Pain Management for Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune condition that affects far more than just the joints. The immune system mistakenly attacks the lining of the joints, leading to swelling, pain, stiffness, and eventually structural damage if not properly managed. Because RA is systemic, it can influence tendons, ligaments, muscles, and even organs—making early, comprehensive care essential.

The pain associated with RA can affect every aspect of daily life. Simple activities like gripping a cup, walking across the room, or getting out of bed may become difficult during flares. The ongoing struggle with pain can also impact mood, energy, independence, and confidence. Over time, unmanaged inflammation may lead to joint deformity and long-term functional limitations.

At Medici Orthopaedics & Spine, our mission is to support patients with RA through a least invasive, least drug-dependent, highly personalized approach. While rheumatologists focus on controlling the disease process with systemic medications, our team specializes in targeted pain management strategies that help preserve mobility, reduce discomfort, and restore quality of life.

Interventional Pain Management for RA

Targeted Joint Injections

Joint injections provide both diagnostic insight and therapeutic relief for RA-related inflammation.

Corticosteroid injections for inflamed RA joints (e.g., knees, shoulders, wrists):

  • Deliver powerful anti-inflammatory medicine directly into affected joints.
  • Helpful for reducing swelling and restoring ease of movement.

Goals: reduce inflammation, ease pain, improve function:

  • Often reduce discomfort for weeks to months.
  • May help patients more fully participate in physical therapy.

Frequency limits and safety considerations:

  • Injections are spaced out to avoid overexposure to steroids.
  • Your provider will determine safe timing based on joint health and overall treatment goals.

Image-Guided Injections for Precision

Using imaging ensures that medications are delivered exactly where they are needed.

Ultrasound or fluoroscopy guidance:

  • Provides real-time visualization of the joint or soft tissues.
  • Helps navigate complex or swollen joints safely.

Benefits of accurate placement and reduced risk:

  • Maximizes effectiveness of the injection.
  • Minimizes discomfort and procedural risks.

How image guidance improves pain relief outcomes:

  • More precise treatment leads to more predictable relief.
  • Especially valuable for small joints affected by RA, such as wrists or ankles.

Nerve Blocks and Ablation Techniques

Sometimes RA pain becomes nerve-driven, especially when inflammation irritates sensory pathways.

When RA pain has a strong nerve-related component:

  • Shooting, burning, or radiating pain may indicate nerve involvement.

Use of nerve blocks to localize pain sources:

  • Temporary numbing injections can pinpoint which nerves are contributing to pain.
  • Useful for creating targeted treatment plans.

Radiofrequency ablation (RFA) to “turn down” chronic pain signals:

  • RFA gently disrupts nerve pathways that send persistent pain messages.
  • Can provide relief for months at a time in selected cases.

Spine-Focused Interventions

RA may also affect the spine or sacroiliac joints, creating additional sources of discomfort.

Managing RA-related neck, back, or sacroiliac joint pain:

  • Cervical spine involvement is common in long-standing RA.
  • Lower back and pelvic pain may develop due to joint changes or compensatory movement patterns.

Facet joint injections, epidural steroid injections, or sacroiliac joint injections as appropriate:

  • Reduce inflammation in the joints or tissues surrounding the spine.
  • Help patients remain mobile and engaged in daily activities.

Physical Therapy & Rehabilitation for Rheumatoid Arthritis

Role of Physical Therapy in RA Pain Management

A skilled therapist helps patients maintain function even during flares.

Maintaining joint mobility and preventing contractures:

  • Gentle motion helps preserve joint flexibility and reduce stiffness.
  • Prevents tightening of tissues that can limit movement.

Improving strength and endurance despite chronic disease:

  • Tailored strengthening supports joint stability.
  • Gradual conditioning helps patients stay active without overexertion.

Individualized Exercise Programs

Exercise must be personalized for each patient’s tolerance, symptoms, and disease stage.

Gentle range-of-motion and stretching routines:

  • Keep joints flexible.
  • Reduce morning stiffness and ease daily activities.

Low-impact strengthening for major muscle groups:

  • Examples include light resistance training, aquatic therapy, or cycling.
  • Supports joints without causing strain.

Activity pacing strategies to avoid overuse and flare-ups:

  • Balancing activity with rest helps prevent symptom escalation.
  • Therapists teach patients how to recognize early flare signs.

Balance, Gait, and Fall-Prevention Training

RA can affect stability due to joint pain, deformity, or muscle weakness.

Addressing instability from painful joints or deformities:

  • Therapists evaluate gait patterns and correct unsafe movement habits.
  • Training improves safety and confidence.

Assistive devices (canes, walkers, splints) when needed:

  • Help redistribute weight and reduce joint stress.
  • Improve independence while preventing injury.

Home Exercise Plans

Home routines support ongoing progress between visits.

Simple, sustainable routines to practice between visits:

  • Maintain flexibility and strength.
  • Can be modified during flare periods.

Education on how to adjust exercises during flares:

  • Ensures patients move safely and protect vulnerable joints.
  • Reinforces long-term self-management strategies.

