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Joint pain and arthritis

Man with joint and arthritis pain
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How to ease your joint pain and stay mobile

Whether you're experiencing a new joint pain or are living with arthritis, we've put together some help and advice to support your pain throughout the day. From common symptoms and causes to medication and drug-free treatment, read on for the latest pain relief support.

What is arthritis?

There are many things that can cause joint pain, from strains and injuries to arthritis. Arthritis is the name for a group of conditions which involve one or more joints in the body.

There are several types of arthritis, but the two main types are osteoarthritis and rheumatoid arthritis, which are described in detail below. For advice on general joint pain, scroll to the bottom of this article.

Osteoarthritis

About 9 million people in the UK have osteoarthritis, making it the most common type of arthritis.

Osteoarthritis affects the cartilage lining of the joints, causing it to roughen. This makes it more difficult to move and causes pain and stiffness. As the cartilage becomes rougher and thinner, the tendons and ligaments in the joints work harder. Small bits of bone can grow in the joint, and there can be an increase of fluid. The joint can also change shape.

Osteoarthritis can affect any joint, but it usually occurs in the knees, hips and hands.

Signs of osteoarthritis that you might notice are:

  • Increased pain or stiffness when you haven't moved your joints in a while
  • A grating or crackling sound or sensation in your joints
  • Your joints appearing slightly larger or more “knobbly” than usual
  • Your range of movement being limited

Osteoarthritis pain relief

Osteoarthritis can initially be managed through lifestyle changes, such as exercise.

When you do need a painkiller, the first choice tends to be paracetamol, often taken regularly for the full effect. If paracetamol isn't effective, you can try an NSAID (non-steroidal anti-inflammatory drug) like ibuprofen. Topical NSAIDs, such as ibuprofen gel, are often useful for hand or knee arthritis.

If these pain-relievers don’t work, you might be offered stronger pain relief, prescription capsaicin cream, or steroid injections into the joint.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune condition which causes the body to attack the joints, leading to pain and swelling.

When you have rheumatoid arthritis, antibodies are sent to attack the linings of your joints. As a result, the cells covering your joints become sore and inflamed, and release chemicals which damage the bones and connective tissue around the joint. Without treatment, this process will continue and the joint will gradually lose its shape and go out of alignment.

The symptoms of rheumatoid arthritis include:

  • Throbbing and aching pain in the joints, which is normally worse in the morning or after not moving for a long period
  • Stiffness in the joints which limits mobility
  • Swelling, warmth and redness around the joints
  • Firm swellings under the skin around the affected joints
  • Tiredness
  • High temperature and sweating
  • Loss of appetite and weight loss

Rheumatoid arthritis treatment and pain relief

The main treatments for rheumatoid arthritis are:

  • Disease-modifying anti-rheumatic drugs (DMARDS)
  • Biological treatments
  • JAK inhibitors
  • Pain relief

DMARDS are tablets that block the effects of the chemicals which cause progressive damage to the bone and tissue of the joint. This eases symptoms and slows down the damage caused to the joint. A commonly prescribed DMARD is methotrexate, but there are others available if this treatment isn’t right for you.

Biological treatments like adalimumab are usually taken in combination with a DMARD. They’re given as an injection and they work by preventing the immune system from attacking your joints.

JAK inhibitors are a newer type of rheumatoid arthritis medication and are available for people who can’t take DMARDS or biological treatments.

Pain relief options for rheumatoid arthritis include:

  • Paracetamol, sometimes combined with codeine
  • Non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen, which may be given with another medication to protect the lining of your stomach
  • Steroids, given as a tablet or injection

In addition to the treatments listed above, rheumatoid arthritis can also be treated with physiotherapy, occupational therapy and podiatry, as well as acupuncture and osteopathy. In severe cases where the joints become very damaged you might need surgery.

Topical treatments for joint pain

Topical treatments, those that are applied directly to the area, are commonly used for joint pain and there is evidence they can help relieve osteoarthritis pain in your knees and hands particularly. Hand and knee osteoarthritis is usually treated with creams containing NSAID (non-steroidal anti-inflammatory drug which you can get over the counter at your local LloydsPharmacy. They are best applied with a gentle massage, using the amount specified on the leaflet.

Drug-free pain relief

If you’re looking to ease your pain without medication, there are various options out there if you want to try drug-free alternatives or something to use in combination with medication.

