challenges that come with your illness and plan a life despite the complications. It is important to learn about your condition and opting for treatments that suit your body. Do not let rheumatoid arthritis bring you down. If you or your loved ones are suffering from RA, get the help you need, today.