Strategies to Relieve Arthritis Pain
Overview of Arthritis
Degenerative, or osteoarthritis is mechanical wear and tear to joints from repeated movement over our lifetime. Parts eventually wear out. None of us can escape degenerative arthritis, short of dying young. Rheumatoid arthritis, on the other hand, is a disease of the immune system. Clients with arthritis may complain of pain, stiffness or swelling of the joints of the hands, arms, legs, feet or spine. I will share proven strategies for relief from arthritis pain that I have learned over my 20-plus years as an Occupational Therapist. But first, a bit more background on arthritis.
It is not unusual to see signs of osteoarthritic joint wear, such as erosions and small bone spurs on x-rays of anyone in their 40s and 50s. It is common to see these changes on the films of people in their 60s and 70s. Not all people with radiographic evidence of arthritis complain of pain. Many people with obvious deformities that you can see do not complain of pain of these joints. Some people speed up normal aging and wear on the joints through sports, motor vehicle accidents and other injuries. I have seen clients in their 20s or 30s with debilitating joint pain from post-traumatic arthritic changes.
The incidence of rheumatoid arthritis is about 70 in every 100,000 people in the US, or about 1% of the population. Incidence worldwide is 1% to 2%. Average age of onset is 30s to 60s. Women are affected more often than men. Progression of the disease is unpredictable, and x-ray findings such as erosions, can be quite dramatic. Relatively young individuals may have shockingly damaged joints.
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Symptoms and Solutions
Clients with arthritis complain of stiffness on waking, or after sitting “too long”, as well as increased symptoms at the end of the day. Understandably, clients also note increase in pain and other symptoms when “I don’t behave myself,” meaning they engaged in activities for which they knew they “would have to pay for later.” Then there is weather. How many people do you know that can predict when a storm is coming? Turns out joints are essentially barometers.
I offer my list of self management strategies here. These interventions benefit clients with osteoarthritis as well as rheumatoid arthritis. I have also included an overview of a few in-clinic treatments. Strategies fall in the categories of thermals, gloves and orthotics, exercise, and joint protection. Read, and take charge!
Most people with arthritis use one or more heat modalities for easing arthritis symptoms.
Warm Showers: Most people with arthritis have already discovered that a long warm shower is helpful to warm up their arthritic joints and to slowly get moving each day.
Contrast Baths: Use alternating warm and cold water 2 to 5 times a day to relieve achy and stiff joints in the hands or feet. Warm water should be pleasantly warm, like an inviting bath. Cold water should be to tolerance, but not icy. Start with 3 minutes in warm water, then 1 minute in cold. Do 3 cycles, then end with another 3 minutes in warm water. Do contrast baths on waking and again at the end of day, more often during flair-ups of symptoms. See my contrast baths hub for full details including indications and precautions.
Paraffin: Try paraffin baths for hands or feet. Similar to the spa treatments for moisturizing, paraffin baths provide deep penetrating heat to joints. Once only available as a clinic therapy treatment, paraffin baths are now available at stores such as CVS, Walgreen’s and Wal-Mart. I do not recommend paraffin baths for rheumatoid arthritis clients during flair-ups.
ZsuZsy Bee's Story and Tips
- Hands On .....On Hands!
I'm sitting here plastering some of my special arthritis massage oil onto my sore hands. I see them but really look at them for the first time in ages. That's such a stupid statement you say...but tell me...
Therapy Clinic Thermals
Paraffin: Most Occupational Therapy clinics have paraffin.
Fluidotherapy: First of all, Fluidotherapy does not contain any type of liquid. It contains a synthetic fine sandy substance. The machine has a heater and a blower, and is a dry heat modality, as opposed to moist deep penetrating heat, such as paraffin. Fluidotherapy is typically used for hands and arms, although some clinics use it for feet and legs. Fluidotherapy is better suited for Rheumatoid clients, who may experience swelling with moist heat.
