Rheumatoid arthritis is a pain in the... well, it can pretty much be a pain anywhere and everywhere. Whether you're dealing with the intense pain of a flare or the cranky muttering in the background when your RA is mostly controlled, you'll probably need to find a way to manage pain. Unlike the "minor arthritis pain" of commercials that magically disappears when you take Drug X, real RA pain needs more - it needs a toolbox.

Medication

The proper medication is the foundation of it all. It starts with one (or more) of the DMARDs (disease modifying antirheumatic drugs like methotrexate, Arava or one of the Biologics) to suppress the disease and anti-inflammatories or narcotics to deal with the pain. It's important to find a doctor who will understand this and prescribe the meds you need. If your rheumatologist "doesn't believe in" painkillers, try finding another one or talk to your family doctor about your medication needs. You may also ask for a referral to a pain clinic where they use a multidisciplinary approach to teach you how to live well with pain, e.g., pain meds, biofeedback, exercise and counseling.

When you have the prescriptions, take the pills. You are in a race with the pain and if you wait to take painkillers until you can't bear it anymore, you will never catch up. Taking your painkillers on a regular basis will ensure that you always have a certain level of medication in your system, which will keep you ahead of the pain.

Exercise and a Healthy Diet

Another important tool is a balanced diet and exercise routine. You want to make sure that you're as healthy as possible. Eating a well-balanced diet with plenty of fruits and vegetables will help build your physical resources and the right diet may even help you control inflammation. For instance, the Mediterranean diet has been shown to have anti-inflammatory properties. If you're overweight, consider trying to lose some of the extra pounds as it can ease the stress on your joints and help you manage pain.

Exercise is part of becoming healthy. Not only does it keep you fit, but it will keep your joints moving and strengthen your muscles, which will offer extra protection from joint damage. Ask your doctor for a referral to a physical therapist who can put together an exercise program that will help you get fit while avoiding exercises that are bad for your joints. Swimming and exercising in water, yoga and tai chi are examples of exercises that can accomplish your goal (check out AmyAria's post on exercise and Sara Nash's post about yoga).

Work within Your Limits

When you have a good day, it is so tempting to overdo -- you never know if tomorrow is going to be bad and it's easy to get caught up in being able to work in your garden, write, clean the house, etc. The problem with getting carried away is that it practically guarantees that tomorrow will be a bad day, likely followed by several more bad days. However, if you work within your limits -- stopping before you start getting tired or before that first twinge -- you will be able to do more of the same tomorrow. This one requires mental discipline and the ability to beat down the part of you that says "just five more minutes." I'm still learning how after 40 years with RA. However, much to my surprise, I've recently learned that working within my limits actually gets more done in the long run.  Pretty revolutionary stuff.