Health Getting to grips with arthritis pain Arthritis can be uncomfortable in different ways. Here, we focus on the pain that can come with osteoarthritis and rheumatoid arthritis I f you live with arthritis, youll know that the pain you experience can vary. It can be acute, which means its sudden and severe, and you can often tell what causes it. It can also be chronic, which is ongoing discomfort that can lead to muscle tension and restricted movement. Chronic pain often doesnt have a specific cause, but is felt over a longer period of time, commonly for six months or more, says Dr Gill Jenkins, a GP based in Bristol. As well as physical symptoms, it can also lead to low mood and anxiety. Osteoarthritis is the most common type of arthritis in the UK, affecting nearly nine million people. The condition begins when the cartilage between the bones in your joints, such as your hands, spine, knees and hips, begins to thin and roughen, causing gradual damage to the joints that makes them stiff and painful, says Ashley Oliver, senior physiotherapist at Bupa (bupa.co.uk). Rheumatoid arthritis occurs when the bodys immune system gets confused and attacks its own joints, which causes painful swelling. This can lead to an eventual change in shape and the potential breakdown of bone and cartilage. This form of arthritis affects more than 400,000 people in the UK. ISTOCK.COM / GZORGZ / DKARTW / VENUSPHOTO WORDS: CLAIRE LAVELLE Osteoarthritis: tips for pain relief Common symptoms of osteoarthritis include joint pain and stiffness, often with swelling and tenderness. Its most likely to affect the joints that bear most of our weight, such as the knees and feet. Joints that we use a lot in everyday life, such as the joints of the hand, are also commonly affected. How bad peoples symptoms are can vary greatly no two people with osteoarthritis experience it in the same way. Medication Paracetamol, commonly used to treat mild to moderate pain, will often be the first treatment recommended, along with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Codeine, a type of opioid, offers more powerful pain relief, but can cause drowsiness and constipation. If you need to be on this long term, your doctor may advise a codeine/caffeine combination, and also prescribe laxatives. Capsaicin cream Available on prescription and made from chilli, this cream works by blocking the nerves that send pain signals to the affected area. It takes a while to work up to four weeks and youll need to be careful when applying it to skin, taking care to thoroughly wash your hands afterwards. It may be useful if paracetamol and ibuprofen fail to control pain effectively. However, this cream can be in high demand and isnt always prescribed. Talk to your doctor to see what they can offer a weaker version may also be available over the counter in some pharmacies. Rest One of the best ways to combat pain is to rest and take some me time, advises Oliver. If you can, try to get some good quality sleep. Dr Chris Etheridge, a medical herbalist and advisor to Puressentiel, agrees. Sleep reduces the levels of stress hormones, such as cortisol, epinephrine and norepinephrine, while boosting the chemicals associated with cell repair and restoration, he says. Lavender oil has been shown to increase deep or slow-wave sleep, and it has also been shown to help with anxiety and pain, both of which can make sleep problems worse. Use in an oil diffuser or room mist to create an environment conducive to sleep. Hot or cold pads Cold packs to reduce swelling and heat packs to reduce pain can be very helpful, as can warm baths, says Dr Etheridge. An additional benefit is that there are no side effects. Rheumatoid arthritis (RA): tips for pain relief Characterised by swelling and stiffness in the joint, this condition can affect any joint in the body, although it is often first felt in the small ones in the hands and feet. Periods where symptoms become worse are known as flare-ups, or flares. Medication Youll normally be offered disease-modifying anti-rheumatic drugs (DMARDs) if youve been diagnosed with RA. These slow down the conditions progress and help with symptoms. Your doctor will work closely with you to find the one that suits you best. Biological therapies, which work by blocking the chemicals that trigger your immune system to attack your joints, are also available. Paracetamol and ibuprofen can also be used for pain relief, as with osteoarthritis. Corticosteroids are more powerful pain relievers that can help to reduce pain, stiffness and inflammation. These can be taken in tablet form, or as an injection directly into a joint (to relieve pain in that specific joint) or a muscle, for more overall relief. Keeping yourself healthy When youre not having an arthritis flare, its important to maintain a light exercise routine to avoid joints becoming stiff, says Ashley Oliver. A physiotherapist will be able to advise you on this. And make sure your friends, family and colleagues are kept in the loop with how youre Massage feeling, and understand Massage with clinically proven essential oils such as lavender can be helpful in cases of painful how pain can affect you. flare-ups, advises Dr Etheridge. In addition, Asia rosewood, Roman chamomile, cypress, lemongrass, This can help you both mandarin, marjoram, neroli, orange, palmarosa, petitgrain and sandalwood essential oils all have emotionally and practically, relaxing and comforting properties, he adds. Make sure you speak with a qualified aromatherapist to so that a flare doesnt add ensure youre using them safely. any extra unnecessary Getting enough sleep, and using hot and cold pads regularly, can also help. stress to your home or working life. n Find out more about how to manage pain at versusarthritis.org/managing-pain