Rheumatoid Arthritis and Pain.
Managing pain in Rheumatoid Arthritis (RA) involves a multidisciplinary approach of medication physiotherapy, procedure to manage pain, psychology, Transcutaneous Nerve Stimulation (TENS) and acupuncture.
The reason for the multidisciplinary approach is because pain sensation come more than one way and to achieve an acceptable pain management, more than one treatment is needed.
For us to feel pain, a specific part of the brain needs to be excited. Another sensation of pain is nerve damage of the pain pathway, it may also be as a result of psychological mechanisms enhancing the severity of pain.
Pain Control Method
Medication: an acute pain, anti-inflammatory drugs are of vital. Other analgesia and opioids may also be necessary to supress the pain from the Central Nervous System (CNS).
Pain Management: Pain management use cognitive therapy, realistic target setting, as well as physical therapy in other to regain function lost during the restriction of movement and function caused by RA.
Nerve Blocks: The use of slow release of steroid to temporary block the nerves is another way of pain management in RA. This can be achieved by infiltration of a peripheral nerve with local anaesthetics.
Administration of joints injection causes prolonged relief of pain by suppressing the joint inflammation. The pain will settle if inflammation does not return, the benefit effect of nerve block takes up to three months.
Transcutaneous Nerve Stimulation (TEN): This reduces the severity of pain site by massaging it. It is achieved through the stimulation of skin touch receptors or electrical TENS stimulations.
Physiotherapist: The physiotherapist advises and train on how to gain back and maintain array of movement and physical function.
W., H (2002) Pain Management Unit Guys and St’Thomas Hospital
W., Hamann (2000) Handbook of Rheumatoid Arthritis, eds Oxford University Press.
National Rheumatoid Arthritis Society http://www.nras.org.uk/