arthritis & pain stop

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Better, more effective, and safer ways of controlling pain are always welcome.

With pain relief as the goal, people try a variety of techniques. The success or failure of each type of treatment is individual. What works for one may not work for another person.

Here is a list of treatments that are often used:

Medication
Medications are often used to reduce pain. Analgesics (pain-relievers) and non-steroidal anti-inflammatory drugs are most often prescribed. As the medications serve to regain some level of comfort, they do little to change the disease state. Painkillers are used to mask the pain and hide the problem. The amount of pain medications consumed must be controlled since there are known side effects, and also the potential for "tolerance" exists (whereby more and more is required to obtain the same effect). Usually non-narcotic agents are tried first.

Heat
Morning stiffness is often relieved by the use of hot showers or baths. The warmth of the water relaxes muscles and eases the stiffness. Assistive equipment such as hot packs, electric blankets, heating pads, hot tubs, and saunas are beneficial in the same way. Paraffin wax baths for the hands have also been used.

Cold
Cold therapy, otherwise known as cryotherapy, is a preferred treatment for some people as opposed to heat therapy. The cold works to relieve pain by numbing nerve endings in affected areas of the body. It also decreases activity of body cells and slows blood flow, resulting in decreased inflammation. Cold compresses, wrapping a plastic bag filled with ice cubes, or frozen gel packs can be applied locally. A bag of frozen peas also works in a pinch.

Massage
Pain relief can also be hastened by massaging tight muscles. As muscle tension is relaxed and circulation is increased, pain is decreased.

Exercise
A joint which is not utilized can lose surrounding muscle tone and range of motion. Gentle, yet consistent, range-of-motion exercise can help maintain function and lessen pain. This should be done under close supervision.

Rest
Pain can also be an indicator of the need for rest. It is important to pay attention to the signal and allow the body the required time to "recharge". Inflammation decreases during a restful phase, however too much stillness can lead to muscle weakness. It is essential to strike a balance between rest and exercise.

Other cognitive, non-medicine therapies
Deep breathing- Clear the mind and alleviate stress by breathing in and out, slowly, deeply, and rhythmically. Inhale through the nose and exhale through the mouth, releasing tension.
Progressive relaxation- Lie on your back and systematically tense and relax each part of your body. The relaxation works toward controlling pain.
Creative Imagery- Following progressive relaxation, the mind can be engaged into imagining a pleasant and happy scene.
As the mind is occupied with the scene, the stress level diminishes, as does the pain level.
Biofeedback -As you are attached by electrodes to a machine, you are taught to control blood pressure, muscle tension, heart rate, and temperature. Biofeedback uses a combination of relaxation, visualization, and signals from the machine to gain control of pain.

Occupational therapy is based on physical medicine, psychiatry, and behavioral psychology principles. The objective of an occupational therapist is to help the pain sufferer determine which activities or behaviors intensify pain; to learn methods for decreasing the amount of time in pain; use techniques to decrease pain intensity; to become more functional in daily activities and in the workplace; and practice a lifestyle based on good health habits. Techniques used include body mechanics to move the body in ways that do not increase pain; adapting daily activities to conserve energy; exercise to reduce pain by increasing strength; developing a focus on abilities rather than limitations thereby reducing the effects of pain on life; adaptive equipment to simplify tasks; and relaxation techniques the reduce tensions which exacerbate pain.

Pain Clinics
The objective of a pain clinic is to offer some pain management to patients with prolonged pain who cannot be helped by medical and surgical treatment options. The goal is to diminish the pain as much as possible and maximize the quality of life within the patient’s limitations. The approach is usually comprehensive and encompasses medication management, nerve blocks, physical therapy, relaxation training, counseling and support.

TENS/Electrical Stimulation
Used mostly as a last resort, TENS or transcutaneous electrical nerve stimulation, utilizes low-voltage electrical stimulation to the nerves to block pain signals to the brain. Electrodes are placed on the skin and emit the electrical charge. This is used primarily for chronic, localized pain which is intractable.

Surgery
Surgery can be performed with the goal of eliminating pain in a specific joint. Joint replacement surgery has become more common over the years, and is regarded as a viable option when all else has failed. The damaged and painful joint is removed and replaced with a prosthesis made of metal and plastic. Arthrodesis (fusion), synovectomy, re-section, arthroscopy are also surgical options

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Arthritis & pain stop