Sometimes—and I’m not alone in this—the medications we’ve been prescribed for our rheumatoid disease simply don’t do much in the way of pain relief.
That is not to say that RA medications don’t work. They do. But while most of them reduce inflammation and even slow the progress of the disease down to a crawl, they don’t always erase the pain. They also don’t always address the fatigue or that draggy, all-over-ill feeling so characteristic of RA.
Even the big guns, the narcotic analgesics, aren’t always reliable against pain. Like RA itself, these drugs often affect each one of us differently. Some can’t tolerate them because of allergic reactions (common with codeine) or because we dislike the disorientation, the “high” and/or drowsiness they can cause. Or, if you’re like me, you’ve taken these potent painkillers for so many years that you’ve built up a rather formidable resistance to them. They still work, but not nearly as well as they once did.
So, as the old saying goes, what’s a girl (or guy) to do?
Fortunately, there are a lot of things we can do to soothe—if not eliminate—the symptoms of rheumatoid arthritis. Let’s start with the basics:
First, eata healthy, nutritious, balanced diet, one that helps you stay light on your feet (thus taking the stress of extra poundage off your weight-bearing joints) and helps your body function at its best. I always feel better when I’m eating meals that are high in protein and moderate or low in carbohydrates, with plenty of vegetables for their vitamins, minerals and fiber. I try to satisfy any sweets-cravings with fresh fruit instead of cookies.
Another basic: Get plenty of sleep. It’s hard to cope with pain and stiffness when you’re exhausted right out of the gate every morning. Make sure you stick to a sleep schedule—go to bed at about the same time every night, and get up at about the same time in the morning, even on weekends. Try for seven or eight hours each night.
Next up is exercise. Our bodies need to move. Everything works better when it’s kept strong and supple; exercise is the best key to that. It doesn’t have to be like boot-camp. Gentle movements like stretching and resistance exercises, including isometrics, go a long way toward helping us feel better.
Hot baths and cold/hot packs can be very soothing to painful joints. So can creams and lotions that mimic hot or cold sensations.
Assistive devices like jar openers and two-handled cookware, and mobility aids like canes, crutches and wheelchairs can help keep joint pain at bay or to a minimum.
I can hardly believe it, but I’m just three years shy of 60—an age I’ve always associated with grandmothers, polyester outfits in pastels and flower patterns, scented bath powder, support hose and thick, blocky, sensible shoes.
But I’m not a grandma, have no polyester in my wardrobe, no bath powder in my bathroom cabinet, and I’ve never worn support hose in my life. I guess there’s still time…
I do have thick, blocky, sensible shoes—but not because I’m elderly, but because I have rheumatoid disease and pretty, thin, narrow shoes with elevated heels cause me pain. I’ve been wearing ugly shoes since I was 31 years old. They look OK to me now.
When I turned 50 a friend said, “Hey, don’t worry! Fifty is the new 30.” I laughed. “Yeah, right.” Talk about a boomer cliché! We’re the Peter Pan generation. We’ll never grow up. I rolled my eyes and blew out the candles.
But now that I’m closing in on 60, I’m beginning to change my mind. If “50 is the new 30,” then isn’t 60 the new 40? Because while I didn’t feel a bit like I was 30 years old when I turned 50, I do feel about like I did when I turned 40.
Well, minus the active RA. When I was 40, my ol’ rheuma-dragon was dozing.
And that’s the point of this silly post. I don’t feel like I’m 57, even though my re-awakened rheumatoid arthritis often makes my joints feel stiff and achy, my daughter is now in her 30s and my husband has gone almost completely gray. No, I feel like the 40-ish woman who went backpacking in the Desolation Wilderness and hiked the California foothills back-country, photographing firefighters battling wildfires.
But most of all, I just feel like myself—the same self I was at 10, 20, 30, 40 and 50 years old, that same curious, knowledge-hungry child I’ve always been, still gazing at this wild, wonderful world from the same big blue eyes.
Rheumatoid arthritis is a serious disease. It’s called an autoimmune disease because its symptoms are brought about by the body’s defensive antibodies attacking its own tissues.
In RA, they attack the synovium, a fluid-filled capsule that surrounds the joints, causing inflammation and often, severe pain. As it destroys these tissues, RA may eventually cause joint deformation and disability.
But RA is also systemic. It affects the entire body, sometimes attacking organs like the heart and lungs, the eyes, other soft tissues such as the tendons and ligaments, and even the veins.
The good news is that it’s treatable. Modern medicine has developed several types of medications that, while they cannot cure this incurable disease, can slow its progress to a crawl and help to relieve pain and stiffness.
There are several simple lifestyle changes that can have a beneficial effect regarding rheumatoid arthritis as well. These include a healthy diet to keep body weight under control, stopping smoking and getting adequate, gentle exercise to build and maintain muscle mass in weight-bearing joints and to preserve range of motion.
In my previous post I wrote about the controversy over nightshade foods as to whether they cause increased disease activity. Now I’d like to talk about foods that can be beneficial.
