are walking, swimming and water aerobics. The most important thing, says Callahan, is to do something every day, even if you start with just a few minutes of an easy walk at lunchtime or a short bike ride after work. “Don’t push yourself or your joints beyond your comfort level,” she advises. “The point is to help the pain, not to cause pain. If it hurts, stop and rest your body or do something else.” Make your goal to work up to 30 minutes of exercise daily, including 10 minutes of range-of-motion moves.
plan to succeed.
Why should you borrow trouble when you’re not having a flare? Because thinking about exactly what triggers your pain before it strikes can minimize it in a big way, says Deborah S. Litman, M.D., a rheuma- tologist and assistant clinical professor at Georgetown University School of Medicine, in Washington, D.C. “Stopping pain is almost always harder than prevent- ing it,” she says. “In many cases, you can deal with these pain triggers before they happen.” Rheumatologist Dennis Boulware says there are
three factors that very often will bring on an arthritis flare: dramatic changes in temperature (whether too hot or too cold); high levels of stress; and increased physical exertion. When Allen Baird’s early-morning swim sessions left him with a throbbing hip, he switched his medication schedule and started taking a larger dose of his NSAID at bedtime instead of at breakfast. “When I woke up, my medicine was already working, and swimming hurt a lot less,” Baird says. Changing your medication schedule (and/or dosage), as Baird did, can improve your body’s ability to han- dle physical strain when you know you’ll have more of it to deal with. Similarly, if you’re sensitive to tem- perature, Litman suggests always dressing in layers because it’s simple to add or remove clothing as tem- peratures fluctate and stay comfortable. You can warm up your joints by marching in place for a few minutes before going out in cold weather. Because stress and pain feed off each other, find-
ing effective methods to deal with tension is integral to effectively managing your pain. What helps you relax is very personal, but Joseph Barber, Ph.D., clin- ical professor in the department of rehabilitation medicine at the University of Washington, in Seattle, says “there’s substantial evidence” that hypnotherapy can significantly reduce pain—“the pain of arthritis as well as any other kind of pain.” How so? By chang- ing how you perceive pain, as well as giving you bet- ter options to deal with joint aches. Or consider acupuncture, which “reprograms the way your brain processes pain, making you better able to cope with
Some Like It Hot (Or Cold)
An irony of living with arthritis is that while extreme tempera- tures can bring on pain, using heat and cold can also work to take the edge off a flare when your meds can’t kick in fast enough.
HOT STUFF Why heat works: When your tissues warm up, the blood can move more efficiently to the areas where you feel pain, easing inflammation and relaxing tight muscles.
Soak in a hot tub. Warm water provides nearly instant relief, and you can add a handful of mint or eucalyptus bath salts for mental and physical rejuvena- tion. (If you’re over 70 or have a history of respiratory problems, check with your doctor before taking the plunge.) Try a paraffin treatment. If your pain is in your hands or feet, dip sore digits in liquid paraffin and let the wax cool and harden before peeling it off. Use a heating pad. Place the pad directly on your aching parts for 10 to 15 minutes. Don’t use a heating pad with heat-inducing creams. Instead opt for a microwaveable pad or one with an automatic shut-off to avoid burns.
CHILL OUT Why cold works: Because cold slows blood flow, it also slows the transmission of pain signals and chemicals that cause inflammation.
Use a cold pack. David Borenstein, M.D., clinical professor of medicine at George Washington University Medical Center, in Washington, D.C., recom- mends applying a cold pack during the first 24 hours of a serious flare or joint injury. Keep the cold pack on the affected area for 15 to 30 minutes.
For severe flares, try alternating 10 minutes of a hot-water soak with a one- minute dip in cold water. Repeat two to three times.
Find out what
triggers your flares. It’s much easier to prevent pain than it is to stop it once it’s happened.
both physical and emotional pain,” says Tim Rhudy,
L.Ac., an acupuncturist in the department of pain management at the Cleveland Clinic. If hypnosis and acupuncture are outside your comfort zone, try med- itation: People with RA who practiced mindfulness meditation for 45 minutes a day reduced their stress levels by one-third in a 2007 study in the journal Ar- thritis Care and Research. New to meditation? Even starting with 10 minutes a day, and adding time as you get more comfortable, can help your pain. Having arthritis doesn’t just affect your joints, of
course; it changes your whole life, so it makes sense to incorporate solutions that touch on all parts of how you live and who you are. Says Pat Conger, “[Ar- thritis] made me feel like a different person and not always a person I liked. I am so grateful for medicine that helps with the pain, but the thing that has made the biggest change for me has been learning how to do everyday things so that they hurt less.” PR amy brayfield is an Atlanta-based health writer.
PAIN RESOURCE FALL 2012 39
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