Monitoring And Discussing Rheumatoid Arthritis Pain
Pain is pretty subjective and variable, says Dr. Schulman. How people perceive and tolerate pain may differ a lot from person to person.
Some patients with little joint tenderness may experience a lot of pain, and some people with really bad inflammatory arthritis dont experience any pain, she notes.
This is why its important to monitor your pain and be open with your rheumatologist about the level of your pain, your personal threshold for pain, and whether the pain seems new or different from your past RA pain. Pain is very tricky for everyone involved, says Dr. Domingues. There is no lab test for pain, so we really need to have a good honest doctor-patient relationship to gauge pain.
Tracking your RA pain can help you better understand your condition. Join ArthritisPower, a patient-centered research registry, to learn more about tracking your RA. .
Having an open dialogue with your doctor can help them identify the causes of your pain whether RA inflammation or a co-occurring condition is the likely culprit and come up with a treatment plan. Treatment is very different for fibromyalgia than for rheumatoid arthritis than for osteoarthritis, notes Dr. Domingues.
What specifically does your rheumatologist want to know about your pain?
Keeping a pain diary can help you clearly communicate the details of your pain to your rheumatologist. Here are some questions to consider when monitoring your pain prior to your next visit whether in-person or telehealth:
If Youve Got Arthritis Youve Probably Experienced The Intense Pain Of Flares Heres How To Handle Them
Youre feeling good, barely thinking about your chronic pain, and then wham an arthritis flare hits you like a Mack truck. These periods of increased disease activity take a toll on you physically and emotionally, especially because they can come on unexpectedly. If youve got either osteoarthritis or an inflammatory type of arthritis like rheumatoid arthritis, you probably know what were talking about.
So how can you deal with an arthritis flare-up when it happens? I remind myself, This, too, shall pass, arthritis patient Beth Bloomfield told us on Facebook. Like a kidney stone! another patient, Katie Resnick, joked back. Although arthritis flares are never pleasant, there are techniques that can help shorten their duration. Also important: Being able recognize when a flare is starting and avoid the triggers that may cause your flare-ups in the first place.
What About The Relationship Between Stress And The Onset Of Lupus
The exact cause of lupus is unknown. Isolating the cause of lupus and other immune disorders is a very active area of research around the world. To date, there is some evidence that supports a number of possible factors that lead to the development of lupus. For one thing, the genes that are inherited from parents to children clearly play a role in increasing the tendency toward developing lupus or other so-called autoimmune diseases, such as rheumatoid arthritis and immune thyroid disorders. Thus, other autoimmune diseases are more common among relatives of patients with lupus than in the general population.
Environmental factors also seem to play some role. For example, symptoms of lupus might first occur after exposure to ultraviolet light from the sun. Further, some scientists hypothesize that the immune system in patients with lupus is more easily activated by external factors, such as viruses and ultraviolet light. What’s more, a variety of drugs has been reported to trigger lupus. Finally, the sex hormones are also believed to be factors in predisposing a person to lupus. For example, women are affected with lupus far more often than are men.
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How Long A Flare Lasts
The length of a flare varies, and can be different for different people. Some may experience it for a year, months, or days. A flare can last as long as there isnt a change in treatment. In one study, flares lasted longer than two weeks in 30% of participants, one to two weeks in 13%, and less than one week in 57%. Longer duration of a flare was associated with changes in disease-modifying therapy.
Its essential to work with your healthcare provider to monitor your symptoms and tweak your treatment plan accordingly when you experience RA flares.
Patients with RA experience flares more often when noted to be in higher disease activity states than when in remission.
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Make Your Peace With Stress
It may sound counterintuitive but learning how to accept stress and put it in perspective has been key for Meghan H., of Ridgecrest, California, who has rheumatoid arthritis. Some days are just going to be better than others and thats okay, she explains. I tell myself to just do what I can do and not worry about the rest. Tomorrow will probably be better so theres no point in stressing out about today.
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What Is A Rheumatoid Arthritis Flare Up
A rheumatoid arthritis flare up describes a short-term escalation of your RA symptoms. A flare up can subside within a day or two, or it can persist for several weeks or months.An RA flare up generally involves joint stiffness and pain, although it can manifest itself as a worsening of any symptom. If the flare up is especially severe, it can affect your ability to perform your everyday activities.
Can Stress Make Rheumatoid Arthritis Worse
In short, yes. However, the reality is a little more complex. Thats because while stress can worsen the disease, rheumatoid arthritis can create stress for you.
Stress is especially tough on people with autoimmune diseases such as RA. Some of the pathways involved in your bodys stress response are the same ones involved in autoimmune disease. For people with RA, stress releases chemicals that can trigger flare-ups, along with inflammation and pain.
