Dealing with pain

Living with pain can be one of the hardest parts of having arthritis. Effective pain management involves goal setting. The focus of these goals should be on helping you live the life you want, rather than just reducing pain. A multidisciplinary approach to your treatment pathway is the best way to achieve these goals. Remember the most important member of your Health Care Team is YOU!

What causes pain

There are now thought to be three types of pain:

• Tissue damage or inflammation, the process that causes heat and swelling in your joints
• Nerve pain
• Increased sensitivity (hypersensitivity) of the pain system

For some conditions, such as fibromyalgia, the cause of the pain is not fully understood.

Everyone’s pain is different and everyone is affected by pain in different ways

What you can do to manage your pain

Pain may limit some of the things you do, but it doesn’t have to control your life. Your mind plays an important role in how you feel pain. Thinking of pain as a signal to take positive action rather than being scared or worried about it can be helpful. 

You can learn ways to manage your pain. What works for one person may not work for another, so you may have to try different techniques until you find what works best for you. It is not best to go in to treatment expecting to be pain-free. The main aim is to help you manage your pain so that you can still do the things you enjoy in life.

Here are some things you can try:

• Work closely with your Health Care Team to develop a management plan for your chronic pain. 
• Set goals and pace yourself. Goals should be SMART (Specific, Measurable, Achievable, Relevant and Time-based).Pacing is important. By conserving your energy, you can gradually work towards achieving your SMART activity goals.
• Mind your emotions and thoughts. A trained professional, such as a psychologist, can help you learn relaxation and pain coping skills so you can better manage your pain. Some of these techniques include:
  • Relaxation: Relaxation techniques, such as deep breathing, guided imagery (mental pictures) and progressive muscle relaxation, can help you reduce stress and muscle tension. These techniques need to be practised and you may have to try several methods before you find one that works for you. You may find it helpful to use Apps and audio recordings, or books to help you learn relaxation techniques.
  • Mindfulness Based Stress Reduction: This is a structured program developed at the University of Massachusetts Medical School. It helps you become aware of thoughts that may be exaggerated or unhelpful and then how to respond to them.
• Stay active. Research has shown that regular appropriate physical activity can help reduce pain. It also keeps your joints moving, strengthens muscles to support your joints, reduces stress and improves sleep. A health professional (eg. a physiotherapist or exercise physiologist) or your doctor can help you work out a program suitable for you.
• Take care of your joints and save energy. Looking after your joints during your daily activities can help reduce pain, stress and tiredness. It involves simple habits such as: – avoiding activities that cause pain – asking for help when you need it – using special aids and gadgets to make tasks easier. See Fatigue and arthritis.
• Get enough sleep. A bad nights sleep makes people more sensitive to pain during the day. Introducing good sleep habits such as reducing screen time in the hours before bed, avoiding caffeine late in the day and waking up and going to bed at the same time each day can help. 
• Eat well. Research suggests that a well balanced diet of mainly fruit and vegetables, that is low in sugar and processed foods is the best diet to follow. Omega-3 rich foods such as salmon also have anti-inflammatory properties and may assist in managing your Arthritis.
• Make the most of medicines. Take medicines wisely. Many different types of medicines can help control the pain of arthritis. Your doctor or pharmacist can help you understand which medicines are right for you and how best to use them. Medicines alone are rarely effective and can come with troublesome side effects.

Other treatments that could help may include:

• Heat and Cold therapy. The benefits of heat and cold for arthritis are yet to be proven by research. However these treatments are soothing and safe when used carefully. Heat relaxes your muscles and stimulates blood circulation. You could try a warm bath, or place a heat pack or hot water bottle over the painful area for 15 minutes. Cold numbs the painful area and reduces swelling. Applying cold treatments, such as ice packs, to the painful area for 15 minutes may be especially useful for hot, swollen joints, such as during a ‘flare’. You can repeat heat or cold treatments throughout the day. Make sure the temperature of your skin has returned to normal before re-applying, to prevent any tissue damage. Ask your doctor or physiotherapist whether heat or cold is best for you.
• Massage. There are limited scientific studies that show massage may temporarily improve pain and mobility of joints and muscles. Make sure the massage therapist has experience working with people who have arthritis. You can find a qualified therapist by contacting the Australian Association of Massage Therapists, or the Institute of Registered Myotherapists of Australia.
• Acupuncture. Acupuncture is an ancient Chinese practice of putting small, thin needles into the skin at specific points on the body to block the pain signal. There are mixed results from studies of acupuncture for arthritis. However some people may find it useful alongside other proven treatments, such as medicines. The Australian Acupuncture and Chinese Medicine Association can help you find an accredited practitioner.
• Transcutaneous electrical nerve stimulation (TENS). A TENS machine applies very mild electric pulses to block pain messages going from the painful area to your brain. TENS can be useful for longer-term pain but does not work for all people. See a physiotherapist to trial a TENS machine, and to learn how to use it correctly, before you buy one

Considering taking opioids for your pain?

This animated video below, from NPS MedicineWise and the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists (ANZCA), provides information to people who may be considering taking opioids for  chronic (ongoing) non-cancer pain.

For more information see our Pain booklet Taking Control of  Your Pain in Arthritis

Websites: Australian Physiotherapy Association, Exercise and Sports Science Australia, Versus Arthritis,  Arthritis Foundation (US), Australian Psychological Society.  The Pain Management Network has a range of video episodes for you to work through to help you manage your pain.

Page last reviewed and updated July 2023