When you're in pain, all reason goes out the window. When you live with chronic pain due to rheumatoid arthritis, all sanity starts to go out the window too, along with anything else you want to throw in frustration--dirty dishes, laundry, ever-growing medical bills, etc.
So how do we manage pain?
First, we have to recognize that we're in pain. Sounds silly, right? Wrong. If you live every day in pain, it starts to present in odd ways--restlessness, bickering with those around you, midnight cookie binges. This is why, when I was a child living with juvenile arthritis, I was convinced I hated museums. That wasn’t it. It was the standing around on painful joints that I hated. Once the pain was controlled, I discovered that I actually love museumsThe first step to dealing with your pain is finding a doctor who understands that pain is a very real symptom of the disease and needs to be managed appropriately. What is appropriate? It can vary from person to person. Whether it be through prescriptions for medications or physical therapy, or making you aware of alternative treatments, such as acupuncture, you need a doctor who is your teammate and willing to work with you to treat your pain.
That said, your doctor can do only so much. When you live with a chronic disease, you have to learn what works best for you and make a commitment to taking care of yourself.
Let's get the boring (necessary) stuff out of the way. Diet and exercise are the two things everyone loves to hate. But learning to love them can greatly enhance your quality of life. Not every diet works for everyone, so it is important to do some testing and find what works for you. Many people with RA say they have dramatically reduced pain and inflammation by cutting out processed foods and refined sugars. Some report that they’ve responded well to a variety of diets, including gluten-free, vegan or dairy-free. There also is some evidence that the Mediterranean diet may help control RA symptoms. If this all sounds too extreme, even small changes can make a difference. Start small, take baby steps. See what works for you.
Exercise. Oh...exercise! It's no secret that exercise is good for us, so why is it so hard? For starters, we usually make goals that are too big. Again, start small, take baby steps. Ten minutes a day of gentle stretching (even in bed or from the couch!), walking the dog or light weightlifting (lift soup cans!) is enough to loosen tight muscles and tendons, and release pain-relieving endorphins. Ten minutes, that's just two commercial breaks while watching TV! Remember to discuss exercise with your doctor or a physical therapist to make sure you’re picking the right activity for your joints.
Even if we make great daily choices with diet and exercise, RA can still throw us curveballs. That’s when we need to be ready for it. If we're prepared, we're less likely to get upset when the pain strikes. If we're unprepared, the emotional blow of pain could actually make us feel the physical pain even more.
I recommend pulling together your RA arsenal ahead of time. This can be a box, a bag or a place in your home where you keep all your helpful items.
My pain arsenal includes variations on the following:
- Heat/cold therapy wraps filled with flax seeds
- Ice packs always in the freezer
- Compression braces and socks to reduce swelling
- Pain-relieving creams that work for you
- A moist heating pad with a timer
- Your favorite teddy bear or pillow. Mine is a small green monster named "Ibs," given to me during my last knee surgery
- Foam rollers to help stretch muscles that might be locking up
- Massage oils--even self-massage can go a long way
It’s also important to remember how tough your brain is at helping you through pain. When pain becomes all-consuming and my RA arsenal isn't enough, I turn to the power of music and meditation. Finding something to focus on other than the pain is crucial--whether that’s losing yourself in your favorite lyrics or finding peace in white noise apps downloaded to your phone.
And lastly, don't forget the power of a positive attitude. My rheumatologist often tells me in the bad times, “The best thing you have going for you is that you’re tough." A positive attitude goes a long way in the ability to weather pain.
When all else fails, you always have your RA community to turn to. They can provide you with more tips and tricks, a shoulder to lean on, jokes to make you laugh at 3 a.m. and, when you're not feeling tough, they'll be tough for you.