How to treat hands/wrists pain due to Rheumatoid Arthritis (RA)?

My wife has RA and has for many years. She uses compression gloves and CBD.

I also gave her an article on a new RA treatment approved by the FDA in August or September from Setpoint Medical. It essentially is a small device implant on the Vega nerve that sends a daily electrical signal down that path which impacts inflammation. The randomized trial showed at least a 20% improvement in Joint inflammation. She will be talking to her doctors about it.
https://setpointmedical.com/

@bens1 Please keep us posted. We have a current discussion asking whether anyone has tried it. Since my RA is "dispersed" and affects more than one part of my body, I will ask my rheumatologist about it at my next appointment.
So far, it appears use will be limited to people who have failed both DMARD and Biologic drug treatments, so I probably won't qualify. But my daughter is on her third biologic, so she might qualify.

I've just had a meeting with my Rheumy who has, at my request, rerun my blood tests and agreed that I'm largely in remission. CRP in October was 2.4, I'll update when I get the new lot soon.

I'm on no prescribed meds, I couldn't take a HCQ and I'm not prepared to risk lowering my immune system possibly catching every bug going, and damaging my gut lining, to prevent what for me is only occasional, if excruciating, pain.

I'm palindromic, meaning that episodes go after 24-48 hours, leaving very limited damage.

I take 4 supplements all properly tested again RA inflammation, but they also have osteo benefits.

MSM 2 x 2g
Liquorice root 2 x 1g
Curcumin (not turmeric, pure curcumin) 2 x 500mg
Cats claw 1 x 1g standardised 1.5% alkaloids

My hands and wrists are riddled with osteoarthritis. I flex all my joints constantly through the day, it's become second nature. Any joint that sticks I force through the maximum range I can make it do, by using my other hand.

Very interested. I have been on Enbrel for a couple years which gave me complete remission from RA. But I recently had sinus surgery, got an enormous infection and had to stop Enbrel. Now I am suffering. Hands and wrists very painful. If there is something else available that has no affect on infections, I am interested.

or doesnt affect the eyesight?

@tisme Hello, I have BE and MAC under control with no meds. Due to lung diseases, Doctors started with Sulfasalasine, added hydroxychloroquine, although I am blind in one eye, so far so good. Still nervous about eyes but pain lower. Also small dose 1.5 once a day of prednisone. Hands still sore but knees, ankles doable. Hope this helps.

@playadelcarmen I'm very glad for you. Congratulations and happy days.

@phxbarb I am known to weap my wrists and hands in lidocaine patches. Helps some but along with paine in wrist I feel like hole in wrist, bones forearms feel broken andvthere are deposits of some sort between bones and on backs if my hands which and rheumatologust says is RA. Anyone else hear this ir do this? Dr mived too far away. Need new one who knows what to do.

@jimiwho I understand. My hands and wrists are almost useless with RA. I have a miracle drug (Enbrel) which cures this for me. I inject it every 10 days and the pain is gone. Unfortunately I have an infection now and had to d/c the Enbrel. I cannot start it again until the infection is gone. Maybe Enbrel would help you? But you need an RA doctor who would prescribe for you. Good luck to you.

I was diagnosed with seronegative RA 3.5 years ago, and it primarily affects my hands. I’ve got two small kids, so I’ve chosen a pretty aggressive course of treatment to manage symptoms, maintain mobility, and prevent long term damage. It’s my understanding that beginning therapies sooner than later is ideal to keep your joints in good shape for as long as possible.

I initially was started on hydroxychloroquine, which I tolerated well and was effective at managing mild flares for about 2.5yrs. I utilized occasional rounds of prednisone for particularly stubborn flares, as well as cortisone injections for a couple unresponsive joints. I also saw an acupuncturist regularly (which I highly recommend), and deployed ibuprofen strategically.

I also started seeing hand OT, which was very useful - I strongly recommend getting set up with an OT who works specifically with hands and is knowledgeable about inflammatory arthritis because the exercises and management are different than for osteoarthritis. I’d suggest making “acute care”, “recovery”, and “management” plans with the hand therapist. I have an arsenal of splints, exercises, gadgets, and tricks they’ve given me that are all useful depending on the circumstance.

My RA has worsened somewhat in the last year, so I’ve changed up my meds but I still utilize cortisone injections as well as acupuncture, hydrotherapy, and compression gloves or sleeves for individual fingers or the whole hand. I also follow an anti inflammatory diet and try to be mindful about not pushing my hands too far. It’s all been an exercise in trial and error and it evolves over time - communicating any significant changes to your rheumatologist in a prompt fashion will help them create a good plan for you.

But really my best advice is to take a multifaceted approach to pain and symptom management - meds + PT/OT + alternative therapies + lifestyle modifications tailored to your specific needs is the way to go. Meds will help reduce or prevent flares/joint damage, while the rest will help support the joints and facilitate recovery over time. No amount of PT will prevent a flare for me personally, but knowing how to manage when I’m having one and how to regain mobility when one is over has helped enormously!