Arthritis pain: Do's and don'ts

Arthritis is a leading cause of pain and disability worldwide. You can find plenty of advice about easing the pain of arthritis and other conditions with exercise, medication and stress reduction. How do you know what will work for you?

Here are some do's and don'ts to help you figure it out.

Basics

Whatever your condition, it will be easier to stay ahead of your pain if you:

• Learn all you can about your condition, including what type of arthritis you have and whether any of your joints are already damaged
• Enlist your doctor, friends and family in managing your pain
• Tell your doctor if your pain changes

Everyday routines

Pay attention to your joints, whether sitting, standing or engaging in activity.

• Keep your joints moving. Do daily, gentle stretches that move your joints through their full range of motion.
• Use good posture. A physical therapist can show you how to sit, stand and move correctly.
• Know your limits. Balance activity and rest, and don't overdo.

In addition, lifestyle changes are important for easing pain.

• Manage weight. Being overweight can increase complications of arthritis and contribute to arthritis pain. Making incremental, permanent lifestyle changes resulting in gradual weight loss is often the most effective method of weight management.
• Quit smoking. Smoking causes stress on connective tissues, which can increase arthritis pain.

Exercise

When you have arthritis, movement can decrease your pain and stiffness, improve your range of motion, strengthen your muscles, and increase your endurance.

What to do

Choose the right kinds of activities — those that build the muscles around your joints but don't damage the joints themselves. A physical or occupational therapist can help you develop an exercise program that's right for you.

Focus on stretching, range-of-motion exercises and gradual progressive strength training. Include low-impact aerobic exercise, such as walking, cycling or water exercises, to improve your mood and help control your weight.

What to avoid

Avoid activities that involve high impact and repetitive motion, such as:

• Running
• Jumping
• Tennis
• High-impact aerobics
• Repeating the same movement, such as a tennis serve, again and again

Medications

Many types of medications are available for arthritis pain relief. Most are relatively safe, but no medication is completely free of side effects. Talk with your doctor to formulate a medication plan for your specific pain symptoms.

What to do

Over-the-counter pain medications, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can help relieve occasional pain triggered by activity your muscles and joints aren't used to — such as gardening after a winter indoors.

Cream containing capsaicin may be applied to skin over a painful joint to relieve pain. Use alone or with oral medication.

Consult your doctor if over-the-counter medications don't relieve your pain.

What to avoid

• Overtreatment. Talk with your doctor if you find yourself using over-the-counter pain relievers regularly.
• Undertreatment. Don't try to ignore severe and prolonged arthritis pain. You might have joint inflammation or damage requiring daily medication.
• Focusing only on pain. Depression is more common in people with arthritis. Doctors have found that treating depression with antidepressants and other therapies reduces not only depression symptoms but also arthritis pain.

Physical and emotional integration

It's no surprise that arthritis pain has a negative effect on your mood. If everyday activities make you hurt, you're bound to feel discouraged. But when these normal feelings escalate to create a constant refrain of fearful, hopeless thoughts, your pain can actually get worse and harder to manage.

What to do

Therapies that interrupt destructive mind-body interactions include:

• Cognitive behavioral therapy. This well-studied, effective combination of talk therapy and behavior modification helps you identify — and break — cycles of self-defeating thoughts and actions.
• Relaxation therapy. Meditating, doing yoga, deep breathing, listening to music, being in nature, writing in a journal — do whatever helps you relax. There's no downside to relaxation, and it can help ease pain.
• Acupuncture. Some people get pain relief through acupuncture treatments, when a trained acupuncturist inserts hair-thin needles at specific points on your body. It can take several weeks before you notice improvement.

• Heat and cold. Use of heat, such as applying heating pads to aching joints, taking hot baths or showers, or immersing painful joints in warm paraffin wax, can help relieve pain temporarily. Be careful not to burn yourself. Use heating pads for no more than 20 minutes at a time.

  Use of cold, such as applying ice packs to sore muscles, can relieve pain and inflammation after strenuous exercise.

• Massage. Massage might improve pain and stiffness temporarily. Make sure your massage therapist knows where your arthritis affects you.

What to avoid

• Smoking. If you're addicted to tobacco, you might use it as an emotional coping tool. But it's counterproductive: Toxins in smoke cause stress on connective tissue, leading to more joint problems.
• A negative attitude. Negative thoughts are self-perpetuating. As long as you dwell on them, they escalate, which can increase your pain and risk of disability. Instead, distract yourself with activities you enjoy, spend time with people who support you and consider talking to a therapist.