From the FMS Global and UK News Desk of Jeanne Hambleton
Courtesy of WebMD.com
By Bill Hendrick – WebMD Health News- Reviewed by Louise Chang, MD
March 25, 2009 — Many people with rheumatoid arthritis may have barriers that hinder optimal management of their pain, a study suggests.
Barriers to pain reduction, Canadian researchers say, include fear of medication side effects, fear of drug interactions, worry about drug addiction, concerns that the effects of medication might mask the disease, and aversion to taking too many pills.
McGill University scientists studied 60 patients with rheumatoid arthritis, all of whom were being treated by specialists. Of the rheumatoid arthritis sufferers, 53% described their pain as moderate to severe.
Forty-seven percent reported that pain was mild or absent. And 65% of all patients, including about half of those with moderate to severe pain, were satisfied with current methods to control suffering, the researchers report in the March issue of The Journal of Pain.
Although 87% of the patients reported that they expected to have “some” pain to “much” pain from their rheumatoid arthritis, only 13% didn’t expect any pain or only slight pain.
The researchers, led by Mary-Ann Fitzcharles, MD, of Montreal General Hospital at McGill University, were interested in the potential barriers to reducing pain that kept some people hurting.
The top barriers to optimal pain management found in the study participants included:
Worry of medication side effects (80%)
Not wanting to take “too many pills” (63%)
Worry about medication interactions (57%)
Worry of addiction (35%)
The researchers found that more than half of the patients had at least three barriers.
The researchers conclude that people with rheumatoid arthritis should be questioned vigorously about their pain, and that clinicians should explore potential barriers to effective pain control.
News release, McGill University.
Fitzcharles, M. The Journal of Pain, March 2009; vol 10: pp 300-305.
© 2009 WebMD, LLC. All rights reserved.
Hand Exercises Aid Rheumatoid Arthritis
Muscle-strengthening exercises may ease pain and help individuals with RA improve their quality of life
By Gina Shaw -WebMD the Magazine – Feature Reviewed by Michael W. Smith, MD
For 25 years, New Yorker Carol Solomon, 69, ran a knitting store. In 2006, a few years into retirement, she was diagnosed with rheumatoid arthritis (RA) in both hands.
“I have movement in my thumb and in my pointer finger, but my other three fingers are pretty stiff,” she says. Solomon did not want to give up the knitting and sewing she loves, so she sought help from her doctor and physical therapists at New York’s Hospital for Special Surgery.
There is a saying about exercise and RA: Use it, but do not abuse it.
“Studies have shown that strengthening the muscles around the joints leads to overall improved function and better quality of life,” says Heather Williams, DPT, a physical therapist in the Hospital for Special Surgery’s Joint Mobility Center.
“Patients can be afraid to exercise those joints because of pain, but they really benefit from strengthening exercises.”
RA is an autoimmune disease in which the body attacks its own tissues. It is a chronic disease, but when diagnosed and treated early with a combination of medication and physical therapy, joint damage can be limited.
When it affects the hands or wrists, like Solomon’s, some helpful exercises include squeezing small exercise balls or putting the hand out flat, palm up, and bending each finger one by one into the palm. Take it slowly, advises the physical therapist. She says Solomon should try three sets of five repetitions of each exercise instead of 10 or 12 reps — and then work up to more as she builds her strength.
People with RA go through phases called “flare-ups,” with extremely swollen and painful joints, and then “subacute” phases when the disease is less active. Modifying activity depending on what phase you are in is important, says Theodore Fields, MD, clinical director of the Gosden-Robinson Early Arthritis Center at New York’s Hospital for Special Surgery.
“When you have a significant flare-up, the joints need more rest.”
Whatever kind of exercise you do, be sure to discuss your exercise plan with a physical therapist who understands RA.
“Have your physical therapist work out a home-exercise program that fits your needs and respects the joints you have trouble with,” says Fields.
Solomon knows her knitting needles will never fly like they used to, but she has started to work with yarn again and can even sew with a needle and thread, an impossible feat when she first was diagnosed.
“I am just seeing what I can do every day, and trying to adjust the way I do things to give myself as much function as possible,” she says.
Hand Exercise for Rheumatoid Arthritis
Fill an empty box with small items such as nuts, screws, and bolts. Reach in and, handful by handful, pick the screws and bolts out of one box, place them in your other hand, and place in a second box.
This exercise helps strengthen muscles around joints for improved finger mobility and helps prevent future joint damage.
Originally published in the September/October 2007 issue of WebMD the Magazine. © 2007 WebMD, Inc. All rights reserved.