Arthritis Rheumatoid Arthritis Causes of Rheumatoid Arthritis Pain and Treatment Options By Laken Brooks Laken Brooks (she/hers) is a freelance writer with bylines in CNN, Inside Higher Ed, Good Housekeeping, and Refinery29. She writes about accessibility, folk medicine, and technology. She served as a Fulbright Scholar at the University of Szczecin, Poland and has worked with various museums and nonprofits. Learn about our editorial process Laken Brooks Published on December 14, 2020 Print Table of Contents View All Causes of RA Pain Treatment When to See Your Doctor Rheumatoid arthritis (RA) is one of the most common types of arthritis. Like other forms of arthritis, RA can cause your joints to swell and hurt. While RA can impact many joints throughout the body, it often starts in the hands and fingers, which makes grasping objects or opening containers difficult. Initial arthritis pain may feel like a dull ache or a deep, burning sensation. More progressed arthritis may cause you to feel stiff or sore when you sit down or bend over, and you may have trouble clenching and unclenching your fingers or bending your knees. RA is an autoimmune condition, so it can impact more than a person’s joints. Unlike some other kinds of arthritis, RA isn't caused by the normal wear and tear on an aging musculoskeletal system. RA pain can be complicated, but patients might find better coping strategies when they learn more about rheumatoid arthritis and its symptoms. AaronAmat / Getty Images What Causes RA Pain? Medical researchers remain uncertain about which factors definitely lead to the condition. Certain people have a higher risk of developing the disease, such as women, those with a family history of the disease, and people age 60 or over. Environmental and lifestyle factors also play a role, as smokers are more at risk than non-smokers. What we do know, though, is that rheumatoid arthritis forces a person’s immune system to attack their own joints and tissues—namely, the lining of their joints called the synovium. The synovium is a soft tissue layer that cushions and connects your joints. Your synovium helps your knees, shoulders, and wrists move easily and freely. If a person has RA, though, this synovium becomes hardened, which makes movement more difficult. Without the soft synovium to protect your joints, those tissues may become stiff and inflamed. Some people describe their RA pain as an ache, a burn, a tingling, or a twisting sensation. However, RA also can present several non-pain related symptoms. In severe cases, rheumatoid arthritis can cause symptoms outside of the joints. In fact, almost half of RA patients report that the condition impacts other parts of their bodies, especially their lungs. RA patients may find that they have difficulty catching their breath or breathing deeply. About 25% of people with the condition develop firm lumps under their skin, called rheumatoid nodules. These nodules may appear near bony areas like on your hands or your elbows. As with many other inflammatory and autoimmune diseases, rheumatoid arthritis can impact many parts of the body, and different people report different symptoms. Always check with your doctor to receive a formal diagnosis. Other Causes Certain situations can cause RA to flare. For example, weather changes like shifting seasons or incoming storms can result in higher or lower atmospheric pressures. These changing pressures can irritate inflamed joints. Cold weather, especially, can cause joints to feel stiff. Physical and psychological stress can also exacerbate your RA symptoms. When we are stressed, we often tense our shoulders or other parts of our bodies, which can in turn impact existing stiffness or pain. If your body is fighting an infection, that will impact your autoimmune system. Because RA is an autoimmune disorder, your immune system may attack its own joints as it is trying to fight off a bacterial or viral infection. Therefore, other infections or illnesses can trigger or worsen your normal RA symptoms. Treating RA Pain Prescription Medications Your doctor may prescribe a disease-modifying antirheumatic drug (DMARD), such as methotrexate. These drugs help suppress an overactive immune system, which prevents your body from attacking your joints. With these medicines, people may notice less joint inflammation, which can prevent long-term bone and tissue damage. DMARDs are used specifically for rheumatoid conditions like RA or connective tissue diseases. To help alleviate pain, many patients use nonsteroidal anti-inflammatory drugs (NSAIDs) pain-killers. Some common NSAID pain relievers include Advil, Motrin, and Aleve. These basic NSAIDs can be purchased at a pharmacy near you. However, your doctor may prescribe a more powerful narcotic pain reliever, such as hydrocodone. These medications can help provide relief from severe pain. Pain medications can cause side effects, and some (like opioids) are highly addictive. These medications should never be used without a doctor’s advice. Weighing the Benefits and Risks of Pain Medication for Arthritis Home Remedies People with mild to moderate RA often use home remedies as part of their treatment plan. Warmth can help reduce stiffness and alleviate aches. Heated blankets, compresses, baths, and hot water bottles can help keep certain parts of your body warm. Meditation and deep breathing may not seem like effective tools against arthritis, but these mindfulness activities can reduce tension in your body, including some of the tension that may be causing you pain. Guided meditations and progressive muscle relaxation can help you focus on specific parts of your body as you relax. Turmeric and lemon water are both touted for their anti-inflammatory properties, although few studies have quantified just how much these ingredients