Lupus Pain Management Options
Getting in and out of the car in one swift, graceful motion is what you would expect of a 20-year-old. It’s a time of great movement in one’s life, when the path ahead has more opportunity, mystery, and possibility than ever before.
Unfortunately, the movement I was focusing on was the short distance from the car seat to the pavement, the bottom of the porch steps to the door, or the achingly slow climb over the lip of the bathtub.
I was 20, but my body felt aged, worn, and weighted down by the arthritic pain that can come with a lupus diagnosis.
In the last 15 years, the physical pain and the resulting emotional stress I’ve experienced have taught me that managing chronic pain goes beyond addressing physical symptoms. As lupus patients, we also need to understand the emotional and psychological aspects of pain in order to take control and ownership of our lupus pain management.
What Is Pain?
The International Association for the Study of Pain (IASP) defines it as: “An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” This means that pain is subjective and depends on a person’s description.
For this reason, it is important for lupus patients to learn how to describe their pain to their rheumatologist. This will help ensure a more concise treatment plan.
Pain Diary: Describing Your Lupus Pain
Keeping a pain diary will strengthen your ability to articulate how your body is feeling and it will encourage habitual body awareness. According to Health.com, the “LOCATES” memory aid is a great way to structure your pain diary entries:
- L: Location of the pain and whether it travels to other body parts.
- O: Other associated symptoms such as nausea, numbness, or weakness.
- C: Character of the pain, whether it's throbbing, sharp, dull, or burning.
- A: Aggravating and alleviating factors. What makes the pain better or worse?
- T: Timing of the pain, how long it lasts, is it constant or intermittent?
- E: Environment where the pain occurs, for example, while working or at home.
- S: Severity of the pain. Use a 0-to-10 pain scale from no pain to worst ever.
Now that you’ve described your pain effectively, your rheumatologist can suggest different pain management options.
The following medications are most common in treating lupus. Each medication has a different way of targeting inflammation in the body, which is what causes most lupus-related pain.
- Non-steroidal anti-inflammatories (NSAIDs), such as naproxen, and ibuprofen
- Antimalarial medicines, such as hydroxychloroquine
- Corticosteroids, such as prednisone
- Immunosuppressants, such as azathioprine and cyclophosphamide
- Biologics, such as rituximab and abatacept
Taking medication when needed is an important part of your health plan, but it is in your interest to seek alternative therapies that will complement your medical treatment. This could help shorten how long a medication is taken, thus decreasing any resulting side effects that could occur with prolonged use.
The S.L.E Foundation states that massage increases pain-relieving endorphins (the feel-good hormones), and reduces inflammation and soreness. As a result, you will experience less of the exhaustion and physical pain of lupus.
If possible, seek out a licensed massage therapist who not only delivers excellent services, but with whom you also connect personally. I’ve been going to my massage therapist for the last 11 years and her care helped me decrease the pain I feel on a daily basis.
If you an uninsured, look up your local massage therapy schools. Most offer massages at low prices in order to provide students with hands-on experience during their studies.
Although it is unproven by science, many people have claimed that acupuncture for lupus has aided in alleviating pain. This traditional Chinese medicine involves an extremely thin needle, which is inserted into your skin at strategic points in your body as a way to re-balance your energy flow, and thus decreases pain.
A more Western interpretation is that the needles stimulate nerves, muscles, and connective tissue, which boosts your natural painkillers and increases blood flow. This treatment can be expensive, but if you have an insurance plan, it could be an option to explore.
An occupational therapist’s job is to help a person with physical or mental illness regain control over their lives through the performance of activities required in daily life. Since lupus can prevent us from doing some of the simplest of daily tasks, an occupational therapist has valuable insight into what we can do to make our lives easier in the midst of pain management.
An occupational therapist is able to provide aids and appliances like long-handled shoehorns, adjustable tables, dressing aids, toilet aids, support rails, etc. OTs can also assist in work and home adaptations and the fitting of mobility aids like walkers, wheelchairs, perching stools, and sprung cushions.