Self-help tips to relieve arthritis pain

How to minimise arthritis pain

Long-term pain can greatly affect your ability to carry out daily activities. You may find certain movements are particularly painful so you avoid them altogether. But it’s important to remain as active as possible as lack of use can lead to loss of strength and coordination. And trying some of the ideas below may help to minimise the pain relief medicines you need to take.

Exercise for pain relief

Long-term pain affects the way you move your body. You may stop using specific joints as you normally would, or you might reduce your level of activity overall. This results in a steady loss of joint mobility, muscle strength, co-ordination and balance – and it probably won’t stop the pain. And by trying to protect the painful area you may put strain on other parts of the body, resulting in secondary pain.

Increasing your physical activity and maintaining a good posture can help you cope more effectively with pain by:

• improving your ability to carry out daily tasks
• making you feel better in yourself
• giving you more energy
• improving your sleep
• helping to control your weight – which is especially important if you have leg pain.

How can I increase my physical activity?

Simple things like aiming to walk a little more each day will lead to gradual but important improvements in your physical fitness. But more structured forms of physical activity will increase the benefit.

Community activity or exercise groups are an excellent way of increasing physical activity and have the added benefit of meeting other people. Leisure or community centres, libraries and GP surgeries often hold details of local activities.

Walking is particularly good for your health. The ‘Walking for Health’ scheme has over 600 local groups, so there’s likely to be one close to you. Walks are designed for all abilities. Stand tall with your stomach pulled in when you’re walking as good posture minimises the strains on your body.

Other community activities that offer significant health benefits and may help with pain are T’ai Chi and qigong. Both consist of gentle low-impact movements that you can do either standing or sitting, so they’re suitable for anyone.

Yoga has been shown to be helpful for low back pain, reducing pain and helping people to perform everyday activities more comfortably.

Whatever type of physical activity you prefer, check that your instructor is properly qualified. Take some time to speak to them about your specific needs before starting an activity.

Increasing your general level of activity is the best long-term strategy to manage and cope with persistent pain. But there may be times when you need help from a physiotherapist – for example, if you have difficulty with particular activities, if you’re prone to falling, or develop new problems.

Your physiotherapist will assess your difficulties before showing you specific exercises to move your joints, strengthen your muscles and improve your coordination and balance. Follow the instructions you’re given carefully to get the most benefit from the exercises.

Protecting your joints

It’s important to understand how your condition affects your joints and causes pain so that you can think about how best to move without unnecessary strain.

An occupational therapist (OT) will be able to offer further advice on joint protection techniques. Joint protection doesn’t mean you should stop using your painful joints but it may involve finding different ways of doing particular tasks or using gadgets to help you.

Your OT will be able to advise you on the gadgets available and may also make suggestions on how to reorganise your home or work environment to reduce unnecessary strain.

Pacing yourself

If you have long-term pain, then you may also experience extreme tiredness (fatigue). A key aspect in managing pain and fatigue is finding the right balance between activity and rest, otherwise known as pacing.

Too much rest is likely to increase stiffness and over time can result in the muscles weakening, so that getting active again becomes harder than ever. On the other hand, pressing on to get everything done when you’re having a good day is likely to lead to more pain and fatigue the next day.

Try taking short breaks of 3–5 minutes every 30–45 minutes to sit and rest your joints. Or, you might find that even shorter breaks of 30 seconds every 5–10 minutes might suit your lifestyle better.

Try also to switch between jobs that you find tiring and those you find easier or more enjoyable. Finding time for the things you enjoy in between the things you need to do will be good for your mental wellbeing.

Your occupational therapist, physiotherapist or psychologist can offer further advice on pacing your activities. You may find it helpful to make a note of your daily activities and highlight times when pain or fatigue caused difficulties. This will help you to spot any patterns and may suggest possible solutions.

Finding time to relax

Many people find that learning relaxation techniques can help in managing pain and reducing stress. There are a number of options available.

Some approaches take you off on a scenic journey describing restful locations (this is known as guided imagery), while others focus on tensing and relaxing various parts of your body (progressive muscle relaxation). It’s worth trying a few different approaches to decide what works best for you.

Self-directed forms of relaxation include:

• meditation, which involves concentrating on breathing or a sound (called a mantra) that you repeat to yourself
• breathing techniques which, once mastered, can be performed anywhere to relieve anxiety.

You may need to attend a class to learn some of the techniques, but regular practice will increase the effectiveness of relaxation.

It’s best to apply relaxation techniques in a way that supports the activities you want to do. Often brief spells of relaxation that you can incorporate into your activities work best. Longer relaxation exercises that act as a form of escape from reality are perhaps less useful, though you may want to try them occasionally.

Getting a good night's sleep

Pain may make it difficult to get to sleep or it may wake you from your sleep. If you often lose sleep, this can make the pain seem worse, which in turn can disturb your sleep even more.

