The Pain of RA is Not Just an Ache

The pain of rheumatoid arthritis (RA) is real and it’s debilitating. That much is evident to anyone who lives with the illness. Unfortunately, when people hear the word "arthritis," they immediately think of little old ladies in the grocery store hunched over a wheeled basket or retired baseball pitchers with a "bum elbow." I have always said that our disease name is one the worst jokes ever played on a group of patients, and it’s true, but the pain... well, the pain is no joke.

RA pain is complicated

The pain of rheumatoid arthritis (and many chronic illnesses) is not a singular entity. What I mean is that it’s not just, "Ow, that hurts," and then take some ibuprofen or pain meds and go on with your day. The pain of RA is complicated, it’s deep, and it has several layers that come in more than one form. Let’s break it down for those who don’t understand and those who are recently diagnosed.

First, let me start by saying that I am not writing this to scare anyone who has recently been told they have rheumatoid arthritis or, really, any form of autoimmune arthritis. Even osteoarthritis, as much as it is labelled with the "old grandma" stereotype, is painful and debilitating, but that’s for another time. We are talking about RA and its cousins, and the first type of pain that anyone deals with is the ever-present joint pain from swelling.

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Inflammation pain in our joints

Inflammation pain is a common type of discomfort associated with RA. It’s the hot, inflamed elbow that makes it difficult to make it into work that day. It’s the painful, swollen knee that makes it hard to walk around the block with your loved ones. It’s the red, ballooned knuckles that make it difficult to type.

This is a very common type of pain we deal with when our rheumatoid arthritis is active and uncontrolled by medicine. It’s usually an achy, burning feeling that throbs sometimes, and it can be like the worst sprain you've ever experienced that just doesn’t seem to go away. But there’s more to RA pain than just this discomfort.

The pain of RA fatigue

Next, there’s the pain that comes with fatigue. Fatigue is a huge part of many rheumatoid arthritis experiences and, really, chronic illness in general, and something that most people don’t realize is that it’s extremely painful. Not painful in the normal, "My annoying niece kicked me in the shins," "I stubbed my toe on that damn night stand again," or "I banged my head on the open microwave door, grr," sense, but painful nonetheless.

It’s difficult to put the "pain" of fatigue into words — but I will try. You see, fatigue from chronic illness is an energy-draining, all-encompassing, general malaise. It is a full-body, extreme type of exhaustion, and with that exhaustion comes a pain that is almost impossible to treat. How do you deal with an overall ache-that-isn’t-really-an-ache? You don’t. You do your best to live with it and get on with things.

The mental and emotional pain of RA

Finally, there is the pain that comes from the mental aspect of RA and chronic illness. I know what you might be thinking: "Mental? That’s not real pain." But I assure you, it’s real, it’s debilitating, and it’s awful.

The mental component of living with RA and, especially, dealing with the unpredictability of the illness can lead to things like depression, feelings of isolation and helplessness, and the killer for me: stress.

RA pain has full-system, full-body involvement

Now, taken alone, sure — these things don’t usually cause actual, physical pain, but nothing with our wonderful disease ever is just one thing. In fact, it’s one of the hallmarks of rheumatoid arthritis - full-system involvement, and everything is linked like a string-filled pain murder bulletin board in a cheap episode of Dateline.

These feelings of depression, isolation, and especially stress can manifest physically and cause a flare-up, and flare-ups are the worst kind of RA pain there is. It’s when your illness decides to go nuts, as if it stuck its finger into a pain electrical socket and all the body’s systems go haywire all at once. Just as many times as it’s caused by a physical reason, flare-ups can come from a mental shake-up, and as I said, it’s one of the worst kinds of pain an RA patient can experience.

We are in this together

As you can see, the pain of living with rheumatoid arthritis and chronic illness is a complicated, multifaceted thing. It is not just as simple as, "Take some Naproxen and shut up," as one of my wonderful high school teachers told me to do one day after class. It is a constant battle, and not only that, but you can be hit by several different forms of pain all at once.

I wish I had a remedy that I could share that would stave the pain off, but after 30-plus years of RA, I haven’t found anything reliable. All I can tell you is that we are in this together, for what it’s worth! Talk soon.

How do you manage the multifaceted pain of RA? Share an experience or pain management tips in the comments below.

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.

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