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Ways To Prevent Future Arthritis Flare
Luckily, you may be able to cut down on the number of arthritis flare-ups you are experiencing by doing a few simple things.
Know Your Triggers
The things that trigger your arthritis flare-ups might not cause a problem for someone else. Every persons body responds differently. Try to document the circumstances around every flare-up and see if you notice any patterns so that you can better prepare for future issues. Once you know your triggers, you can try to avoid or at least limit your exposure to them.
Get Help
You need to give yourself a break and not try to do it all alone. Try to find someone who can help with some or all of the activities that may aggravate your arthritis. It can be hard to admit when you are having a hard time, but you are only increasing the likelihood of an arthritis flare by pushing yourself too hard.
Protect Yourself From Infection
For inflammatory types of arthritis that are triggered by an immune response, an illness or infection can really set your arthritis symptoms off. Take extra precautions to avoid illnesses like the flu and go see the doctor if you believe you could have any kind of infection.
Get Enough Rest
Our bodies need rest. You need to make sure you are getting plenty of sleep to prevent your body from becoming run down. Getting quality rest with arthritis pain can sometimes be difficult, so dont hesitate to add in a nap during the day if you need to. Try to learn the limits of your body and not overdo them.
Exercise
What Is An Ra Flare
Flare-ups are episodes of increased disease activity in which the body is fighting itself. With RA flare-ups, inflammation increases.
With a flare-up, you experience a short-term increase in RA symptoms. A flare-up can last a few days or persist for weeks or months.
Flare-ups typically involve joint stiffness and pain, but all RA symptoms can worsen, including fatigue. If a flare-up is especially severe, it can affect your ability to perform daily tasks.
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Stress And Arthritis Can Be A Vicious Cycle Any One Of These Tips Can Help You Improve Your Stress Management And Coping Strategies
Fact: Having a chronic illness like arthritis can make you stressed. Also a fact: Being stressed can make your arthritis worse. And even knowing these facts is stressful. Figuring out how to deal with the stresses of your illness on top of those from your everyday life should be one of your top priorities, but its easy to get overwhelmed.
When Mathias P., of Portland, Oregon, was first diagnosed with ankylosing spondylitis he went into a tailspin. I was just 28, I was super fit, I didnt fit the profile of someone with arthritis, and I was devastated, he says.
The stress of the diagnosis worsened his AS flare-ups and before long he was almost fully disabled. In addition, the stress caused other symptoms including hair loss, cold sores, weakness, headaches, increased pain, and crushing depression. In the span of a month I went from a guy who had some pain but still did stuff to a person defined by my illness. I was so miserable I even briefly thought about ending my own life because I couldnt see a future like this, he confesses.
At his next doctors appointment, he told his doctor about all the symptoms that seemed to appear out of nowhere. I told him, I feel like Ive lost everything I love about my life and Ill never forget what he said next, Mathias says. He just looked at me and asked Why? You can still do all those things you just might have to do them differently now. It was like a light went on and I felt so much less stressed about my future.
Adopt A Habit That Promotes A Healthy Weight
Dennis L.s chronic illnesses lead to serious fatigue, which in turn made him gain more than 60 pounds. The extra weight made his illnesses worse, putting serious stress on his body and his emotions, the British Columbia native says. The weight itself caused me to feel stressed out and made it harder to deal with other stressors, he explains. So he decided to lose weight slowly and under the guidance of his doctors by walking and riding his bike, along with watching his diet. Today hes lost the weight, gained confidence in himself, and feels less stressed out in general, he says. Today I am an endurance biker and runner and am fitter than I have ever been, he says.
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Schedule A Nap In Your Calendar
As someone who has lived with chronic illnesses for years, I have learned the hard way that when it comes to coping with stress, there is no substitute for rest, says Monica C., of Phoenix, Arizona. The trick is to actually schedule your rest time, just like you would any other appointment. This way you will be less tempted to push through or forget about it.
How Stress Affects Arthritis
Managing a chronic disease affect many aspects of daily living, including emotional health . Heres what to do if youre stressed out.
Stress is a constant presence in our lives. A chronic disease like arthritis, which brings pain, high medical bills, and an uncertain future, ramps up stress levels even more. Being under stress can worsen arthritis symptoms. The best solution is to manage stress before it can undermine disease management and quality of live
How stress contributes to arthritis
Your bodys stress response triggers the release of chemicals that ready you to face the challenge at hand. Your breathing quickens, your heart rate increases, and your muscles tense in preparation. This reaction is fine in the short term, but when it fires repeatedly, the increased tension in your muscles can amplify your arthritis pain. Stress also sets off the immune systems inflammatory response. Inflammation is what fuels joint damage in rheumatoid arthritis , lupus, psoriatic arthritis , ankylosing spondylitis , and other inflammatory forms of the disease. The longer youre exposed to stress, the more destructive the inflammation can become. In a PLoS One study, people with RA identified stress as a trigger for disease flare-ups.