Establishing a regular bedtime routine may help to break this cycle. You might want to try a warm bath, calming music or relaxation techniques before going to bed. A supportive pillow, and avoiding caffeine or watching TV close to bedtime may also help. Your occupational therapist can help you to identify other things that might help to improve your sleep.

Sleep medications are usually only partly effective for most people and they’re not ideal for long-term sleep problems. However, there are very effective psychological methods for improving sleep.

If modifying your night-time routine isn’t enough on its own, then cognitive behavioural therapies (CBT) may help you to establish a regular pattern of sleep. Ask your GP to refer you if you’d like to try CBT for your sleep problems.

Coping better at work

It can be challenging to remain in work if you have long-term pain. Learning practical things that you can do to help manage the pain, such as joint protection, pacing, exercise and relaxation, will help. If your company has an occupational health advisor, you may want to discuss this with them.

Occupational therapists can help by assessing work tasks in order to modify and reduce the effort required. They may recommend changes to your physical working environment and can provide support by liaising with your employer. Some may carry out workplace assessments with you.

Other self-help tips

Other pain-relief techniques that might help include:

• a heat pad, heated rice pad or a hot-water bottle
• an ice pack or a cold-water compress
• massage (with or without creams that create a sense of warmth)
• rest and good quality sleep – disturbed or unrefreshing sleep can increase pain, so speak to your doctor if you have this problem.

These techniques are often helpful after an injury and for sudden flare-ups of arthritis or back pain.

Is your pain management right for you?

Because nobody else can experience your pain or fully understand what it’s like to live with it, only you can decide what treatments or therapies are right for you. But that can be difficult if you’re feeling low or anxious or if you don’t know what support is available in your area.

Taking some time to think about what’s worked, what hasn’t and what your priorities are may help in making choices that fit in better with your way of life. A useful first step in forming a pain management plan is to think about how your pain affects your life.

Try completing each of the following phrases. "Since my pain began...":

• I spend more time thinking about
• I spend less time thinking about
• I spend more time doing
• I spend less time doing

What are you doing to manage your pain?

Below are some of the methods people use to deal with ongoing pain. Which ones have you tried?

• Taking drugs
• Distracting yourself
• Looking for information
• Modifying your home
• Homeopathy
• Taking time off work
• Resting
• Trying to relax
• Using braces or aids
• Seeking a clear diagnosis
• Massage
• Chiropractic treatment
• Seeing your GP
• Other alternative treatments
• Complaining
• Denying you have pain
• Asking for help with tasks
• Stopping painful activities
• Seeing another doctor
• Exercise
• Looking for the answer
• Pacing activities
• Surgery
• Hydrotherapy
• Acupuncture

These methods listed aren’t necessarily good or bad – some of them may work for some people, but that doesn’t mean they’ll be right for you. There may be other things on your list as well.

When you’ve thought about your own list, ask yourself the following questions about each method:

• Has doing it honestly helped your pain in a lasting way?
• Has it helped you to live the kind of life you want to live, especially in the long-term?

Weigh up the benefit you got from each method against the time and energy you put into it. Use this to decide:

• whether it’s worth trying a particular method more often
• whether to try something different.

Is your pain management working?

When we have problems, we automatically try to work them out. And sometimes we refuse to give up on a problem even though we’re not getting anywhere. At the other extreme, we sometimes feel confused or scared when we have problems and give up or do nothing. As you look at your pain-management methods, see if you notice yourself doing this.

Check if your pain management works for you

Ask yourself the following:

• Do you feel that the ways you’re trying to manage pain are successful?
• Do they improve your life?
• Do you ever feel like you’re struggling and getting nowhere?
• Does trying to control pain actually stop you from doing what you want to do?

Seeking treatment for pain is useful when it works, but it can hold you back when it doesn’t, and can create a life focused on pain instead of on what you really want to do.

If you think some methods aren’t working, discuss this with your healthcare team. There may be some treatments that you need to continue to control a specific condition or others that shouldn’t be stopped suddenly. But beyond those you do have choices.

If you find yourself stuck in a trap, trying things that aren’t helpful or don’t suit your lifestyle, then try refocusing on your goals. Think about the circumstances that will get you there. Try not to let pain, fatigue or other symptoms distract you.

Determine your own focus

Try the following exercise to remind yourself that you can determine your own focus:

1. Put your index finger in front of your face and stare at it.
2. What looks clear and what looks blurry?
3. Shift your focus beyond your finger. What looks clear and what looks blurry?

Which view shows you more of what is around you and gives you a more complete picture?

Sometimes, we focus on one issue that feels close, like the finger. These issues don’t always affect us in the same way if we look at a wider view.

As you do this exercise, don’t think about it too much or try too hard to figure it out. It’s enough to simply notice what the experience is like of switching focus and seeing what’s in front of you in a different way.

These exercises won’t always help you to find the right answer, but they might help you feel more confident about letting your experience be your guide and using the quality of your life as a measure for the success of pain management methods.