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Managing Pain on Bad Days

As the weather turns colder I gather up my pain management tools to cope with more frequent rheumatoid arthritis flare days.

I have found my joints increasingly sensitive to changes in weather and temperature. As cold days turn more frequent, I feel more stiffness and pain in my joints. Sometimes I wonder if I should move to a warmer climate, but as much as I hate the cold I would miss the winter and am happy with the life I’ve built.

That means I just have to continue recognizing my bad days and coping with them to the best of my ability. I employ a number of strategies to manage pain on RA flare days:

  • Stay warm. During cold days and when my joints are flaring painfully, it’s important for me to stay warm. When I go outside I wear a ridiculous amount of layers—sweater, scarves, coat, hat and even a blanket over my lap. I also use a heating blanket while at home. If I am comfortably warm, my joints are less likely to stiffen up and become more painful.
  • Adjust my medications. I have arranged in advance a protocol with my doctor so that if I am feeling more pain or an RA flare, I know I can increase my prednisone temporarily by a certain amount. I will also call and leave a message with my doctor so that we can touch base and see if anything else should be done, like a 10-day course of increased prednisone.
  • Sometimes use ice. I feel conflicted about ice. On the one hand when I have a hot and painful joint, it can really help to calm it down by applying ice for 15 – 20 minutes. However, my joint will often become stiffer from the cold. So I tend to use ice sparingly and when I have pain focused on a particular joint.
  • Rest. We’ve all been there—our RA flare becomes so strong with pain, throbbing joints and stiffness that there is no alternative but to rest. Sometimes this may feel like surrender, but I think of it as an opportunity to recuperate. It may be that in the winter I just need a little more rest and downtime than usual, but if that will help keep me in better health it is something I must do.
  • Massage. It’s a real treat but a gentle massage can really alleviate my joint and muscle pain from RA. I have found a great place with a masseuse that really listens. For me, a lighter touch is better because I can be very sensitive to massage. However, after some time working on my most problematic joints, I feel so much better and looser than before. And in between visits to the masseuse I have an accommodating husband who is willing to give some supplemental massage.


Over the years I’ve found other techniques that can help relieve RA pain and stiffness, such as gentle exercises, paraffin wax treatments, acupuncture and more. It really depends on how I’m feeling and what help is available.

My preference is to avoid additional medication as much as possible. With being on medications for so many years I am leery of the side effects and long term changes they can inflict on my body. However, I’m practical and if I need a jolt of prednisone to lift myself out of a bad flare-up I will do what is necessary.

I continue to experiment with pain management methods. This winter I’d like to incorporate more regular meditation as I’ve read that this practice can prevent pain and reduce it when it arrives.

What techniques can you share about your RA pain management?

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

Comments

  • Leah1322
    4 years ago

    In the winter I soak my ankles in hot water with lavender. It really helps. I also make sure to limit myself. If i work i dont plan more than one thing after work so I have that time for my body to rest and heal. Before i acceptedmy limitations I was in agony all the time. I stopped trying to do what I “should” be able to do and started living with what I could do. Accepting my limits and working gradually to surpass them has helped to have fewer and less severe flare ups. Also if it is a bad flare up i do MILD stretching 2-4 times an hour and every time I wake up at night. In my experience though when the pain gets to be its worse all I can do is take my meds, run hot water over it, and try to watch or read something distracting..

  • Tiptoetammy17
    3 years ago

    I agree 100 % its about what you can do and how to pace your self as you do the activity

  • Kim
    5 years ago

    So encouraging to read others experiences…but unfortunately for me I have great difficulty managing pain…have been blessed to have great medical insurance, have been through a pain management program…which was really helpful…but still managing pain is hard…have tried many pain meds…acupuncture…etc…at this point along with my regular RA meds Naproxen and Morphine help the best but not always great…Ice helps very temporalily…I exercise consistantly…etc….unfortunately med changes have brought on awful flares…and I am unable to get below 10 mg of prednisone…which is a total bummer…

  • Nanci Burns
    4 years ago

    Damn, I wish I could get a Dr. to give me morphine, or even codeine. Asshat Dr.s here in Indiana only want to give Tramadol, & it doesn’t help me it gives me headaches.

