Pain Management Strategies for Rheumatoid Arthritis

Non-Pharmacological Approaches

The American College of Rheumatology recommends applying heat therapy to affected joints to improve pain and physical function during cold weather 1, 2
Thermal therapy can be self-administered at home, though guidance from a physical or occupational therapist may be beneficial for optimal technique 2
Regular exercise programs that include aerobic and resistance training can improve muscle strength and reduce pain, with indoor exercises recommended during winter months 2, 4
Hand therapy exercises are important for patients with hand involvement to maintain strength and reduce cramping 4
Massage therapy can provide pain relief, preferably delivered by a provider with experience treating RA patients 2, 3
Cognitive behavioral therapy and mind-body approaches are conditionally recommended for pain management, helping to manage pain perception and reduce stress 2, 3, 5

The Arthritis Foundation suggests using appropriate splinting, orthoses, or bracing for affected joints to maintain proper alignment and reduce muscle strain 4
Assistive devices can reduce strain on muscles and joints during daily activities, and wearing warm, layered clothing and gloves can protect joints from cold exposure 4
Participating in standardized self-management programs can help develop skills for managing pain and other symptoms, including activity pacing, energy conservation, and fatigue management strategies 2, 3, 4

Acupuncture is conditionally recommended for pain management, though evidence shows inconsistent improvements 1, 2, 3

Electrotherapy modalities such as TENS are conditionally recommended against due to lack of evidence for improvement in pain and physical function 1, 2, 3
Chiropractic therapy is conditionally recommended against due to potential cervical spine complications in people with rheumatoid arthritis 1, 2, 3

Ensuring medication regimen is optimized before winter can prevent flares, and addressing sleep disturbances can help reduce inflammation and pain 5, 6
Tobacco cessation is important, as smoking can worsen RA symptoms and reduce treatment effectiveness 1
For patients with frequent winter flares, consider adjusting baseline therapy before the season changes 6