Get to the root of your chronic pain to find long-lasting relief.
As we age, aches and pains go from making the occasional guest appearance to being center stage (complete with marquee sign). And when pain strikes, most of us head to the medicine cabinet without looking into what’s causing it—we, understandably, just want it to go away.
But, contrary to popular belief, pain isn’t the enemy: Think of it as the oil light on your body’s dashboard. “The old medical paradigm has been to attempt to disable the oil light to block the pain,” says Dr Jacob Teitelbaum. “Unfortunately, this approach hasn’t been very effective, with roughly one-third of people suffering with pain issues.”
Now, becoming pain-free is all about giving the body what it’s (desperately) telling us that it needs—the problem is, our bodies don’t come with an owner’s manual to tell us exactly what each kind of pain means, nor the other symptoms that might accompany it.
Clearly defining the pain you’re experiencing is an important step to finding long-lasting relief. Take our pain quiz below to learn more about the hints your body’s dropping and what they might mean:
1. Where is your pain located?
A. Predominantly in my joints (hands, knees, hips, neck, lower back, etc.)
B. Predominantly in my joints, and the pain is symmetrical—affects the same joints on both hands, knees, hips, etc.
C. My hands (especially the first three digits), wrists, and forearms
D. Everywhere—both sides of my body, above and below the waist
2. When is your pain typically at its worst?
A. At night
B. First thing in the morning (for an hour or more)
C. After repetitive use
D. After waking or staying in one position for too long
3. Which of the following best describes your pain?
A. Achy, sore and stiff joints that are sometimes tender to the touch
B. Throbbing, tender joints that are frequently accompanied by redness and swelling
C. Burning, tingling wrists and forearms that are sometimes accompanied by numbness or electric shooting sensations
D. A persistent, dull ache that’s often accompanied by muscle twitches and stabbing pain—muscles also tend to feel overworked or pulled
4. Which statement most accurately describes the frequency of your symptoms?
A. The pain came on slowly—usually, after physical work or exercise—then gradually became more persistent.
B. I’ve had fluctuating symptoms for years—relatively mild joint pain punctuated by painful flareups that seem to come and go as they please.
C. The pain in my hands seems to come and go based on usage, and is gradually increasing in both intensity and frequency.
D. I’ve been experiencing widespread pain for three months or more.
5. The pain affects my…
A. Range of motion, especially after excess use
B. Ability to function on a basic level (walking, running, bending, using my hands)
C. Ability to hold onto objects or feel the difference between hot and cold
D. Ability to concentrate, remember things and get a good night’s sleep
6. I also experience…
A. Cracking sounds when I move the affected joint, tenderness to the touch
B. Weakness in the joint, fevers, fatigue, loss of energy
C. Temperature changes in my fingers or hands, muscle weakness at the base of my thumb
D. Headaches, brain fog, extreme fatigue, depression, anxiety, insomnia
7. Which of the following tends to relieve the pain?
A. Resting the joints, especially overnight
B. Warming up and stretching the joints
C. Shaking out and flexing my hands
D. Exercising as able and getting a good night’s sleep
8. Do you have any of the following?
A. A job or hobby that requires consistent use of your sore joint or a past injury at the site of your current joint pain
B. Depression, anxiety, feelings of helplessness, low self-esteem
C. A job or hobby that requires repetitive hand motions or hand pain that wakes you up at night
D. Another chronic pain condition, such as chronic fatigue, IBS, interstitial cystitis, temporomandibular joint dysfunction, vulvodynia or endometriosis
Mostly As: You Might Have Osteoarthritis
Osteoarthritis is the most common form of arthritis, and typically strikes in the hands, knees, hips and spine. It causes cartilage (the tissue that covers the ends of bones in a joint) to break down and the bones underneath to rub against each other.
“Although most patients present with joint pain and functional limitations, the age of disease onset, sequence of joint involvement, and disease progression varies from person to person,” says Dr Niket Sonpal. Osteoarthritis is most common in older people, but it can affect younger people, too (especially in joints that have been injured).
Osteoarthritis is treated with a combination of pain relievers, physical therapy and exercise. For mild to moderate pain, OTC pain relievers (think: Panadol, Advil) might do the trick. If the pain is affecting your day-to-day, stronger pain relievers are available by prescription.
Exercising and achieving a healthy weight are paramount in improving function: Strengthening exercises help with, well, strengthening the muscles that support your affected joints, and range-of-motion exercises will help keep your joints limber. Meanwhile, weight loss can reduce stress on weight-bearing joints and limit further damage.
