Skip to main content
Submitted by PatientsEngage on 14 November 2017

Vidya, a long-standing patient of rheumatoid arthritis (RA) narrates her experience with specialized medications, nonsteroidal anti-inflammatory drugs, yoga, Ayurveda, oil massage, warm baths among other things to alleviate severe, chronic pain, stiffness and flare ups. Read for useful tips and better pain management.

First things first. Pain and Rheumatoid Arthritis go hand in hand. Sometimes, when I reflect on my journey with RA, one thread that immediately comes to mind is how I coped with the pain at various stages of the illness. I even think that my capacity to bear pain or the lack of acknowledging it as a limiting factor undermined my early stage disease management.

In the initial days, it was morning stiffness and pain that was prominent. The most difficult part of the day was getting out of bed and getting started with your day. I was working and in a demanding job role. So I think, that took care of the need to get up and get going. As the day progressed, the pain and stiffness would ease and the mind engrossed in work would be a good distraction. But at the end of the day, pain and discomfort would overtake the best of you. Those days I was put on NSAIDs (nonsteroidal anti-inflammatory drugs) and was yet to go for detailed investigation.

Once diagnosed, I was on aggressive treatment and fortunately or unfortunately my pain and swelling disappeared and I was back to work after a month of sick leave. Why I say unfortunately is - with hardly any awareness of RA, I thought I was back to normal forever. Had I been more aware of the illness itself, I would have followed up on the treatment and medication.

Use of NSAIDs

Over the course of my treatment, I have been prescribed many NSAIDs, especially in times of a flare up, like Voveran, Naprosyn and Microcid. I still use Microcid (Indomethacin) 25 mg as it works well for me. Whenever I have been on daily NSAID, I have tried to stop it gradually as the situation improves as they are not good for the kidneys over a long time. Generally, I will stop it over a weekend so that even if things go bad my work day is not affected and then I slowly cut it off completely. I keep my doctor informed of my plan and that's when he starts to write SOS against my NSAID. Recently one pain physician advised me that if one is well hydrated while taking NSAIDs (called pain killers in general) one can avoid the side effects.

Traditional Ayurveda Medicines

I have also been on traditional Ayurveda treatment in the early stages of RA for almost 3 to 4 years. They prescribe various medicated oils to control stiffness and pain which are to be applied externally (self-application) multiple times a day; this is apart from the oral medications. The physicians used to jokingly say applying oils many times will keep you busy through the day. Well, I was on a sabbatical so it was okay with me. I found them quite useful and my favourite is a concentrated ghee (it is Dhanwantharam Thailam 101 times medicated oil). Sometimes, when it is rainy and chilly, I would find some veins on my feet and hands ballooned and the pain was excruciating and would restrict movement. Soon the corresponding joints and surrounding area would also ache. In one of the early episodes of this, I was admitted in an Ayurveda nursing home and, one afternoon, it became pretty bad and I went to the duty physician’s room and showed him my aching foot. He took a look and said the return blood flow in the ballooned up vein was blocked. He gave me medicated oil and asked me to apply it stroking the area backwards using not so much oil but firm massage. I did and it worked! I still get these episodes and always keep a stock of this medicated oil bought from Kerala and gratefully remember that wonderful physician. I have also taken Pranic Healing in the peak of my early RA days and was able to keep off NSAIDs with daily remote Pranic Healing.

Exercise and Meditation

Later, I have tried deep breathing and meditation on a particularly bad day and have realized, increasingly over the years, that meditation, guided meditation and other relaxation techniques can reduce pain and calm our mind. Exercise and physiotherapy can help improve pain and mobility and keep away deformities. How much, when and what - these are the questions often not easily answered. But, in my experience, whenever I have exercised regularly, I have found my flexibility, mobility and confidence improve and pain subsiding. I do yoga, Upa yoga and other stretching and strengthening exercises from time to time. The trick is to do some kind of movement and stretching in whatever stage of the illness you are. When you have stiff and painful joints one can do passive and isometric exercises specific to the joint and associated muscles. As the situation improves do stretching exercises, yoga and preparatory yoga poses and strengthening exercises. Consulting an experienced and innovative physiotherapist/yoga teacher is an option and don’t hesitate to ask your doctor if you can be put on physiotherapy and share your feedback with him/her. In my opinion Physiotherapy and rehab and are highly under explored as a treatment in RA.

Apart from all these I use oil massage and warm bath and it has helped me most of the time. A hot water bath is a sure jump-start for the day as it eases pain and stiffness and the muscles gets relaxed.

Professional Pain Management

More than a year back I consulted a Pain Physician when I had a bad flare up after a long period of remission. This was the first time that I went to a Pain clinic. The difference between a Rheumatologist addressing your pain concerns and going to a Pain Physician is that they address all aspects related to your pain, the functional aspects, how to improve your quality of life and also the emotional aspects which your rheumatologist may not have the time for. But it is hard to find these specialists under one roof.

It’s well advised by these physicians and portals giving patient information to watch out for what triggers your pain and how to address it effectively. A day of house cleaning will definitely follow with more ache and pain, so does a bad weather day. But understanding the cause will keep you calm and face it.

I have resorted to assembly line cooking, breaking house cleaning into small chunks and taking paid help regularly to do tasks that are hard for me. But at the same time I don’t totally give up doing it myself. Whenever I think I can pull it off I do it and pass it on without regret at other times.

Internet for comfort

These days I read up on the internet on how to live and cope with RA. They tell you to celebrate even small achievements like you had a good and active morning, so pamper yourself by drinking a hot cup of tea and listening to your favourite music or reading your fav author/column. Pacing your activities is another useful tip.

Conclusion

Yes, there are multiple things you have to do just to keep you going everyday especially during a flare up. It is hard and sometimes a lot of your time goes in self-care and taking help looks difficult. But over the years, I am more than convinced that doing something about it, communicating with your doctor and discussing with your inner circle and being an active stakeholder in your health and mobility is the only way out.

It has been my personal experience that when one door to recovery closes another opens. Don’t allow pain and disability to consume you, try to get over them with all your might.

Name changed on request. These are personal experience. Each one's pain threshold is different. And people often need to try different approaches to find what works best for them. Often the palliative effect of complementary solutions is temporary. 

Condition