Physical Agent Modalities: Clients may benefit from various modalities under the direction of a Physical or Occupational Therapist. Modalities like underwater ultrasound can be used to the small joints of the hands or feet. Diathermy is re-emerging as a clinic treatment after a long absence, and may help hand and other joint pain. There are an array of physical agent modalities, ultrasound, diathermy, electric stimulation and interferential current for example. Your doctor or therapist can discuss clinic modalities which may be used for your upper extremity, neck, back, or lower extremity joint pain.
Resting Hand Splint
Hand-Based Thumb Splint
Gloves and Orthotics
Gloves. Sleep in lightweight gloves. Cotton moisturizing gloves can be beneficial in providing a layer of protection from the air. Even slight temperature increases of less than one degree can help decrease arthritis symptoms.
Compressive gloves, such as the beige gloves made by Isotoner specifically for arthritis, swelling and other problems of the hands, also provide slight warmth.
The compression however provides even greater pain relief. Wear fingertips free gloves for activities. If you cannot find gloves, try North Coast Medical’s Functional Solutions.
Hand Splints: I recommend resting hand splints for most of my clients, to decrease hand pain. Splints are worn at night for sleeping. There are commercially available splints, but we make custom splints at out facility.
There are an array of options for thumb pain, such as forearm versus hand-based thumb splints. Again commercial splints are available, but these especially are not particularly comfortable.
Other Orthotics: People with knee pain often have foot or ankle issues. This does not necessarily mean pain in the feet or ankles. Many clients are shocked when their Physical Therapist or doctor recommends shoe inserts for their knees! Custom orthotics as well as commercial inserts are available.
Aquatic Exercise for Arthritis
Stretches: Commit to daily head to toe stretches. Arthritis self help books usually include stretching exercises. My favorite is The Arthritis Helpbook by Lorig and Fries.
Strengthening: People with knee pain often have weak hips, particularly hip extension and hip abduction, which contribute to knee pain. Shoulder rotator cuff exercises can be beneficial. Abdominal or core stabilization exercises are often recommended for people with back pain. There are stabilization exercises for the neck too. Arthritis self help books usually include general strengthening exercises. Ask your doctor to consider a physical therapy consult for more specific recommendations.
Aquatics: Do range of motion and strengthening exercises in a pool, and gentle aerobics such as walking in water or light swimming. There are many benefits, including reduced impact of gravity and minimized stress on joints. Many YMCAs, community pools, hospitals and rehabilitation centers offer classes tailored to clients with arthritis. Also, some rehabilitation facilities offer their heated pools to the public during lunch or after 5 or 6 p.m.
Joint Protection Strategies
Joint Protection Strategies: Essentially, don’t overdo it! As we age, the less we can get by with in terms of activity. Ignoring this fact does not negate it. If a joint hurts, it is already telling you that you have reached the overuse threshold. If your knees regularly hurt, be kind to your knees. Don’t do squats and lunges. Minimize stairs. If your finger joints hurt, be kind to them. Minimize forceful gripping with your hands. Crochet 10 minutes not 10 hours. Get a good self help book, such as The Arthritis Helpbook.
Adaptive Devices: There are many devices on the market to help accomplish daily activities with less stress on the joints. My favorite is overall source is Functional Solutions.
Pacing: Pace your activities. Don’t re-landscape the yard in one weekend just so you can cross it off your list and do something else crazy to your body next weekend! Start with baby steps. One client reported he now mowed the lawn and used the weed eater one mowing, then on the next mowing he used the edger, rather than doing all of these things each time. An older gentleman, more experienced with compromise noted, “By the time I get to the back of the yard [mowing], it’s time to start over in the front.”
Arthritis Self Help Book
Self Help Book: As we say at our house, books are our friends. Get yourself a great self help book. I have been partial to The Arthritis Helpbook by Lorig and Fries my entire career. I recommend the 2000 5th edition. They have a 2006 edition, but it does not have the photos and drawings of joint protection strategies and exercise. I love this book.
We can’t escape arthritis. Contrary however to what many people think, there are many things we can do to self manage our pain and stiffness. Use of heat strategies, gloves and splints, exercises, and joint protection strategies are very effective. I have provided some options that I hope you will be encouraged to try. They are all highly endorsed by clients with arthritis.
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