Hot and cold treatments

Warmth has been used for many years to help relieve pain and stiffness. As well as a warm bath or shower, you could try heat packs that can be placed on the area which is in pain to help.

Cold can relieve swelling which can then ease pain. You can apply an ice pack or cold pack for up to 20 minutes every couple of hours. Some people use a mixture of both hot and cold alternately. It’s best to try a few options to find what is right for you.

Turmeric

There is some limited evidence to suggest that turmeric supplements can help relieve joint pain - although it’s not listed as a recommended treatment by the NHS. Read more about this topic here.

What else you can do to help relieve joint pain?

Although strains and sprains can often be the cause of painful joints, there are other causes to watch out for, including cold weather, along with gout, bursitis and arthritis.

  • Take regular exercise - it helps build the muscles that support the joint, helping with pain. Choose gentle low impact exercises such as swimming and speak to your GP first if you're not used to exercise
  • Keep to a healthy weight - excess weight can put more stress on joints such as your knees
  • Pace your activities and don't do too much in one go
  • Keep warm - many people find their joints hurt more in the cold and wet, so keep well wrapped up
  • Alongside your painkillers you can also use a TENS* machine, like the LloydsPharmacy joint pain reliever, and other drug-free products, such as hot and cold packs. To find out more about how TENS machines work and their benefits click here

Online Doctor VideoGP

Exercising with joint pain and arthritis

Having a healthy lifestyle, along with the right treatment or management can help to reduce joint pain. Maintaining a healthy weight can reduce the impact on your joints and staying active can help to improve the strength of your joints. Exercise can help keep your muscles strong so that they can support and keep the joints mobile.

60.7% of those with back pain and 56.6% of those with joint pain usually rest rather than exercise when they’re in pain.

These low impact exercises could help with joint pain:

  • Cycling can give you a good workout, is gentle on your joints and you can enjoy it with all the family
  • Swimming is easy on the joints too and it also works all the muscles in your body, so can help keep you in shape too
  • Using weights or resistance bands can help boost the muscles around your joints, helping to make them stronger and more stable
  • Yoga or Pilates can also help strengthen your joints and maintain mobility

For strengthening exercises, start with as many repetitions you can comfortably do and then build up gradually. When doing exercises, slowly move as far as you can until you feel a stretch in the muscles around the joints. Then hold still in the position, aiming for 20 seconds.

Exercise 1 - Sit on a chair and using one leg at a time, pull your toes up, tighten your thigh muscle and straighten your knee.

Exercise 2 - Stand in front of a chair and hold on with both hands for support. Slowly crouch keeping your back straight and heels on the floor.

Exercise 3 - Sit with your knees bent and feet together. Press your knees down towards the floor, using your hands as needed.

Exercise 4 - Lie on your back. Pull each knee in turn to your chest, keeping your other leg straight.

Don't forget, if you have arthritis, it's advisable to check with your GP before starting any new exercises.

Speak to your pharmacist or GP about joint pain if:

  • You have symptoms of arthritis but haven't been diagnosed
  • Your pain isn't controlled
  • You're on medicines to tone down your immune system and you get symptoms such as a sore throat - seek urgent advice as this may be a sign of a blood disorder
  • Your joint pain becomes worse
  • There are any changes in your condition
  • You regularly buy diclofenac or ibuprofen products

The cold can also make joint and muscles pain worse. Making sure that you wrap up warm during the winter months and ease aching joints with a hot bath or hot water bottle.

If your joint pain is stemming from an injury or strain, try to rest and apply a cold pack for 15-20 minutes every two-three hours during the day. You could also bandage it to contain swelling and keep it raised if possible. It's best to start using the joint soon to keep it mobile, but always see your GP if there's no improvement.

References

www.nhs.uk/conditions/arthritis
www.versusarthritis.org/about-arthritis/conditions/arthritis
www.nhs.uk/conditions/osteoarthritis/treatment
www.nhs.uk/conditions/rheumatoid-arthritis/causes
www.nhs.uk/conditions/rheumatoid-arthritis/symptoms
www.nhs.uk/conditions/rheumatoid-arthritis/treatment

*A TENS machine is not suitable for use during pregnancy or labour, or if you suspect you may be pregnant. It’s also unsuitable for people with pacemakers or other implanted medical devices or heart rhythm problems. Cancer patients and people with diabetes or epilepsy should seek medical advice before using this product. A TENS machine should not be used without supervision by children under 16 years of age.