  • Kelly Mack moderator author
    5 years ago

    Really feel for you Kim. I hope you find some ways to comfort yourself. Couple things I enjoy is a long massage and hot shower. Take care–Kelly

  • Barbara cates
    5 years ago

    It’s so good to read about other with RA sometime you feel so alone. I have had RA about ten years I have couple medicine now on low dose prednisoneI did Tia chi it really help I try to keep busy water exercise bike walking this past winter put a hurting on my knees I try to keep warm I have a parfinwax I use for hand I now have a empi machine for knees and hand I really don’t want to get on any more medicine I take Aleve when needed hot shower and bath help

  • Kelly Mack moderator author
    5 years ago

    Thanks for your comment Barbara. Sounds like you have some good ideas for managing your joints. Hope you are feeling better. Stay well.

  • Sarah Collett
    6 years ago

    This is a fantastic post! I’ve dealt with chronic pain my whole life. Diagnosed with fibromyalgia before anyone even knew what it was and told I had some RA as well a few yrs ago (autoimmune runs 100% in one side of my family). When I was first diagnosed with fibro, I felt like I had to take a pain pill every time anything hurt. Then I tried to commit suicide while in a bad relationship and it was probably 1 of the best things that ever happened to me (crazy perspective huh?). But after that, the only thing my doctors would give me was naproxen. Prior to that I was taking darvocets, percocets and ultram. Once all I had med-wise was naproxen, I didn’t have any choice but to learn to manage my pain in other ways.
    Most of the techniques listed here by you all have been very helpful to me! 🙂 I give myself mini-massages often and knee/elbow/wrist/ankle braces are some of my best friends. Also IcyHot and NSAIDS, although too many can wreak havoc on the liver and kidneys, especially if one takes a lot of meds.
    I find that heat works much better for me than cold, as it brings intense painful chills. I get a towel slightly wet and put it in the microwave or grab clothes straight out of the dryer. I also use hand warmers on painful areas, sometimes with a brace to keep it there. My hubby has an aromatherapy beanbag that he heats up and uses often. Menthol rubs can be great as well.
    Exercise is one of those double edged swords for me as it does help but most often I hurt myself more (2 degenerative discs from landscaping in my yard). A friend suggested tai chi (sp?). I haven’t tried it but the low impact would have to be better! Just don’t forget to stretch first regardless of which exercise method…a tight joint injures easier than a limber warmed up one. Stretching also improves range of motion.
    Another thing that has been helpful for me is distraction and not dwelling on the pain or its cause. I hope I don’t offend anyone with this as I know there are some pains that just can’t be willfully “ignored”!! If only… But some can. I found that before I was cut off my painkillers, that I dwelled on it. Afterward, I had to keep going even without the meds. I have 2 kids with autism and my pain doesn’t stop the fact that they need a mommy. There are many days that I’m in pain and later on I realize it went away. Before, I would’ve dwelled on it, focused on it, cussing the cause, and it would increase. Now I address it, do what I can, and move on (when possible). I also try to use some of these methods at the beginning, before it’s completely unbearable because it’s much easier to knock down at a slight pain than an all out pain siege. I tell myself I have to keep going, that I’m going to manage the pain instead of letting it manage me. Doesn’t always work but perspective and focus are powerful – in both positive and negative ways. This is me, it’s part of who I am. I have a choice in how to see it and how much control I let it have over me.
    One last thing, something I’m still struggling with – proper sleep and nutrition really do matter. I want to scream every time one of my docs gives me the “eat well, exercise, get rest and don’t smoke” speeches. But there is a lot of truth in all that. Especially in the getting proper rest part. When I don’t sleep well, my pain is much more pronounced.
    This is a great site! Glad a friend shared it on fb. Prayers and hugs to all 🙂

  • Annette
    6 years ago

    I’m very thankful for this site, I tested positive for RA this year but suffered from symptoms for years. I’m 39 and this has been a challenge, I don’t feel like the same person anymore. However, I have learned to accept that I have to respect my pain and limits. My heating blanket and hot showers help me to get my days going. I’m a lab technician and it’s getting harder to use my hands these days.

  • Kelly Mack moderator author
    6 years ago

    Hi Annette, Hope you find some relief from your symptoms and support here for managing your RA. Best, Kelly

  • Carrie
    6 years ago

    Thank you so much for this site! I can’t tell you what a blessing it has been to find others who are experiencing the same things I am. I too am a very active person, hiking, softball, etc. I was just diagnosed with RA about 8 months ago and the problem came out of nowhere! I suddenly went from lots of daily activity and exercise to a couch potato which has led to some level of depression. I purchased a home paraffin kit (WONDERFUL) and an infrared sauna. Both were purchased several years ago, but have been getting much use since the diagnosis and have proven beneficial. I am unfamiliar with the gloves, but will certainly have to look into that. Thank you all!