actually impact RA symptoms. Home remedies are not meant to replace official medical care. Make sure to ask your doctor about home remedies and any other treatments you are considering for your routine. Alternative Medicine Acupuncture is a popular form of alternative medicine that many patients use to cope with mild to moderate arthritis symptoms. The American College of Rheumatology has listed acupuncture as a “conditional recommendation” for osteoarthritis and RA. People may consider consulting their doctor about including acupuncture in their normal treatment plan. Researchers Pei-Chi Chou and Heng-Yi Chu say that arthritis is one of the most common conditions treated with acupuncture. They note that before 2010, around 41% of people with rheumatoid arthritis in Israel sought acupuncture. Acupuncture may releases endorphins, which are hormones that can reduce inflammation—including the inflammation that may make your joints sore or stiff. Some doctors may recommend that patients try cannabadiol (CBD ) oil to reduce tension in their bodies. In a 2019 medical study, researchers found that CBD helped promote more restful sleep, which can benefit RA patients who would otherwise wake up with pain or stiffness. Talk to your doctor or pharmacist before trying any new treatments. Like the home remedies listed above, these alternative medicines are meant to supplement, not replace, your current medications. Lifestyle Modifications When you are in pain, the last thing you may want to do is to exercise. However, a medical study from the Journal of Aging Research found that physically fit RA patients report fewer and less severe symptoms than do patients who do not exercise regularly. When maintaining a fitness routine, someone with rheumatoid arthritis may prioritize a low-impact activity to prevent further strain or pain. People with RA may consider the following: Yoga Walking Hiking Swimming Weight training Tai Chi Exercise is not a cure for RA, but the movement can keep your joints open and help increase your mobility over time. gilaxia / Getty Images When to See Your Doctor Rheumatoid arthritis is a chronic condition, so it's likely that your RA may change over time. You may need to adapt your treatment plan if your symptoms become worse. There are several indicators that your current treatment might not be working as effectively as it should. First, you might feel deeper or stronger pain. Second, your symptoms may prevent you from participating in your normal activities. You may not be able to walk, sleep, or move without bouts of stiffness or discomfort. Third, you may notice new symptoms like nodules. Perhaps you feel pain in different locations or you wonder if your arthritis is spreading, such as if your pain or stiffness began in your hands but you now feel similar soreness in your knees or back. If you notice any of the above changes, you should consult your doctor to determine the cause of your symptoms and to pursue treatments that may better fit your needs. A Word From Verywell Rheumatoid arthritis may make you feel isolated, especially if your joint pain prevents you from leaving your home or doing your normal activities; however, it is a very common condition. While there is not yet a cure for this disease, millions of people survive and thrive with rheumatoid arthritis. Talk to your doctor about how you can make a plan to cope with your RA pain. Was this page helpful? Thanks for your feedback! Dealing with chronic inflammation? An anti-inflammatory diet can help. Our free recipe guide shows you the best foods to fight inflammation. Get yours today! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Deane KD, Demoruelle MK, Kelmenson LB, Kuhn KA, Norris JM, Holers VM. Genetic and environmental risk factors for rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2017;31(1):3-18. doi:10.1016/j.berh.2017.08.003 Das S, Padhan P. An overview of the extraarticular involvement in rheumatoid arthritis and its management. J Pharmacol Pharmacother. 2017;8(3):81-86. doi:10.4103/jpp.JPP_194_16 American Osteopathic College of Dermatology. Rheumatoid nodules. Deall C and Majeed H. Effect of cold weather on the symptoms of arthritic disease: A review of the literature. J Gen Pract (Los Angel). 2016, 4:5. doi:10.4172/2329-9126.1000275 Yilmaz V, Umay E, Gündoğdu I, et al. Rheumatoid arthritis: Are psychological factors effective in disease flare? Eur J Rheumatol. 2017 Jun; 4(2): 127–132. doi:10.5152/eurjrheum.2017.16100 Arthritis Foundation. What triggers an arthritis flare? Wasserman AM. Diagnosis and management of rheumatoid arthritis. Am Fam Physician. 2011;84(11):1245-52. Ghosh S, Banerjee S, Sil PC. The beneficial role of curcumin on inflammation, diabetes and neurodegenerative disease: A recent update. Food Chem Toxicol. 2015;83:111-124. doi:10.1016/j.fct.2015.05.022 Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol. 2020;72(2):220-233. doi:10.1002/acr.24131 Chou PC, Chu HY. Clinical efficacy of acupuncture on rheumatoid arthritis and associated mechanisms: A systemic review. Evid Based Complement Alternat Med. 2018 Apr 12;2018:8596918. doi:10.1155/2018/8596918 Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in anxiety and sleep: A large case series. Perm J. 2019;23:18-041. doi:10.7812/TPP/18-041 Cooney JK, Law RJ, Matschke V, et al. Benefits of exercise in rheumatoid arthritis. J Aging Res. 2011;2011:681640. doi:10.4061/2011/681640 Additional Reading Aletaha D, Neogi T, Silman AJ, et al. 2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569-81. doi:10.1002/art.27584 Merola JF, Espinoza LR, Fleischmann R. Distinguishing rheumatoid arthritis from psoriatic arthritis. RMD Open. 2018;4(2):e000656. doi:10.1136/rmdopen-2018-000656 Ruffing V. and Bingham CO. Rheumatoid arthritis signs and symptoms. Johns Hopkins Arthritis Center.