First up is extra-virgin olive oil. It’s rich in oleic acid, an omega-9 fatty acid that keeps inflammation down. It doesn’t hurt that EVOO is also considered a “good” fat to use if you’re trying to keep your cholesterol levels under control. It also tastes really good.
Certain types of fish, like salmon, tuna or bass are also beneficial—they’re packed with omega-3 fatty acid. The anti-inflammatory activity of long-chain omega-3 fatty acids may be beneficial. These are also wise fish choices for healthy weight loss or maintenance.
Eat several servings of fruits and vegetables each day. Many of them have anti-inflammatory properties, and it doesn’t hurt that they’re generally low in calories and high in nutrition. Green tea can have an anti-inflammatory effect, too. It’s also been shown to reduce the risk of heart disease and cancer. Nuts and seeds like almonds, hazelnuts, sunflower seeds help to reduce inflammation and have the added benefit of providing healthy fats in your diet.
Herbs and spices flavor up food and help reduce inflammation, too. Ginger and turmeric are particularly good for that, and garlic is wonderful. Low-fat dairy foods are rich in bone-building calcium, which is vital in regards to RA. Whole-grain breads, brown rice and other products made with whole grains provide fiber and help to keep your blood-sugar (glycemic) level under control.
After being diagnosed with rheumatoid arthritis, one of the first “facts” I ran across was that I should avoid eating foods from the nightshade family. Although nightshade is a deadly poison derived from atrope belladonna, an inedible weed, its distant relatives just happen to be potatoes, tomatoes, eggplant and peppers. In some people, I read, they might trigger flares.
Of course I was devastated. Those are just about the only veggies I’ve ever liked, other than lettuce and green beans and corn. OK, and carrots. And maybe celery, once in a while.
Here’s the thing: I heart potatoes just about any way you can make ‘em: potato chips, mashed potatoes, spuds baked in their jackets. Fried potatoes—oh, my. Roasted taties—delectable! And there are so many, many dishes that include potatoes. How in the world could I ever cut such a humble but mighty food out of my diet?
And … tomatoes. Really?? What’s a tossed salad without tomatoes? Is a hamburger still a hamburger without a thick slice of beefsteak tomato tucked between the onion and melted cheese? You can eat a pizza without tomato-based pizza sauce, I guess (there are pizzas out there made with that white garlic sauce stuff, but they don’t really deserve the name). I prefer the traditional version, myself. And without the lovely tomato in all its many varieties, how can you eat spaghetti? Or chicken cacciatore? What would you dip your French fries in? There are entire categories of cuisine that wouldn’t exist without the humble tomato.
Then there’s eggplant—or aubergine, to you foodies out there. It’s an odd vegetable, I’ll admit that. It’s a rich, lovely purple, only vaguely resembles an egg, and it makes me giggle. But what would eggplant parmesan be without it? Just plain ol’ parmesan. Meh. What about ratatiouille, that fabulous French Provençal rat—I mean veggie dish—that was the subject of that delightful animated movie a few years back? And let’s not forget the surprisingly scrumptious Middle Eastern dish called babaganoush. Not only would we not get to say that really-fun-to-say word, but it wouldn’t even exist without eggplant.
Finally, there’s the pepper. Most Hungarian, Serbian, Italian, Chinese, Indian and Mexican dishes would be dull, bland and blah without peppers. I’m probably missing several countries that revere peppers in all their fiery grandeur, but you get my gist. What would we do—I mean, what would I do—without peppers to keep me on the straight and narrow?
So you can imagine that I was deeply, greatly, incredibly relieved to learn that I didn’t actually have to avoid eating potatoes, tomatoes, eggplants and peppers just because I had RA. There’s no hard scientific evidence that those veggies cause RA flares, or make it worse or whatever. It’s just a myth, repeated so often and by so many people that it has become a pseudo-fact.
Here’s the truth: “Nightshade” the weed (atrope belladonna), potatoes, tomatoes, eggplants and peppers are distant members of the same family, but it’s Solanaceae, not nightshade. And contrary to what alternative medicine/foods texts and websites may state, those veggies do not contain evil oxalic acid, which inhibits the absorption of calcium. Nor do they contain the toxic alkaloid compound called solanine, a defense mechanism found in some Solanaceae plants that protects them against natural threats such as insects.
What it all comes down to is this: If “nightshade” family foods seem to trigger a flare if you eat them, then don’t eat them. Same with cake and ice cream. If it makes you hurt, avoid it. When you eat foods that have wheat gluten in them, and you flare soon afterward, well, try not eating them and see if it helps.
The fact is that in most people, most foods have little if anything to do with their rheumatoid arthritis, unless they eat too much of it and become overweight, which can place more stress on weight-bearing joints. RA is, after all, an autoimmune disease. No one knows what triggers it or what triggers its characteristic inflammatory flares. The food we eat? The weather? Mitch McConnell? Maybe all of the above?
