A crumpled hand is being crushed under the grip of a seemingly normal handshake, with pain squiggly lines resonating from the joints.

Embraceable You

I love to hug. I have been a hugger for as long as I can remember. I also love to not just shake hands but hold onto a hand with both of mine when it is someone I truly care for, or a friend I have not seen in some time. That all changed when RA entered my life. The reality of touch is very different now and something I have learned to quietly assimilate into my day to day life.

We all know that when we are in the midst of a flare, the slightest weight or pressure on a joint can induce pain and suffering. That may well include hugging, shaking hands or hand-holding. I can remember vividly, years ago, the first time one of my sons ran to hug me when my shoulders and arms were flaring and I nearly cried out in pain. It was excruciating and yet this was an expression of love that I relished and encouraged. I was as distressed mentally as physically, knowing that I needed to sort out how best to handle yet another dilemma in the management of RA.

How to show physical affection with RA

First and foremost, we need to understand that touch comes in many forms and they need not all be vigorous. I realized that I could still hug and handhold, but I needed to adapt it to the level of pain I was in at any given time. That is not easy. But it can be done with practice and persistence until it is fully assimilated into your flare management.

Be honest with loved ones

First of all, I needed to be honest with my loved ones. I would simply let them know there would be times when I could only do a light hug, but it still carried the same level of love and affection! Or, as is often the case, when a hug was imminent and spontaneous, I would just say something like “Need to do a light hug today, I am a bit uncomfortable." So, I might offer a kiss as well or a nice touch on their arm to show the same affection, just a little different.

It is remarkable how quickly people adapt! I was more fearful of it than I ever needed to be. Turns out people are amazingly compassionate and understanding when we give them a chance. It is a lot more off-putting if we simply react in pain or reflexively push a person away because of our discomfort, without forewarning. Offering an explanation afterward instead of beforehand can make for an awkwardness that is totally avoidable.

Do what we can, when we can

We can also learn to offer those wonderful hugs when we are feeling good and not flaring. My family kind of lets me control this and that works really well. Additionally, I love to just stroke an arm or lean into my husband when we are together and it is a great way to maintain that human contact we all need and crave.

Trying different forms of affection

I have also learned that just sitting and attending to someone more intently through deeper eye contact and attentiveness, is a great way to show your affection. There are non-physical forms of contact that I have learned to utilize since RA. The danger of pulling back from the physical expression is that you could lose the joy that comes with embracing. So, it is imperative that we learn to adapt.

Tips for formal or professional settings

Handling (no pun intended) this issue on a more formal or professional level can be daunting. I remember going to a conference where I knew that I would likely be shaking hands dozens of times over a three-day period. My hands were swollen and flaring intensely. What to do? 

How to manage social expectations

I figured out that I could do a couple of things to deal with this. One was I could simply say “My hands are painful at the moment but it is a pleasure to meet you.” Then, I would do a slight acknowledgment with my hand, like just lifting it up to signal a greeting. Or, I later discovered, that if I took their hand gently in one of mine and laid the other hand over theirs, I could control the pressure! It really does work. On top of that it is a much nicer form of greeting and was always very well received.

The bottom line is that we need to “embrace” the reality of embracing if we are going to continue to enjoy the pleasure that physical contact brings. As with all of the tools for managing RA, it can be done with persistence and patience so that the joy and satisfaction if brings can still remain in our lives.


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