Rheumatoid arthritis (RA) is an autoimmune disease that primarily affects the joints. In this disease, the immune system mistakenly attacks the joints, which causes inflammation. Typical symptoms include joint pain, swelling, stiffness and limited mobility of the affected joints. These symptoms may worsen in stages.

In addition to physical limitations, chronic pain in rheumatoid arthritis is the main complaint of those affected. Triggered by inflammation of the joints, these place a heavy burden on patients. Other factors can also influence pain regardless of the severity of the inflammation. For example, the disease profile of rheumatoid arthritis can be very different.

“Everything just doesn't go so fast anymore. Some things don't work at all, a lot just with difficulty. It is frustrating when you can no longer do so much that others can do.”

Opposite:

“The swelling is gone, the inflammation is gone. I can fully move my fingers again.”

In this article, you can find out how pain occurs in rheumatism and its forms, why it can occur in episodes and in different ways from person to person, and which therapies can help against it.

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Rheumatoid arthritis: pain in everyday life

Rheumatoid arthritis affects around 1 in 100 people, making it the most common form of rheumatism. Unlike fibromyalgia, this rheumatic disease causes the joints to be chronically inflamed. The immune system is directed against your own body. Rheumatoid arthritis is therefore one of the auto-immune diseases.

If the early warning signs of rheumatoid arthritis are identified early on, the onset, course and intensity of the disease can be influenced. According to experts, the optimal diagnosis period is a maximum of 12-16 weeks after the onset of the first symptoms of the disease. Rheumatoid arthritis can be easily treated through early medication cessation and lifestyle adjustments. Unfortunately, early diagnosis remains difficult due to limited places in rheumatic specialist institutions and lack of access to important information. Many early warning signs that the body signals to those affected are noticed too late or are not correctly classified, which is why a diagnosis is only made later.

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How can rheumatoid arthritis symptoms be treated?

Therapy for chronic joint pain usually consists of a combination of different medications. On the one hand, anti-inflammatory and analgesic “non-steroidal anti-inflammatory drugs” are used. Supplemented with glucocorticoids, such as cortisone, the inflammation of the joints is treated. With the help of various biologics, attempts are made to restrict the body's auto-immune response by intercepting pro-inflammatory messengers. 97% of those affected are also treated with DMARDs. The acronym stands for disease-modifying anti-rheumatic drug, i.e. in German: disease-modifying anti-rheumatic drugs. These drugs act on inflammatory processes in the immune system and prevent the joint structure from being attacked and destroyed. However, this effect is not immediate. It may take around 4-16 weeks for the drugs to take effect. The overall goal of this therapy is remission. This means that the inflammation is controlled and the arthritis is no longer progressing. The dosage of the medication should be adjusted and adjusted regularly under medical advice, as side effects may occur.

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The active ingredient cortisone reduces joint pain for many people, as it can stop acute inflammation. This may sound good at first glance, but long-term cortisone therapy has many side effects. Ingestion can lead to water retention in the body, which leads to weight gain in the long term. This can lead to increased joint stress, which in turn is counterproductive for the already inflamed joints. In addition, cortisone can cause porous bones in the long term, as it is stored in the bone and disrupts the metabolism of healthy bone growth there. Despite its side effects, cortisone is a frequently used medication for pain treatment in rheumatoid arthritis patients.

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Therapy with the described drugs aims to reduce pain, but is not always equally effective. It can happen that although the inflammation of the joints seems to be under control, the pain is almost unbearable. Rheumatoid arthritis is therefore individually linked to many different factors.

Permanent pain can be caused by inflammation in the body that spreads beyond the joints. In addition, patients' pain perception may be sensitized, which in turn increases the central pain sensation. If, in addition to the joints, nerves are also affected by inflammation, neuropathic pain signals can increase the pain due to a malfunction of the affected nerves.

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What influences pain?

Pain is a complex phenomenon and is influenced by the interplay of biological, psychological and social factors. This is illustrated by the so-called bio-psycho-social model. In the chart below, you can see the factors that can have an influence on pain.

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This model therefore states that pain in patients with rheumatoid arthritis should not only be recognized as a purely biological phenomenon, but psychological and social aspects should also be taken into account. What does that mean in practice? If you are affected by pain, it can be influenced by various adjustments (factors).

• Organic: This includes the medicines listed above.
• Psycho: Psychological interventions, such as cognitive behavioral therapy, relaxation techniques, stress management, mindfulness and acceptance, learning coping strategies can positively influence pain perception.
• Social: Creating supportive social networks, self-help groups, and involving family and friends can provide (emotional) support and thus help reduce pain.

Understanding the interplay of these three factors enables better individual care and treatment of rheumatoid arthritis.

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What can positively influence the mental state?

A healthy environment, as little stress as possible and a balanced everyday life can contribute to mental health. How those affected deal with pain naturally differs from person to person. However, there are uniform, pain-improving research results that help many sufferers deal with their pain: the acceptance this one. Mindfulness and acceptance-based interventions may improve some symptoms of rheumatoid arthritis by mediating increased disease acceptance. This includes painful inflammation, low mood, anxiety, and also the quality of life.

By accepting the pain, those affected regain some control over their bodies. This control can be achieved through the concept of Self-Efficacy be further intensified. In the article, you can read about what self-efficacy means and how it can positively influence the way you deal with pain.

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Many routes with the same goal: less pain and more freedom

You have now read a lot about the symptoms and course of rheumatoid arthritis, the development of pain and what factors are related to pain processing. Unfortunately, there is no simple, generally valid recipe. Nevertheless, you have hopefully been able to take away new information that will help you either as a relative or as a person affected.

In our blog, you will find more articles that contain information about the various symptoms of rheumatic diseases, their course and methods of dealing with chronic pain.