  • Kelly Mack moderator author
    6 years ago

    Thanks Carrie! Hope you find continued support here! Best, Kelly

  • Andrew Lumpe, PhD moderator
    6 years ago

    Great post Kelly! I live in a cold, wet climate and don’t look forward to it. I find that my hot tub and electric blankets help for short term. I also have wondered about moving to a warmer climate but job and family must be considered.

  • Kelly Mack moderator author
    6 years ago

    Thanks Andrew! I totally agree. As much as I would love a warmer climate, I’ve got a job and life where I currently live that I wouldn’t want to change. I love my heating blanket too! A hot tub also sounds like a great idea–good for cold days like today.

  • Kelly Mack moderator author
    6 years ago

    Hi Sue, Thanks for the idea about fingerless gloves! That sounds really helpful.

    Have you ever had paraffin treatments on your hands? I love it! Basically, you dip your hands in hot paraffin wax for several layers, wrap your hands in towels and sit for a bit to let your hands soak up the heat. I’ve had this done at hand therapy with occupational therapy. I think there are also home kits that you can buy online. It feels very soothing on my hands! Best, Kelly

  • Kelly Mack moderator author
    6 years ago

    Hi Janet, Thanks so much for your comment! I love hot baths and showers too–sometimes that is the best way for me to get started in the morning.

    For exercise, perhaps the best way is to start slow and see how your body reacts. If you do too much and feel it, perhaps you need to dial back. It may also help to talk with your doctor about exercise and/or a physical therapist. My PT tells me to listen to my joints and that if they hurt more with the exercise the next day, then I did too much. Exercise is generally good for RA because it keeps your joints active and stronger–which protects against the damage of the disease. Too much can aggravate your RA, so a balance is needed. For my amount of damage, my health providers recommend low-impact exercise, for example: yoga, swimming, stretches. So it is about matching what you enjoy as exercise with your abilities. These are just a few thoughts, but hopefully your healthcare providers can give more guidance for your specific case. Thanks for reading and keep in touch! Best, Kelly

  • Sue Ervin
    6 years ago

    In addition to all of the above, I wear the arthitis fingerless gloves. They provide just enough warmth and pressure to help inflamed hands and will fit under mittens or larger gloves. I have also just cut the fingers off those super stretchy knit gloves you can get for about $1.00. I keep a pair of those in glove box of my pickup and some at work.

  • Janet Lemay
    6 years ago

    I have those pressure gloves too- I should use them more often. They came from an airplane Sky Mall mag & are still in there if anyone is interested. Def going to try the hot wax treatment with my nail salon.
    Thx for good reminders Sue! As for the exercise, my Doc has no time for me (true) but he says I’m not doing extended damage….. Hmmmm really? I am painfully aware that it’s too much but sometimes I just need to feel alive. I pay for it – so wisdom & Kelly say “dial it back!”
    Thx Ladies!

  • Janet Lemay
    6 years ago

    Thanks Kelly- I just started following your blogs & they add value each read. I am new to RA (3yrs) however, i am in a moderate severe bracket because the treatments started out with little attack. I am on pain meds like candy & hind sight may show differently but it is how I arise & function & sleep. Your list of other treatments are spot on- maybe you left out my fave which is a scalding bath! Hotter the better! I do not take steroids except a small dose w my plasma treatment for IGG levels, but the pain, sleep & relaxation dope is my friend. I feel guilty, family does not get it- I want to be healed! I want a cure!
    So I have a question for you & possibly others who can help: how much exercise is too much- how do I know since it all makes me hurt later. I love mountain bike riding which is jarring, and tennis that is strenuous. I continue but am I causing harm to my joints & health or simply paying the piper by being sore & in bed to recover? I love outdoor exercise!!! I am an athlete – I feel alive. Since you have suffered thru childhood (I’m so sorry) then this may not hit home. Help please.
    J

  • Cecilia Jankura
    6 years ago

    i agree – hot baths – in my case, the hot tub on a daily basis keeps me loose. most of my flare ups occur after i have tried the next level of exercise – i am in one now after too much strain on my shoulders trying to build up my arm muscles. and yes, rest is best, no doubt!!!!

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