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If you have rheumatoid arthritis, you might worry about how you will cope with the pain in your joints. It's true that rheumatoid arthritis is a painful condition, but there are ways that you can control your pain.

Pain is a warning sign that your body is being damaged in some way. There are two types of pain.

• Acute pain: This pain is temporary, like what you feel after you fall over. It lasts until your body has healed itself.
• Chronic pain: This is the type of pain in rheumatoid arthritis. It can range from from mild to severe and can last weeks, months or years.

Everyone gets different amounts of pain in rheumatoid arthritis. How much pain you get seems to depend a lot on how bad your disease is. Also, everyone copes differently with pain. Some people find it hard to handle any degree of pain, while others are able to put up with a lot of pain.

How the body controls pain is a complex process. Doctors think that our level of stress and our emotions affect how much pain we feel.¹ When pain lasts a long time, it can make you feel stressed and depressed. It is easy to be caught in a cycle of pain, stress and depression. But there are ways you can cope with pain and stop it from controlling you.

There is no one single way to treat pain. What works for one person may not work for another. Doctors often recommend drug treatments to control the pain and swelling of rheumatoid arthritis. Drug treatments can also help to keep your joints from wearing down.

But there are other ways to control pain, too. The following treatments may help.

Some people find that a warm bath or shower helps. Others say that an ice pack (or a bag of frozen vegetables) wrapped in a towel and put on the swollen joint helps to reduce swelling and stop pain.²

Doctors call this transcutaneous electrical nerve stimulation or TENS for short. You use a small device that sends mild electrical impulses to the nerves under your skin. TENS seems to help some people by blocking the pain messages that are sent from the painful joint to the brain.

You might think that exercise is bad for rheumatoid arthritis. But studies show that exercise that does not stress the joints, like swimming, can reduce your joint pain and stiffness.²

Many people are interested in ways of treating their pain beyond what their doctor may offer. Some people try herbal remedies. Other people try acupuncture (this is where fine needles are put under your skin).

There is not much research to prove that these remedies work. It is important that you tell your doctor if you are going to try any type of alternative therapy. That way, your doctor can make sure it fits with your treatment plan and doesn't cause problems.

Some people with rheumatoid arthritis have pain for many years. When you have pain for that long, it is easy to become stressed or even depressed. Coping with long-term pain is now a special branch of medicine, and there are many therapies that can help.

Here are some examples. Your doctor or support group will be able to tell you where to go for these treatments.

Studies show that certain exercise programs can reduce pain and swelling in joints. A physical therapist can show you special stretching and strengthening routines that can help your joints.²

With a therapist's help, you can learn ways to relax, like deep breathing and meditation, and different ways of thinking about the emotions pain can cause. Studies show that these techniques help to reduce the amount of pain people feel and help them cope better with their pain.³

People with rheumatoid arthritis tend to suffer from depression more than people without the condition.⁴ This may be because they worry about how they will cope if the disease leaves them unable to work or do everyday things, like getting dressed. See our section on depression to learn about what treatments are helpful for this condition.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.