Reducing Rheumatoid Arthritis Pain

January 14, 2016

Did you know that 1.3M Americans have Rheumatoid Arthritis (RA)? RA can be hard to diagnose because the types and severity of symptoms vary from person to person. What are the signs and symptoms of RA?  How can someone get diagnosed and what can an RA sufferer do to relieve pain and experience a healthy lifestyle?  Salonpas spoke with two leaders in the field, Dr. Nathan Wei, Arthritis Treatment Center and Dr. Javier Vilasuso, an interventional pain medicine physician at Anesthesia Pain Care Consultants,  to learn more about this painful disease.

“Rheumatoid arthritis is the most common form of inflammatory arthritis,” says Dr. Wei. “It is a systemic disease affecting multiple organ systems, the most important, of course, are the joints.”

Dr. Nathan Wei

Dr. Nathan Wei

Dr. Javier Vilasuso

Dr. Javier Vilasuso

What are some overlooked signs and symptoms that one may have RA?  “Non-joint features can sometimes be overlooked in the diagnosis of RA such as skin, heart, lung, kidney and liver problems,” says Dr. Vilasuso. “Neurological symptoms may be present as patients can have peripheral neuropathy and even carpal tunnel syndrome. One should be followed by a primary physician and have routine history, physical exam and laboratory work done on a yearly basis to ensure general overall health. Symptoms including malaise, fatigue, morning stiffness and low-grade fevers may also be signs of an underlying illness such as RA or other autoimmune diseases.”

To get an accurate diagnosis, Dr. Wei recommends that people visit a good rheumatologist. “A rheumatologist is an internist or pediatrician, who received further training in the diagnosis (detection) and treatment of musculoskeletal disease and systemic autoimmune conditions commonly referred to as rheumatic diseases. These diseases can affect the joints, muscles and bones causing pain, swelling, stiffness and deformity,” reports the American College of Rheumatology.

What makes someone susceptible to getting RA?  Is it hereditary or do lifestyle issues make someone susceptible? “RA is thought to be 50 percent genetic, accompanied by contributing factors such as smoking, stress, vitamin D deficiency and viral infections that may include Epstein-Barr virus (EBV) and HHV 6,” says Dr. Vilasuso.  “Obesity is another risk factor,” adds Dr. Wei.

If an RA sufferer is in too much pain to exercise, what are they to do? “If they are hurting too much, then their disease is not well controlled,” says Dr. Wei.

Dr. Wei with patient.

Dr. Wei with patient.

“Good control of the disease should allow a patient to exercise.”

“Regular exercise is recommended as both safe and useful to maintain muscle strength and overall physical function,” says Dr. Vilasuso.  “If exercise is not an option due to the severity of the pain, management of the pain symptoms is essential to reducing inflammation and facilitating future functional mobility.”

Women are afflicted by RA more than men by a 60/40 ratio per Dr. Wei.  “Dietary recommendations to help reduce inflammation include a good healthy diet with fish oil supplements,” says Dr. Wei. “There is some evidence that a Mediterranean diet may help with inflammation.”

“OTC NSAIDs such as ibuprofen or naproxen reduce both pain and stiffness in those with RA,” says Dr. Vilasuso. “Generally, they appear to have no effect on people’s long-term disease course and thus are no longer first line agents. NSAIDs should always be used with caution for those with gastrointestinal, cardiovascular and kidney problems.”

Dr. Aristotle Economou

Dr. Aristotle Economou

“Acetaminophen has a narrow therapeutic window, meaning the difference between a safe and effective  dose and an overdose, which arth-big-212x300could lead to liver toxicity, is a relatively small increment in milligram consumption,” says Dr. Aristotle Economou,  author and acclaimed Beverly Hills physician.  “Topical pain relievers such as creams, gels and sprays work locally and largely reduce, although they do not entirely eliminate the systemic risk that OTC pain pills can present.  The Salonpas patches are the first and only topical non-steroidal anti-inflammatories approved through the FDA’s rigorous New Drug Application process which is the same process used to approve prescription medicines.”

“The good news is that we are able to put this disease into remission with many of the newer medicines available to us,” says Dr. Wei.

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