When the doc first thought the pain in my hands was inflammed tendons, he suggested iceing them. Now mind you, it never really worked. Just made them stiff as brick bats and couldn't tell a thing for pain. It DID make me feel good from the standpoint, like I was doing SOMETHING! Hands and wrists hurt like a son of a gun last night and in an act of desperation thought I would get out the old ice packs again. And once again, nothing but worse. (I know, slow learner!) Am I just being a total dork trying to use an old solution that doesn't work with my corrected "RA" diagnosis? Someone tell me the "no stupid questions" thing here, cuz I'm thinking I might be being a complete idiot. Warm good, cold really really not so good??
7/13/08 12:54pm
There are no stupid questions. Living with RA is a continuing learning experience and as you're relatively new on the path, you can't be expected to somehow magically know these things.
The thinking behind ice is that it will reduce inflammation - that's why it's used when you have an injury like a sprained ankle, especially for the first few days, as it keeps the inflammation from getting out of control. However, doctors prescribe generalities and sometimes forget to mention that the same thing doesn't always work in the same way for different people.
Personally, I've found that ice doesn't work for my RA-related issues (pain, swelling) at all. My joints generally need heat, whether it's a heating pad, a rice bag warmed in the microwave or keeping them warm in general with wrist warmers, woolen socks, etc. Ice, on the other hand, works really well for my tendon- and muscle-related pain and if I've done so much that I'm verging on injury. One side note on this is on the days where my joints have been swollen and hot and where heat just makes them feel more hot and swollen, putting e.g., my hands in cool (not cold) water eases the symptoms.
Trust your body. Trust yourself. Do what feels good to you and if heat works and cold doesn't, then use heat. Different kinds of pain require different solutions and you'll find out which pain needs what with some trial and error.
7/15/08 6:09pm
For me personally, I use ice packs most of the time for just about everything dealing with pain. My children tease me..."awe, it hurts? get an icepack"...but it works for me. After trying to mow my small yard Sunday evening, you'd think I had done it with scizzors, on my knees instead of with a mower. I could barely walk back up the 3 steps into my house. Of course it was hurting while I was pushing the mower, but I figured I could do it! After I made my way to the hot bathtub , I added 1/2 a bottle of alcohol to help my muscles relax and soaked for about 20 minutes. Then I slowly made it to the bed on my icepack (a frozen pack of sausage - 'if it defrosts I'll cook it tomorrow' was my thinking. I LOST my icepacks or someone 'borrowed' them. I took a flexoril (muscle relaxer) and a norco for pain (I borrowed from my mom). After 20 minutes on ice, I switched to heat on medium for about 1 hour then on low for about 30 minutes, then went to sleep. I was miserable the next a.m. but I HAD to go to work because my co-worker was on vacation. If she wasn't I'd probably have taken off of work at least 2 days to rest. I'm still really stiff and hurting when I try to get up out of my chair, but I have to be here. I'm getting ready to leave to go home and repeat the above so I can make it in tomorrow. I'm scheduled for an MRI in a week or two so they can see what's hurting so badly in my back and hips. They already know about the 2 herniated discs but need to look for other deteriation, etc. ANYWAY....I prefer ice for now ....that's a long story to say that, huh? Oh well, to each his own. Everyone is different and we don't always know what's best for our bodies until we try it.
Best of luck to you. Have you tried hot wax baths for your hands? I've heard that's really good. Also, I take generic tylenol arthritis pain relief....2 to 4 per day for pain as needed.
AudreyBee
7/16/08 9:23am
AudreyBee, Alcohol in the bath? I've never heard of that! What does that do....or maybe I misunderstand. Erm...do you dump it in, or drink it?! .....or a little of each, depending on your mood!! ; ) Haven't tried the wax thing, but I've never heard anything but RAVES about that. I wonder what the cost is for a home wax..vat...thingie...?
7/17/08 3:13pm
When my hands ache ... Ice, no; heat, yes ... especially the hot wax treatment.
But for all other joints, ICE, YES!
I was lucky to have an expert in the field of rheumatology diagnosis and treat me for many years. He explained to me that 10% of people with RA do better with cold than heat. I'm in that 10% so I do better in the cool months and suffer swelling in the hotter months.
7/17/08 7:53pm
Hi Amy,
Lene gave you some very good info. As you know, RA can give you lots of swelling around your joints. When this happens around small joints(the hand) it can create incredible pain. If the swelling is severe enough in the wrist area, you can get carpal tunnel symptoms,ie: pain and/or numbness shooting into the thumb and first two to three fingers. Some people love the ice results and others hate it. Ice can slow circulation into and out of the hand, resulting in the effect of trapping the swelling there.(gives you the swollen "brick bat feeling".) Heat can increase circulation and may help,but could increase your swelling and result in more pain. This is not as pronounced in larger joints and they may respond well to ice. The effects of both of these can be a very individual thing.
An alternative that may help is to use very gentle passive stretching, with passive meaning to use one hand to slowly stretch out the fingers of the other. It has to be very slow and easy, if it is too painful, don't force it. If you can get the fingers stretched out, then try gentle active movements, such as slowly opening and closing your hand on it's own. These two things together may help to get your tendons moving and then help pump some of the swelling out the hand. It may also help to lie down and elevate your hand over your head when doing the active part.
Be sure not to force your joints too much.
If you are still awake after reading this, I hope it will help.
Chuck
8/ 9/08 12:49am
Ice is a joke for me too. Does nothing but stiffen me up even more. I have even fell down because my feet did not work any more after soaking them in icy cold lake water. My hands and wrists hurt the worst right now. What relieves some of my pain is using wrist braces-to drive, to work sometimes (as a cook even), and to sleep. Immobilizing the wrists feels soothing to me but wearing the darn braces stinks.
9/17/08 1:06pm
Hi Amy,
I am one of the different ones...ice helps the pain in my hands...but only if I put in on for short (5 min or less) periods. If I do this off and on about 4 times in one hour...3 times a day, I do get relief. Have also used a cold soda can...alternating it between hands while I watch television. That is some days! Other days the hot wax works, or hands in dish water, (always a good supply of dirty dishes here! LOL). I also use an analgesic blue jell stuff that is high in alcohol on my hands at night which helps me ease off to sleep (keep it on my bedside stand--reapply in the night if i awaken) It has a cooling affect, which for me is relaxing. I read something on the internet about an herb called yarrow that people claim has pain relieving properties when applied to painful joints. Havent tried that yet...dont know if it grows wild in my neck of the woods....Anyway hope this has been helpful. Mel
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By AmyAria— Last Modified: 12/26/10, First Published: 07/12/08
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