Joint pain is a very common symptom in several autoimmune rheumatology conditions, where the body’s immune system attacks its own tissues. Chronic pain can reduce your mobility and greatly affect your quality of life, especially with day to day changes that are hard to predict.
Three common forms of arthritis where autoimmune joint pain is present include:
- Rheumatoid arthritis (RA)
- Ankylosing spondylitis (AS)
- Psoriatic arthritis (PsA)
Here, we will cover the characteristics of rheumatoid arthritis joint pain, and touch on the similarities and differences of this same symptom in ankylosing spondylitis and psoriatic arthritis.
Rheumatoid Arthritis and Joint Pain
Rheumatoid arthritis (RA) is an autoimmune condition in which the body’s immune system attacks the synovium - the membrane lining around the joints. This immune system attack results in increased joint inflammation that may lead to swelling, pain, and joint damage over time1.
Rheumatoid arthritis joint pain and other symptoms are often noticed in smaller joints first (hands, feet) before larger joints (knees, shoulders). The pain most commonly will be present in both sides but can also just be present on one side of the body.
Swelling in Rheumatoid Arthritis
Joint swelling is another common symptom of RA, due to the influx of inflammatory cells and fluid in the joint capsule. This swelling often causes joints to seem puffy and feel warm to the touch.
This RA joint swelling can not only cause physical discomfort and further pain, but can also limit range of motion, making movement and activity more challenging1.
How to Ease Joint Pain and Swelling in Rheumatoid Arthritis
Managing rheumatoid arthritis joint pain and swelling includes a combination of treatments and lifestyle changes. Every person is different, so we will work with you to try out different strategies until you find what works to ease your pain most consistently.
7 examples of strategies to help reduce pain and swelling:
- Physical Therapy: Guided movement and exercise can improve joint function, range of motion, and reduce stiffness. A physical therapist can help create a program tailored to you4.
- Cold Therapy: Using ice packs on swollen joints may help bring down inflammation and numb pain4.
- Healthy Diet: Consuming anti-inflammatory foods high in omega-3 fatty acids, plus plant-predominant whole foods can help manage and reduce systemic inflammation5.
- Stress Management: Increased stress can increase symptoms. Techniques such as mindfulness, yoga, deep breathing, and vagus nerve can help lower stress and calm the immune system4.
- Supplements: Taking supplements can provide anti-inflammatory benefits to help reduce joint pain and swelling. These can include Turmeric, Omega-3’s, Vitamin D, and more.
- Anti-Inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are commonly prescribed by rheumatologists to reduce systemic inflammation and alleviate pain1.
- Disease-Modifying Antirheumatic Drugs (DMARDs) and biologics (bDMARDs): These medications may help slow disease progression, thus reducing further joint damage1.
Morning Stiffness in Rheumatoid Arthritis
A third symptom that often accompanies joint pain and swelling in RA is morning stiffness, which often lasts for an hour or longer after waking up. A common misconception is that joint stiffness in RA only occurs in the morning, but this symptom can carry further into your day past the morning, or appear at later times in the day.
While almost everyone experiences temporary joint stiffness after times of increased inactivity, the stiffness in RA is caused by the underlying inflammatory processes that happen (and peak during) after times of rest. This symptom can make it difficult for people living with RA to get out of bed and start their days4.
How to Ease Morning Stiffness in Rheumatoid Arthritis
Similarly to managing pain and swelling, easing morning stiffness can involve a combination of lifestyle changes and medications. Here are some strategies to try:
- Heat Therapy: Applying heat to stiff joints can help stimulate blood blow and loosen up tissues4. Some options include
- Warm showers or baths
- Hot water bottles, heading pads, or hot packs
- Gentle Morning Exercises or Movement: Low-impact exercises like stretching, yoga, or light aerobics can help reduce stiffness4. Listen to your body, and don’t push yourself past what feels achievable - even if it’s just a few light stretches!
- Medications: The same medications listed above (NSAIDs and DMARDs) can help reduce inflammation and feelings of joint stiffness1.
- Ergonomic Adjustments: Making modifications to your home environment can help to reduce the strain on joints during your morning routine4.
- Sleep Hygiene: Restorative sleep can help reduce overall inflammation and reduce the severity of morning stiffness4.
Ankylosing Spondylitis and Joint Pain
Ankylosing spondylitis (AS) is another autoimmune condition where joint pain is one of the key symptoms. AS primarily affects the spine, leading to inflammation, pain, and stiffness especially in the lower back and hips.
Over time, AS may cause new bone to form as the spine tries to heal, which may cause reduced flexibility and potential fusion of the vertebrae.
Similarly to RA, the joint pain in AS is often worse in the morning or after periods of inactivity. In AS, the pain most commonly is localized to the axial skeleton (head, neck, back, and chest) rather than the peripheral joints like in RA2.
Managing AS-Related Joint Pain
Ankylosing spondylitis pain management may include physical therapy, anti-inflammatory medications, and in some cases, biologics to slow disease progression. Consistent exercise and movement is very important to maintain spinal mobility and prevent long-term complications.
Psoriatic Arthritis and Joint Pain
Psoriatic arthritis (PsA) is a third autoimmune condition that often experiences chronic joint pain. PsA often occurs in people who also have a psoriasis diagnosis. Joint pain in PsA can affect any joint in the body, often appearing asymmetrically.
A distinctive feature of psoriatic arthritis swelling is the presence of dactylitis, or “sausage digits” where entire fingers or toes will become swollen and tender3.
Looking ahead: Feeling better with Joint Symptoms
Understanding the full spectrum of joint pain, joint swelling and morning stiffness that are almost always present in people living with RA, AS and PsA is key. Adopting a series of strategies that you can pull out and that you can feel confident with will at least help if not alleviate the pain for the time being, are very important not just for managing your life, but also helping your own mental health that is affected by consistent life with these symptoms.
Working closely with a multidisciplinary team that will surround you with care, such as the one at Rheumission, will give you the tools to develop a plan tailored to your unique needs and circumstances. We are always available to answer more questions and help you create a treatment plan that addresses all these factors.
To learn more about our Rheumission approach to care, please visit the Why Rheumission? section of our site or book a 15-minute intro call with one of our providers. The Rheumission Way helps you get back to being you, with more joy and less pain. We will listen to you and co-create a plan that works for where you are now and where you want to be. We are always here for you.
About the author
Jill Ryan is a seasoned Rheumatology Physician Assistant with over 30 years of experience and a strong commitment to patient care. She worked at Dartmouth Health System as a Rheumatology Physician Assistant for 24 years, and prior to that role, as an Internal Medicine Physician Assistant for 8 years. Jill is deeply passionate about caring for patients and guiding them on their wellness journeys. With training in integrative medicine, she focuses on holistic approaches that empower individuals to manage autoimmune diseases effectively, believing in the importance of patient education and developing personalized care plans that promote overall health and well-being.
Note: This information is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.
References
4. Arthritis Foundation. (n.d.). Morning Stiffness and Rheumatoid Arthritis.