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Feel the Burn . . . and the Ache, the Throb, and the Stab

I often marvel at how one disease can be so inconsistent. Rheumatoid arthritis varies widely in how it affects individuals, with a range of severity, a smorgasbord of symptoms, and an assortment of body parts it can affect. Therefore, RA can look quite different from person to person.

The different types of RA pain

Even in the same individual, there are good days and bad days: joints that are primarily affected, those that are unscathed, and those that only hurt on rare occasions.

Different pain sensations

And, even the sensation of pain itself varies. Most often, the word I would use to describe the pain in my joints is “achy.” However, that doesn’t begin to cover the litany of ways I experience the pain of RA. Sometimes the ache is dull, like a mischievous butter knife, while other times the ache is sharper, like a steak knife. Occasionally the pain escalates to something that can no longer be explained as an ache, being more like a recently sharpened butcher knife.

Pain severity or intensity

The pain can hold steady, with a sustained severity that might be mild, moderate or intense, or it can throb like a Morse code message screaming “S.O.S.!” throughout my body. Sometimes the pain is a deep burn as if someone has inserted smoldering embers deep inside my joints. This burning sensation can also radiate, broadcasting heat into surrounding muscles and tendons. Like an ornery imp sneaking up on me, the pain can also feel like a tight pinch. Or it can be more expansive, more like the pressure of a vise than the precision of a pinch.

As if this wasn’t enough to contend with, sometimes these different sensations mix together. For instance, there’s the throbbing ache that’s like a rubber mallet pounding to the beat of heavy bass. There’s the sharp burn, like the stabbing from a sword fresh from a blacksmith’s red hot flames. There’s also a burning pinch, that feels like skin burns children sometimes give one another on the schoolyard by twisting a wrist or forearm in opposite directions. With all this variety of pain, my threshold for it has increased.

The pain varies from day to day

Sometimes a friend or relative will ask how I’m feeling, and when I respond that I’m fine, a loved one might press and say, “So you’re not having any arthritis pain?” With people I’m close to, I try to explain that I always have some pain in my body. However, if the pain is only a mild ache in my toes, fingers, and wrists, I’ve learned to relegate it to the background of my awareness, like soft white noise. If I take stock of my body in any given moment, I can feel multiple places that ache. However, in comparison to stabbing or shooting pain, or even in comparison to a deep, intense ache, mild pain has become so commonplace for me that I do not give it my awareness.

Talking honestly about RA pain

I have reached a place where I feel like I’m being honest in saying I feel fine if my pain is at a mild level. After all, if I were to have a completely pain-free day, I would be lying to say I felt fine; rather I would be exultant, fantastic, marvelous, amazing. Being as intimately familiar with the many hues and shades of pain that exist, I’ll happily take a day that is only mildly achy.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • ValerieNC
    2 years ago

    I’m new to RA. Pain began in March 2017; diagnosed September 2017. I’m 71 (female) and am fortunate to have had excellent health prior to RA. Your describing the levels of pain helps me greatly to understand this disease. It’s consoling to know that I’m not alone. As you said it’s difficult responding to friends when asked how I am doing. I often say better “I think” because there is always pain and I feel that friends are tired of hearing that I’m in pain and want to hear good news. I often hear – you look so good which insinuates that it can’t be “that” bad. I also make an extra effort to look my best because it makes me feel good about myself and takes my mind off the pain. I do have a question not exactly related to your article and that is how do you handle it when someone wants to shake your hand? So far, I just extend my hand and grit my teeth. Thanks again for sharing your RA experience. It has helped me and as others have said – thanks for making me feel not so alone.

  • Dpapa8
    7 months ago

    Hello! I feel the same as you with regard to someone saying “but I look so good”. It’s so hard not to become angry …. “should I look terrible, would that make you happy”? I don’t say that, of course. But I want to. This disease is so so understood by so many. Unfortunately, we understand it on a daily basis.

  • Tamara Haag moderator author
    2 years ago

    Hey Valerie,

    Thanks so much for your comments! I hate that you are contending with the pain and awkward social situations that come with RA. However, it makes my day to hear that something I’ve written has been helpful to you. I totally agree that knowing we’re not alone is very powerful, and I’m so grateful for this site so that we can find some comfort from one another. Thank YOU for sharing about your experience, and helping the rest of us know we’re not alone!

    Yes, those comments like “but you look so good!” are so double-sided. Of course I don’t want to look terrible, but every time I hear that comment it negates what I’m experiencing. This is one of those tricky aspects about having an invisible disability. In case you find them to be of any use, here are a couple of articles I’ve written that may be of interest. This one is about having an invisible disability: This one is about trying to minimize our own pain with others:

    As for your handshake question, that is indeed a tricky one. It feels so awkward to interject a “Hey, it’s so nice to meet you. I have rheumatoid arthritis and my hand hurts, so I’m not shaking hands today,” although I have done that in the past (and it does help raise awareness about the condition, but sometimes I don’t have the energy to be an advocate and I just want to go about my day). The best thing I’ve found is to do a preemptive wave before the other person goes in for a handshake. If I keep myself back a half step further than I normally would and hold up my hand to wave while saying, “It’s nice to meet you” I’ve found the other person won’t go in for the handshake. But the timing is crucial, because if I don’t catch it in time it’s back to the awkwardness of an extended hand that I don’t want to take.

    Thanks so much for your question and for sharing your experience. We always welcome questions, and especially since this is all so new for you I definitely want you to know that you don’t have to figure it all out alone and that we are here for you.

    Wishing you all the best,

  • RAstar
    5 years ago

    You hit it on the button for me. This is exactly how I feel. So many different kinds and levels of pain. It has made me question my sanity and if the whole disease was in my head. Also your thoughts on never being out of pain. So true. Sometimes even hard to explain to your closest loved ones. Thanks for making me feel not so alone.

  • Kacey
    5 years ago

    Yesterday I had one of my worst pain days in awhile. We had a lot of storms in the area which meant increased barometric pressure which meant misery for me. The pressure inside joints like my hips and elbows was so severe that I made the comment that I wished I could just break them. It sounds bizarre and slightly morbid but when the pressure gets that extreme I just wish I could snap my bones and joints in half to get some relief.

  • Tamara Haag moderator author
    5 years ago

    Hi Kacey – I’m so sorry you had such bad day. Yes, there are those days where our bones can feel like we’re inside a pressure cooker!

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