Your doctor may also prescribe topical pain-relieving creams or rubs to be applied over the joints that are giving you ‘tude. “Your doctor will follow along with your progress and tailor your care to the type of joint affected and how badly it’s damaged,” says Sonpal.
Mostly Bs: You Might Have Rheumatoid Arthritis
“Rheumatoid arthritis is an autoimmune disease in which the body’s own immune system attacks the body’s joints,” says gastroenterologist Dr Partha Nandi. It typically attacks the same joints on both sides of the body, and is accompanied by swelling and redness. Unlike osteoarthritis, rheumatoid arthritis gets better as the joint gets used—hence why the pain can be super-excruciating first thing in the AM.
The severity of rheumatoid arthritis exists on a sliding scale, varying from person to person. For some, periods of mild pain are punctuated by flareups of more severe pain; for others, the symptoms are constant; others still may also experience fevers, fatigue and a loss of energy.
The earlier you can score a diagnosis from your doctor, the better. Staying ahead of the curve can help quash rheumatoid arthritis disease activity and prevent later damage, such as joint loss and breakdown, says Dr Niket Sonpal. Doctors use a combination of treatment approaches—primarily, medications to suppress the autoimmune process that’s attacking your joints, and health modifications based on the severity of your pain and current lifestyle.
Diet can play a major role in inflammatory arthritis, says Teitelbaum, and while there isn’t a specific diet linked to improving arthritis symptoms, experts have identified certain foods that can help control inflammation. Many of these foods can be found in the Mediterranean Diet, according to the Arthritis Foundation.
Other important health behaviour changes for people with rheumatoid arthritis include rest, exercise and stress reduction—more rest during flareups, and more exercise during remissions. Rest helps to reduce active joint inflammation and the pain that comes with it, while exercise helps maintain strong muscles and preserve joint mobility and flexibility. Meanwhile, stress reduction helps combat the emotional challenges that can come with having rheumatoid arthritis, and may even affect the amount of pain you feel.
Mostly Cs: You Might Have Carpal Tunnel Syndrome
Carpal tunnel syndrome strikes when the median nerve—the nerve that runs from the forearm into the palm of the hand—becomes compressed, typically from overuse, says Dr Niket Sonpal. The result? Burning, tingling and numbness in the fingers or hands after repetitive movements (say, typing or biking). You may also experience electric shooting sensations and weakness in the muscle at the base of the thumb.
Carpal tunnel syndrome is diagnosed through physical examination, and treatment should begin as early as possible for optimal pain relief. If diagnosed early, there are plenty of nonsurgical options available.
The condition can be triggered by other health issues, such as low thyroid, diabetes, arthritis, fibromyalgia or a vitamin B6 deficiency, so start by treating any underlying causes first, says Teitelbaum. If caused by a straight-up repetitive stress injury, start by taking frequent breaks to rest your hands, avoiding activities that worsen your symptoms, and wearing a splint during activities that stress out your wrists. Splinting it up while you’re sleeping can also help relieve any nighttime tingling and numbness you might experience.
Your doctor may offer you corticosteroid injections, which decrease inflammation and swelling, relieving the pressure on the median nerve. Yoga poses that give the upper body and joints a workout may help reduce pain and improve grip strength, and certain physical therapy techniques may also send your symptoms packing. Your doctor can hook you up with a strategy that works best for you.
Mostly Ds: You Might Have Fibromyalgia
“Fibromyalgia is a common cause of chronic pain and the most common cause of generalised, musculoskeletal pain in women between the ages of 20 and 55 years,” says Dr Niket Sonpal. The condition involves widespread pain, tenderness, fatigue and insomnia, along with other symptoms like headaches, brain fog, painful periods, morning stiffness and temperature sensitivity. “The manifestations are very individual and vary greatly from person to person,” says Sonpal.
A person with fibromyalgia, for example, may have two or more coexisting chronic pain conditions—chronic fatigue, IBS, endometriosis, to name a few—though it’s unclear whether these disorders share a common thread. It’s also associated with depression, anxiety and PTSD, and may be a physical manifestation of these conditions.
Since it’s unclear what, exactly, causes fibromyalgia, and not all doctors are familiar with the condition, the first step is to find a physician who is. Because there’s no diagnostic test for it, doctors diagnose fibromyalgia through a combination of physical exam, symptom evaluation, and ruling out other conditions.
Fibromyalgia is one of the trickiest conditions to treat, as there’s no universally accepted treatment or cure. Things like getting enough sleep, noshing on healthy foods, exercising regularly, and making changes at work can all help minimise the impact fibromyalgia has on your life. Many people have found complementary and alternative therapies that work for their particular symptoms as well, including massage, yoga, acupuncture and chiropractic treatments.
First published: 23 Sep 2017