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DECREASING PAIN DURING RHEUMATOID ARTHRITIS (RA): DEFINING AND ASSESSING YOUR PROBLEM  Once you have accepted the presence of pain in your life and taken responsibility for your unique experience of it, how can you begin to control it? You can select the following:Define and assess your problem To use this coping tool, think about what is causing your pain. Trace your daily activities to determine whether some specific activity may be aggravating your unusually painful joints. If you identify such an activity, plan ahead to modify it in the future. The following examples may help you to find the cause of your pain and develop methods to alleviate and control it.1. Pain in the morning. Morning stiffness and pain are usually related to inflammation. Setting your alarm clock to go off one hour before you need to get out of bed can help. Keep your medications at bedside, and take them then. An electric blanket can be useful in warming up the bed and your joints. Perform your gentle range of motion exercises in bed to loosen up your joints before getting up.After you have risen, go directly from bed to a warm shower or bath (maybe someone else can draw the bath ahead of time). In other words, ease into morning slowly, and give your joints ample time to loosen up.2.   Pain after sitting (called gelling). This pain is also caused by inflammation in the joints. Gelling can usually be alleviated by taking frequent stretch breaks during prolonged stationary periods.3.   Pain after exercise. If pain persists for more than two hours after exercising, you have overextended yourself. Analyze your exercise – distance walked, number of repetitions done, footwear worn, etc. – and review your exercise program with your doctor or therapist.4.   Pain with specific activities. Some examples: twisting lids, getting into the shower, styling your hair, bending down to pick things up, carrying objects, making love. All of these activities can be modified to limit joint stress. The general approach here is to analyze painful activities, either by taking mental notes or keeping a diary, and then modify them.*42/209/5*

Arthritis is an inflammation of any joint or joints. Arthritis most often affects joints in the fingers, toes, wrists, ankles, elbows, knees, shoulders, hips, jaw, and spine. Six types of arthritis are common to childhood: rheumatoid arthritis; acute rheumatic fever; infectious arthritis; allergic arthritis; arthritis following a viral infection; and arthritis of rubella.

Rheumatoid arthritis can occur at any age past one year old. So far the cause is unknown. It may affect one or several joints. The joints become swollen, warm, stiff, and mildly to moderately painful, but not usually red. The neck is affected in 50 percent of the cases. Arthritis may appear months before or after other signs of illness, such as fever, irritability, loss of appetite, and a fine pink rash.

Arthritis associated with acute rheumatic fever, usually affects many joints, which become red, swollen, and extremely tender. Other symptoms of general illness (including fever) are also present.

Infectious (purulent) arthritis is an inflammation within a joint caused by various bacterial diseases (including staphylococcal, streptococcal, pneumococcal, and salmonella infections). This type of arthritis most often occurs in infants less than one year old. In older children and adults, it can be caused by puncture wounds near the joints. In this type of arthritis, the joint is tender, swollen, and red. The child usually has a fever.

In allergic arthritis the joints are stiff, swollen, and red, but pain is slight. The disease is caused by an allergic reaction to insect stings, medications, foods, or small particles inhaled from the air. It is generally accompanied by hives.

Post-viral arthritis occurs after an illness caused by a virus. The symptoms are similar to those from other causes of arthritis, especially rheumatoid arthritis. Post-viral arthritis corrects itself without treatment.

Arthritis of rubella occurs as a complication of German measles (rubella) or as a reaction to a rubella vaccine, especially in older children. Arthritis of rubella usually corrects itself without treatment and usually causes no permanent damage.

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