Strategerizing RA
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What do you do when your rheumatoid disease flares? Do you have an “action plan?”

I don’t have one of those. My flares don’t come and go like they once did—they’re pretty much constant these days. What I did—and do have—is a strategy.

RD changes so much! It’s hard to predict and hard to plan for. My disease manifests mainly as near-constant joint pain in my hands and feet, but the intensity varies from day to day, hour to hour, and even from minute to minute. One day my pain levels are low, allowing me to do just about whatever I want or need to do. But maybe later that same day, they change. My hands might suddenly get worse, inhibiting easy movement. Or perhaps my feet will become painful enough that walking and standing just isn’t any fun anymore.

So, for me, no one “plan” can work.

My strategy, such as it is, is to know what tools I have available and how to use them to make myself feel better, move better, and get things done. No one tool is best in all situations; like the disease itself, what works is always changing.

For rheumatoid disease, knowledge is the first—and I believe, the best—tool. You must know your enemy to fight it effectively. Instead of working from a position of ignorance and fear, do all you can to understand what the disease is and what it isn’t. Know what treatments are available. They can be as easy as soaking an aching hand in a basin of hot water, to self-injecting a biologic medication, to silently chanting a mantra for calm and patience.

Once you know your enemy, you can gather your weapons.

They’re physical, mental, and emotional. Maybe mine will give you some ideas that will help you come up with your own:

  1. Compression Gloves. When the joint pain in my hands reaches a level where I can no longer ignore it, I reach for these first. They’re warm, which always helps to calm joint pain for me. And the compression is oddly soothing. Sometimes I wear them all day and all night. Sometimes I don’t need them at all. But as a weapon against pain, they’re indispensable.
  2. Warm Socks. RD attacks the balls of my feet most often. It makes it painful to walk and even more painful to stand for any length of time. When it’s bad, they throb even when I’m sitting. My first go-to weapon against RD foot pain is nice, thick, soft, warm socks. Any kind will do—I’ve used everything from old wool hiking socks to those soft, fuzzy ones you see all over the place at Christmastime. If they’re warm and they don’t compress my toes, they’ll do.
  3. Slippers or Shoes with a Padded Sole. These are a daily requirement. Like most people with RD in their feet, I gave up wearing pretty shoes a long time ago. Instead, I look for shoes with a roomy toe-box and, if possible, built-in interior padding. I have a high arch, so an arch support is a requirement, as well. If necessary, I buy inserts to meet these requirements.
  4. A Paraffin Wax Bath. Dipping achy hands into warm, liquid paraffin is heavenly. I bought a home paraffin wax bath at a local drugstore years ago; I buy replacement wax for it periodically through Amazon.com. I dip my hands five or six times per session, building up a thick, seriously warm paraffin “glove” that transfers the heat deep into my joints. The only drawback, if you can call it that, is that while waiting for the “gloves” to cool, you can’t really do anything else. I used to get antsy, but now I use the time to do a short meditation practice. When I finally peel the cool, soft wax off my hands they’re less painful, much less stiff, and, as an added perk, my skin is amazingly soft! A wax bath is worth the price, which is generally under $50.
  5. Meditation. I mentioned this above. There are many kinds of meditation. Some seem woo-woo, and others are more practical. I’d love to be one of those people who can meditate for a long time, but I’ve never quite been able to do it. Instead, I practice the kind that focuses on the act of breathing. Take a slow, quiet breath in, focusing on how it feels to inflate your lungs, and allowing your breath to push your tummy out. Then focus on the exhale, doing it slowly but naturally. Just breathe in and out this way, staying focused. Your attention will wander—that’s natural. Just gently bring it back to your breath. I like this form of meditation because I can do it easily, anytime I have a few minutes to spare. And here’s the thing: when you’re focused on your breath, you’re not focused on your pain. It’s like taking a pain break so you can gather strength, and calm, for whatever comes next.
  6. Warm/hot Water. Sometimes the quickest, best weapon against pain I can use is simply hot water, run into the bathroom basin. I sink my hands into it and just hold them there, letting the heat soothe my aching wrists and knuckles. For larger joints, a nice, hot bath has always been incredibly soothing, as well.
  7. Ice Packs: For many people with RD, cold works better to soothe aching joints than heat does. I’ve used both and prefer heat, but I’ve also found that alternating ice packs and heat packs can soothe and even sometimes relieve pain. You can buy re-freezable ice packs at your local drugstore. I’ve even used a package of frozen corn, wrapped in a tea-towel. It works wonderfully.
  8. Distraction. This works best for me when I’m in pain. Shifting my attention from the pain to something else: a good book, an absorbing movie, sketching or writing (if I can), listening to podcasts, reading articles I’m interested in on the Internet … all are terrific ways to distract me from my hurts. Combined with the other weapons I’ve described above, it’s a winner.
  9. Medications. Sometimes there’s simply nothing you can do to deal with RD pain. It becomes overwhelming. That’s when I go to my other arsenal, the one with the small bottles of pills. I start with NSAIDs (Non-steroidal Anti-inflammatory Drugs). I take the one prescribed by my rheumatologist first. I may add, later, a dose of acetaminophen or some other over-the-counter analgesic (always check with your rheumatologist before taking OTC pain relievers). If neither help to relieve the pain, then I’ll go for the Big Guns, a dose of a prescription opioid analgesic.
  10. Grace. Finally, when I’m in pain I try to think of things in my life I’m grateful for, the gifts life offers all of us if we’ll just look for them. They can be as small as watching the hummingbird at the feeder on my patio or as all-encompassing as the love I feel from my family. Whatever there is in your life that makes you smile, feel warm, or comfortable is something to be grateful for. Take a moment to enjoy it. It won’t make your pain go away, but it will make it a little easier to bear.
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