Arthritis Pain Reliever

Several health care workers may be part of your pain management team: your physician, physical therapist, occupational therapist, a psy¬chiatrist or psychologist and perhaps even a practitioner of alternative medicine such as acupuncture. They may use various methods and techniques to help you manage your pain.

Physical control of pain

Exercise

Exercise is perhaps your best defense against pain. A physical therapist may work with you to develop an exercise program that maxi¬mizes your range of motion and strengthens your muscles around painful joints.

Massage

Massage can improve your circulation, help you relax, decrease local pain and reduce swelling. Some therapists are specially trained in massage techniques for people with arthritis.

If you would like to give yourself a massage or train a family member to do it, remember to stop if the massage is painful. If your joint is very swollen or painful, skip the massage of the joint and instead massage adjacent muscles. Also try a warming or cooling treatment to the joint or muscles or both. And, when giving a massage, use a lotion or massage oil to help your hands glide smoothly over the skin.

Helpful Hint:

If you use a massage oil or lotion, wash it off before any heat treatment to avoid burns.

Additional heat treatments

Unlike the more simplified home heat treatments, a physical therapist may use specialized techniques or equipment to provide pain relief.

Heat treatments might include soaking sore joints, particularly your hands, in a warm paraffin bath. For deep heat penetration, a physical therapist can use ultrasound or short-wave diathermy. This technique requires monitoring and can worsen some forms of arthritis.

Steroid injections

Steroids reduce pain and inflammation. Your doctor may occasionally inject a cortisone drug into an acutely inflamed joint ¬for example, your hip, knee or ankle.

Because frequent steroid injections could accelerate joint damage, your doctor may limit the number of injections to no more than two or three each year.

Nerve block

This is an anesthetic that blocks the nerves to a painful area. Its use is limited because the pain relief may last only a short time.

TENS

TENS, or transcutaneous (across the skin) electrical nerve stimu¬lation, stops pain by blocking nerve signals from reaching your brain. A therapist tapes electrodes on your skin at the site of your pain. The elec¬trodes are linked to a battery-operated stimulator, which delivers a tiny, painless electrical current.

TENS also may help release hormones (endorphins) that fight pain.

Alternative treatments

Other treatments such as acupuncture are gain¬ing some acceptance in the scientific community.

Psychological control of pain

Maintaining a positive mindset is essential to coping with chronic pain. However, you may reach a point at which you need some extra support or training to cope successfully. View this as an opportunity to discover a new dynamic to taking charge of your arthritis.

Behavior therapy

The goal of behavior therapy is to identify and modify some of your reactions to the pain, as well as to make changes to better manage your life despite your pain. This approach may include making changes in your daily routine and incorporating a balance of activities to maintain your ability to be active. You may learn to cope more effectively with changes in your lifestyle, evaluate your priorities and your response to stress and understand and accept your pain.

Related treatments

In addition to learning behavior approaches to managing your pain, there are related treatments that can improve your functioning and may lessen your pain.

Biofeedback Your body has some automatic reactions to stress: muscle tension, changes in skin temperature and changes in blood pressure and heart rate. The goal of biofeedback is to teach you to recognize your body's reactions to pain and learn to modify them.

During a session with a therapist, you are attached to monitors that track your physiologic systems-heart, respiration, muscle ten¬sion and skin temperature. The therapist will help you learn to relieve the symptoms of stress throughout your body through relax¬ation techniques.

Relaxation training

There are several ways you can learn to relax your body and mind. These include progressive muscle relaxation, deep breathing, guided imagery and meditation exercises.

One of the most commonly used strategies for pain is progressive muscle relaxation. You learn to focus on each muscle progressively. First, you tense a muscle and hold the tension for 5 or 10 seconds, focus¬ing on the sensations of tension and identifying specific muscles or mus¬cle groups. Then, you slowly release the muscle while focusing on the sensations of relaxation and released tension. This procedure is repeated in the major muscle groups of your body so you become familiar with the sensation of relaxing your entire body.

The ideal setting for learning relaxation is a quiet room where you can rest comfortably on the floor or in a reclining chair or bed. You need to feel relatively at ease but not tired. An instructor can be a great help in directing your attention toward your inner self. You will learn to con¬centrate and to relax at the same time-and be able to do it yourself at home. You may listen to a tape, although live training may be more effective. Eventually, you learn to relax without verbal cues from another person.

The goal of any relaxation strategy is to reduce the level of tension in your body. You can use relaxation throughout the day, when you feel tension or pain building. In this way you can often prevent a worsening of the tension or pain and successfully complete your activities.

Chronic pain centers

If your pain is severe your doctor may recommend a chronic pain center. In this setting, you may participate for several days and work with physicians and therapists representing various specialties. Some centers require overnight stays, whereas others offer outpatient treatments.

This team approach is essential, because it is unlikely that anyone technique will work in controlling your pain. The professionals in an interdisciplinary center can treat both your pain and its potential conse¬quences, such as disruption within a marriage and family, loss of income, depression and anxiety.