Rheumatoid arthritis (RA) most commonly affects peripheral joints such as those in your hands, wrists, feet, elbows, ankles, and hips. People with this immune disorder often also experience back pain.
If you have RA, back pain can result from your body’s immune system attacking the synovial lining of the small joints of your spine. In advanced cases, this can even lead to compression of the spinal cord and nerve roots. When this happens, you can experience moderate to severe pain.
Keep reading to learn about short-term treatments for back pain and long-term back pain management steps.
Back pain: acute vs. chronic
Before looking at treatments for your back pain, you’ll need to know if you have acute or chronic back pain.
Acute back pain is usually a result of straining your back. It can be treated with medication and usually will get better over time. Exercise isn’t recommended.
Chronic back pain is different. It’s a long-term problem caused by conditions like RA. It can be treated in a number of ways, and exercise can be beneficial.
Hot and cold packs can’t treat the underlying causes of back pain, but they can help to reduce the pain and stiffness you feel during a flare-up.
Use a heat pack to help improve blood flow and reduce muscle spasms. It can also help make your pain more manageable.
Use a cold pack to help reduce RA inflammation. Cold packs may feel uncomfortable at first, but they can numb pain.
Medication can be an effective way of controlling chronic back pain. The type of medication you’ll need depends on how severe the pain is and how often you experience it.
A variety of medications can alleviate pain and even slow the progression of RA:
Managing your pain is an important part of learning to live with a chronic back problem. Analgesics, or painkillers, are one way of easing back pain. Over-the-counter drugs like aspirin may be enough to manage mild pain.
Your doctor can prescribe stronger medications for pain relief, if you need it. However, narcotic medications like oxycodone (Roxycodone, Oxaydo) should be used cautiously for chronic diseases to avoid the risk of dependency. There are other medications that can treat both your pain as well as the underlying inflammation.
Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs (NSAIDs) can soothe pain and inflammation. Anti-inflammatory treatments are helpful because they reduce swelling. This eases pressure on your back and helps make movement easier.
Ibuprofen (Advil, Motrin IB) and naproxen (EC-Naprosyn) are two NSAIDs that are often prescribed. NSAIDs may cause side effects, such as stomach bleeding. Your doctor will be able to help you decide if NSAIDs are right for you based on your medical history.
Disease-modifying antirheumatic drugs
Disease-modifying antirheumatic drugs (DMARDs) are prescribed to help soothe pain and slow the progression of RA. They can help stop future pain flare-ups. A commonly prescribed DMARD is methotrexate.
DMARDs work by blocking chemicals that are released when antibodies attack joint tissue. This prevents further damage to your bones and cartilage.
DMARDs can cause many side effects, such as:
- skin rashes
- liver damage
- abnormal white blood cell counts, leading to infection
Your doctor can help you manage these side effects if they occur.
A spinal injection can be a quick way to relieve chronic back pain. It usually means injecting a corticosteroid or anesthetic into the nerve region that’s being affected by RA inflammation.
The effects of a spinal injection can last for weeks or even months. Corticosteroids may cause other health problems like weight gain and osteoporosis. For this reason, your doctor may suggest you wait several months for your next injection.
Surgery is usually a last resort for back pain treatment. Still, it can be very effective in helping to ease chronic back pain.
For example, your doctor may recommend a “fusion” procedure: This involves cutting out the diseased joint and bonding the vertebrae together, decreasing mobility. In some cases, this will alleviate the pain in that area.
Realigning and stabilizing your spine to ease pressure on your spine’s nerves is another approach. This can lessen pain and even improve mobility.
A range of therapies can help support your back pain treatment. For instance, physiotherapy could improve your flexibility and muscle strength.
Occupational therapy might also be useful. This kind of therapy teaches you joint protection strategies. An example might be how to pick up and carry objects without causing back pain.
Chiropractic therapy usually isn’t recommended for people with RA who are experiencing back pain.
Appropriate exercise can help take pressure off of your back and keep joints supple if you’re experiencing chronic back pain due to RA. Exercise also helps maintain overall body health.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases recommends exercises like walking and stretching to help ward off back pain. Activities like tai chi and water-based exercises like swimming or water aerobics also can be helpful.
Always consult a doctor before starting any fitness program for your back pain.