There are foods that have been proven to be anti-inflammatory, though, and they can be beneficial when it comes to RA. Click right here to read all about them.
Editor’s Note: I’m aware that some readers will heartily disagree with this post; the belief that vegetables in the Solanaceae family (and related to nightshade) trigger arthritic flares is pervasive. I did search for solid evidence regarding the phenomena. I found a few studies, but none produced any hard scientific evidence. That said: if you find that potatoes, tomatoes, peppers or eggplants seem to trigger painful osteoarthritis or RA flares, it is always your right to avoid eating them. I’d be the last person to blame you.
I thought I’d “slept wrong.” I’d wakened that morning with an inexplicably sore right shoulder. I hadn’t injured it—I’d done nothing that could possibly injure a shoulder, and it was fine when I went to bed the night before—so I figured I must have slept on it wrong for hours.
That was the only reason that my right shoulder could be so sore. (And it was pretty lame, as explanations go.) I had trouble washing my hair in the shower, trouble drying it and putting my makeup on, and trouble getting dressed. The shoulder hurt appallingly when I moved it. I could barely raise my arm above my waist.
To make matters worse, I was in a rush. I had to catch a train to Frankfurt, a six-hour, north-to-south ride down the middle of West Germany, something I’d never done before. To add insult to injury, I also had to carry a suitcase (the old kind with no wheels or extendible handles), a carry-on shoulder bag, and my purse. Under normal circumstances, lugging all that stuff would be a hassle, no more. But with my shoulder so sore that even walking made me wince … well, let’s just say I wasn’t looking forward to the experience.
And all because I’d “slept wrong.”
Over the next six months I somehow “slept wrong” on the other shoulder several times, too. I “slept wrong” on both my hands. I also somehow hurt both my knees without realizing it.
And then there was the long weekend in the Baltic harbor city of Lübeck, near the East German border, that was ruined by this strange pain. My husband and I drove northeast from Bremerhaven, headed for the old city near the sea. We arrived in the late afternoon and decided to do a little wandering before finding a restaurant for dinner (for which we’d dressed up a bit). We’d walked all of two blocks when my feet began to hurt. Within minutes, the right foot was so bad—and swollen—that I could barely put my weight down on it. The left foot simply ached sharply, as if I’d been standing on it all day. (I hadn’t been, of course. I’d been in the car, enjoying the north-German countryside.)
We went ahead and ate a fine meal at a magnificent, old restaurant, but I was in so much pain I didn’t enjoy it much. And the next morning, even though I’d rested all night and wore my good ol’, cushiony walking shoes, my feet still hurt so much that wandering the old city on foot was out of the question. We didn’t want to spend the weekend sitting in our hotel room, so we went back home. The pain vanished by the middle of the following day, just as quickly and mysteriously as it started.
I blamed the whole fiasco on a new pair of neat, pretty, low-heeled black patent leather pumps I’d purchased just for the trip. I swore I’d never, ever wear new shoes for walking again. Whatever had I been thinking of? What a silly goose!
A week later it happened again. As before, both feet were involved, but this time it was my left foot that was so horrendously painful—and I wasn’t wearing new shoes. I was completely mystified. And it sounds weird, but I finally associated this freaky foot pain with the freaky shoulder pain, the freaky hand pain, and the freaky knee pain I’d been plagued with, off and on, for six months.
I made a doctor appointment.
He agreed that something was going on. So, he wrapped my swollen left foot in an ace bandage, then got me a cane and showed me how to use it. He told me to take a couple of days off work, staying off my feet as much as I could, alternating ice packs and a heating pad. He prescribed Tylenol with codeine for the pain. (I’d already tried both aspirin and regular Tylenol, without relief.) Finally, he told me to go to the lab for a blood test and come back in three days for a follow-up appointment.
What he didn’t do was speculate.
When I saw him again, he had the answer. My blood test showed a high sedimentation rate, which indicated systemic inflammation. In addition, they’d found a protein antibody in my blood called the Rh factor. Both of those, along with my recent history of mystery pain and stiffness in various, symmetric joints, indicated that I had rheumatoid arthritis, an autoimmune disease.
The doctor asked if I had stiffness when I got up in the morning. Yes, now that I thought about it, I did—even when there was no significant pain. Most of the time the hot shower I took every morning helped to relieve it. By the time I got to work two hours later, it was usually gone. He nodded. That, too, pointed to RA.
And thus started my long, frequently rocky relationship with rheumatoid arthritis—my “rheuma-dragon,” as I call it. We’re still together today.
But in some ways, I’ve been lucky. I’ve rarely felt the crushing fatigue and “flu-like” illness and fever that many people with RA frequently experience. And in spite of our 25-year relationship, my rheuma-dragon hasn’t deformed my fingers and hands or destroyed any of my larger joints. (Not that he hasn’t tried!) My RA has never caused me to lose weight or become anemic, either. Instead, I’ve slowly gained weight over the years. That’s mainly because I’ve often been reluctant to exercise, afraid of triggering a flare.