Hands-On & Supportive Therapies

Myofascial Release & Sports Massage Therapy

Massage and soft-tissue techniques can help reduce muscle tension and improve comfort around inflamed joints.

Reducing muscle tension around painful joints:

  • Chronic inflammation causes nearby muscles to tighten in protection.
  • Myofascial release gently loosens stiff tissues, improving circulation and mobility.

Addressing compensatory tightness from altered movement patterns:

  • RA often forces the body to move differently to avoid pain.
  • Targeted massage therapy helps correct these imbalances and reduces secondary discomfort.

Joint Protection Techniques

Supporting fragile or inflamed joints can reduce stress, prevent further irritation, and allow patients to stay active with less pain.

Splinting and bracing for fragile or overused joints:

  • Useful for wrists, hands, ankles, and knees during periods of increased inflammation.
  • Helps stabilize joints and improve alignment during activity.

Using adaptive tools for hands, wrists, knees, and ankles:

  • Ergonomic tools reduce the force needed for gripping, lifting, or turning.
  • Simple modifications can dramatically reduce daily joint strain.

Heat and Cold Therapy

Temperature-based therapies are easy, accessible ways to manage symptoms at home.

When to use warm packs vs. cold packs:

  • Heat: Eases stiffness and relaxes tight muscles, especially in the morning.
  • Cold: Helps reduce swelling and calm inflamed joints during flares.

Safe application guidelines at home:

  • Apply for 15–20 minutes at a time.
  • Always use a barrier (like a towel) between skin and the heat/cold source.
  • Avoid extreme temperatures to prevent burns or skin irritation.

Occupational & Functional Strategies

Simple changes to daily routines can significantly reduce pain and protect vulnerable joints.

Task modification to reduce strain (cooking, cleaning, typing):

  • Using two hands instead of one
  • Sitting instead of standing for longer tasks
  • Organizing frequently used items within easy reach

Energy conservation and rest breaks built into the day:

  • Scheduling short breaks before fatigue sets in
  • Alternating heavy tasks with lighter ones
  • Prioritizing what truly needs to get done during flares

Regenerative & Advanced Modalities 

Regenerative Medicine Considerations

Regenerative therapies are not designed to treat the autoimmune cause of RA, but they may help support tissues affected by chronic inflammation.

Potential role for certain soft-tissue issues associated with RA:

  • Chronic tendon irritation
  • Ligament strain from joint instability
  • Persistent soft-tissue pain despite standard care

How these options are evaluated on a case-by-case basis:

  • Considered only when safe and appropriate for the individual
  • Used as part of a broader treatment strategy, not a replacement for RA disease control

Hyperbaric Oxygen Therapy (HBOT)

HBOT may support overall tissue recovery and wellness for some patients.

Potential benefits for tissue health and healing support:

  • Enhances oxygen delivery to inflamed or healing tissues
  • Supports recovery in chronically irritated soft tissues

Use as an adjunct, not a standalone treatment:

  • Most effective when paired with physical therapy, medication, or regenerative options
  • Not intended to replace rheumatologic therapies

Integrative Pain Management Approaches

RA affects more than the joints—it influences energy levels, sleep quality, stress, and mental wellbeing. Integrative strategies can help patients feel more in control.

Mind-body strategies (relaxation breathing, mindfulness, stress reduction):

  • Help reduce muscle tension and pain sensitivity
  • Support emotional regulation during flares

Sleep hygiene support, given RA’s impact on rest and recovery:

  • Creating wind-down routines
  • Optimizing sleep environments
  • Addressing nighttime pain that disrupts rest

Take the Next Step Toward Calmer, More Manageable RA Pain

Living with rheumatoid arthritis pain can feel overwhelming, but it doesn’t have to define your everyday life. With the right combination of care, support, and thoughtfully chosen therapies, RA pain can often be managed more effectively than many patients realize. At Medici Orthopaedics & Spine, we’re committed to walking alongside you every step of the way—offering compassionate, long-term partnership for those navigating chronic autoimmune pain.

If RA symptoms are beginning to limit your mobility, independence, or joy in daily activities, now is the time to seek professional support. Early, coordinated pain management can make a meaningful difference in preserving joint function and restoring your confidence in movement. We’re here to help you feel more comfortable, more capable, and more in control of your health.

Contact Medici Orthopaedics & Spine Today

Main Line: +1-844-328-4624
Website: https://www.mediciortho.com/

Clinic Locations:

  • Kennesaw
    2911 George Busbee Parkway, Suite 50
    Kennesaw, GA 30144
    (770) 545-6404
  • Snellville Clinic
    2220 Wisteria Drive, Unit 101
    Snellville, GA 30078
    (470) 645-9297
  • Buckhead PM&R
    3200 Downwood Circle, NW, Suite 520
    Atlanta, GA 30327
    (770) 872-7549

Ambulatory Surgery Centers:

  • Marietta ASC
    792 Church Street, Unit 101
    Marietta, GA 30060
    (470) 795-8398
  • Snellville ASC
    2220 Wisteria Dr, Unit 100
    Snellville, GA 30078
    (470) 795-8398

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