Finding what works for your rheumatoid arthritis (RA) pain may require trial and error with the many treatment options available today. Managing RA and its symptoms usually requires a multidisciplinary team of health care professionals with different specializations. As your rheumatologist searches for the right combination of medication and lifestyle changes for your RA treatment plan, they may refer you to a pain management doctor to better help you address your RA pain.

What Is Pain Management?

The American College of Rheumatology defines pain management as the treatment or relief of pain using medications, techniques such as biofeedback, and complementary or alternative medicine. A pain management doctor is a physician who has undergone specialized training on how to evaluate, diagnose, and treat pain. This doctor can suggest and prescribe different medications or complementary therapies to help address RA-related pain. Depending on your symptoms, a pain management doctor may be a valuable member of an RA health care team.

Pain management is an important part of RA treatment that should be used in combination with lifestyle changes and a drug regimen specifically targeted for autoimmune disease. Pain management alone cannot slow or stop disease progression, and it cannot control the inflammatory effects of RA. Only proper treatment of RA comprising disease-modifying antirheumatic drugs (DMARDs), usually prescribed by a rheumatologist, can affect the severity or progression of RA.

Medications for Pain Management

RA symptoms like pain are often related to the inflammatory effects of arthritis. Some sources of RA pain include inflammation, swelling, musculoskeletal pain, joint pain, joint damage, and morning stiffness. A variety of medications can be used, alone or in combination, to help alleviate and manage RA-related pain.

Over-the-Counter Drugs

Over-the-counter pain medications, or analgesics, are available without a prescription. They are often effective in treating mild to moderate RA pain. Examples of over-the-counter pain medications include Tylenol (acetaminophen) as well as nonsteroidal anti-inflammatory drugs such as aspirin, Advil (ibuprofen), and Aleve (naproxen).

Topical Pain Medication

Topical medications include creams, adhesive patches, and gels that are applied to the surface of the skin to relieve pain in a joint or the surrounding muscle tissue. Some topical products contain a different formulation of the active ingredient that you would take in oral medications. Some products contain a topical numbing agent that may provide short-term pain relief.

Corticosteroids

Corticosteroid medications such as prednisone may help reduce inflammation and pain. They also help slow arthritis-related joint damage. Pain management doctors may prescribe a course of corticosteroids to provide quick, short-term relief of painful symptoms. A myRAteam member commented, “The only thing that eased my pain at first was prednisone until I found an effective RA treatment.”

Biologic Disease-Modifying Antirheumatic Drugs

DMARDs are the primary line of disease management for people with RA, making them an important component of pain management. DMARDs taken orally include older drugs such as methotrexate, Azulfidine (sulfasalazine), and Plaquenil (hydroxychloroquine). Biologics for RA, such as Remicade (infliximab), are commonly administered via infusion or intravenously every few weeks.

Complementary or Alternative Pain Management Methods

Complementary or alternative medicine refers to the use of health care methods that typically fall outside conventional Western medicine. These techniques should be seen as an additive approach and are used with traditional medicine.

Mindfulness and Meditation

There are ways to shift your focus from your physical pain and minimize its impact through mindfulness practices, meditation, and controlled deep breathing.

Massage

Massage can help reduce pain, relax sore muscles, and ease stress or anxiety.

Acupuncture

Acupuncture is a type of ancient Chinese medicine in which fine needles are inserted into specific locations on the body to release tension and relieve pain. Acupressure is similar to acupuncture but uses deep tissue pressure instead of needles.

Cannabis

Medicinal cannabis (marijuana) is specifically grown for medical use and can help treat arthritis pain. As a natural substance, cannabis may be less harsh and have fewer side effects than some medications. “I was given everything under the sun — the side effects were my issue,” commented one member. “It took me 13 years to find the right pain treatment for me. I take CBD oil. It works!” Another myRAteam member shared, “I’m supplementing my biologic infusions with dietary adjustments, mild exercise, hot tubbing, massage, and a little cannabis now and then.”

Find Your Team

On myRAteam, the social network for people living with rheumatoid arthritis, more than 182,000 members come together to ask questions, give advice, and share their experiences with others who understand life with RA.

Have you visited a pain management doctor? Were there benefits or limitations to working with this kind of specialist? Share your thoughts in the comments below, or start a discussion on myRAteam.