How arthritis worsens stress
Coping with stress
Here are a few tips to help you manage stress:
You can use the vim pain management app to help you set goals to manage your stress and connect with others.
Emotional Wellness
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Common Medications To Treat Arthritis Flares
OA patients might just need some OTC pain-relieving medication such as acetaminophen, ibuprofen, or naproxen. Dr. Bose also recommends topical gels and lotions like diclofenac gel or 2 Old Goats. If that doesnt work, Dr. Ashany says joint injections of steroids may be given. RA flares are more complicated. In inflammatory arthritis, steroids are often used to try to quickly bring a flare under control, Dr. Ashany says. If only one joint is involved a steroid can be given by injection, but otherwise it can be taken orally .
In inflammatory arthritis, if flares continue to occur, this indicates that the patients regimen of maintenance medication is not adequate, Dr. Ashany says. This may lead to addition of a medication, switching one drug for another or increasing the dose of medication that the patient is currently taking.
Implement A Bedtime Routine
Chronic pain and sleeplessness can turn into a vicious cycle fast and nothing is more stressful than insomnia. To make sure she gets enough sleep Meghan has developed a bedtime routine that helps her make sure her body is prepped to fall asleep and stay asleep. What routine works best for you will vary but it may include things like a warm bath, a heating pad, a special pillow set-up, a half-hour of quiet reading, meditation, or whatever else makes you feel calm.
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Preventing Ra Flare Ups In The Back
When managing any chronic medical condition, its difficult to predict when a flare up will occur. As a result, there isnt a foolproof strategy for preventing one.
Dr. Mukai does have some advice that should minimize your risks of an RA flare up in the back. a healthy lifestyle including proper nutrition .Getting good sleep , reducing stress , and not smoking can all help to reduce risk of RA flareups, says Dr. Mukai.
Finally, Dr. Mukai offers bigger-picture recommendations that should help all RA patients better manage their condition. Patients in RA should have a good long-term relationship with their rheumatologists and understand that their disease can change over time, necessitating change in medications and need for multimodal treatment. Learning good self-care techniques early will go a long way in managing symptoms.
Tips To Handling Stress
1. Stay as active as you can
Exercise and physical activity such as walking and swimming help:
- Reduce the stiffness that comes with arthritis
- Control weight, which reduces stress on joints
- Release the feel-good endorphin hormones, which can both improve your mood and block pain.
Dr. Model offers the example of one of her patients: Diagnosed with psoriatic arthritis, she was active in a hiking club, often spending three to five hours at a time out on the trail. She got braces, learned how to cope and it hasnt stopped her shes doing great, Dr. Model says.
She also recommends yoga, Pilates and hot-water therapy to foster relaxation and help cope with the stress of arthritis.
Some people are more motivated to follow an exercise program at home, while others may need the support of a class instructor, personal trainer or physical therapist. Whatever it takes to get them moving, she says.
2. Keep pain in check
Talk to your doctor about drugs to help reduce the pain. There is no medicine to cure arthritis, but nonsteroidal anti-inflammatory drugs can help control your pain. And, as mentioned above, keeping your pain in check can help reduce stress levels and vice versa.
What type, how much and how often you should take an NSAID will vary depending on what type of arthritis you have and your symptoms.
3. Eat right to fight inflammation
Eating healthy, especially foods shown to improve arthritis symptoms, can help reduce stress and pain.
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Divide Up Chores Among Your Family
Leave your superhero cape at the door. When it comes to lessening stress, one of the best things you can do is to allow your loved ones to take on more responsibility, Elizabeth says. Even though her children are small they can still do age-appropriate tasks like picking up toys, putting away clothing, or setting the table. Her husband also picks up the slack on days when shes feeling overwhelmed or in pain. Just remember to let them do the task their way as long as it gets done it doesnt matter if its exactly the way you would have done it.
Inflammation And Stress: Theyre Closely Connected
Research shows that stress may play a role in the cascading process that leads to inflammation and causes RA pain. Inflammation in RA is partly caused by molecules called cytokines. While cytokines can be released for a variety of reasons, stress also releases them. If youre stressed and are producing more cytokines, you will most likely develop more inflammation, which may result in more pain.
Whether we consider rheumatoid arthritis, osteoarthritis, systemic lupus, or any other rheumatic disease, the presence of emotional stress may well exacerbate the condition, says Richard Roseff, MD, a rheumatologist at Danbury Hospital and a private practitioner in Danbury and Ridgefield, Connecticut.
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