Rheumatoid arthritis (RA) is an autoimmune disease that causes inflammation in the joints and throughout the body as well as different kinds of pain and other sensations. Sometimes, it can be difficult to tell what “normal” symptoms of RA feel like. You may wonder whether it is normal for your bones to hurt and feel cold.
In this article, we take a look at this particular symptom of RA, including what it feels like, when it tends to occur, and how it can be managed.
People with RA pain typically have joint pain. The way this pain manifests, however, can vary from person to person or even day to day.
Members of myRAteam have described their RA pain in many different ways. “I get a very sharp stabbing pain that increases very quickly,” wrote a member, “and I cannot move or walk and meds don’t help.” Another added, “It feels like a little man is hitting my shin bone with a hammer, and the pain is very intense. It tingles down to my foot and toes. It hurts to walk.”
This bone pain can occur throughout different parts of the body. “My feet and leg bones hurt so bad that I just want to scream,” said one member. “Standing for more than a minute is so painful.” Another reported experiencing similar pain, writing, “I have been having pain in my leg bones. I told my family doctor it feels like someone has a nutcracker on my legs.”
Sometimes, members experience pain or coldness that seems to come from their bones. One member asked, “Does anyone ever feel like inside your bones are ice cold, followed by sharp pains?”
“Yes,” replied another member, “I get that, too. It seems to be worse at night for some reason. Causes a lot of sleepless nights.” Another member reported having similar sensations: “It feels like my arms and legs get cold and they hurt!”
A few myRAteam members reported that this symptom coincided with colder weather. “That happens to me a lot,” replied one, “especially in winter.” Another member answered that they feel painful cold in their bones, but “only when I’m in very cold weather. Keeping warm helps me.”
A person with RA may experience sharp, cold, or stabbing pain in their bones for several reasons:
RA affects the joints, which are places where two bones meet. Each bone is covered by a layer of slippery cartilage, and it is all held in position by the synovium (protective tissue that lines the joints). This lining between the joints is filled with a fluid that helps lubricate and separate the bones. Swelling from RA stretches the synovium, filling it with fluid and causing potential problems, all of which can be painful.
In other cases, RA pain is caused by structural damage to the bones caused by the disease. For example, RA can cause bones to wear down, which could lead to sharp bone pain. RA can also cause swelling in the ligaments and tendons, which connect bone to bone and bone to muscle. If these ligaments and tendons swell and cause joint damage or pull on the bones they are attached to, that may also cause sharp bone pain.
RA pain that worsens in the cold may be due to other reasons. Colder weather can cause the synovial fluid to thicken, which might make painful joints even more swollen and cause additional pain. Genes that lead to an increase in inflammation are also more active in the winter, so cold weather could cause additional pain that way, too.
You have several options for managing sensations of cold and pain that seem to come from the bones:
If you experience sensations of cold and pain that seem to come from your bones, be sure to talk to your rheumatologist. They can provide medical advice on adjusting your treatment or adding new pain management techniques for you to try.
The first step to managing RA pain is to get the disease under control. There are several medications used to treat RA and reduce flare-ups, from nonsteroidal anti-inflammatory drugs (ibuprofen or naproxen) to disease-modifying antirheumatic drugs to biologics (like methotrexate) and more. Your doctor will help you determine which of these RA treatment options might be right for you.
Even when taking a regular treatment for RA, bone pain and discomfort may break through. Fortunately, there are ways to handle this pain.
One approach is to have another pain medication on standby. This medication may be something available over the counter, like Tylenol — as one member wrote, “If the pain is really bad, I will also take a Tylenol, wait 45 minutes, and take a second one if it is still hurting.” Make sure you talk to your doctor before adding any medications to your regimen.
Whether you are actually cold or are experiencing sensations of extreme cold, getting warm might help your joints and the tissues around them feel better.
Several members recommend keeping warm to help stave off bone pain and coldness. As one explained, “I usually either take a long hot shower and/or drink a cup of hot tea, which seems to help. Not to mention, I always have my trusty throw that I wrap up in!” Another member wrote, “I bought one of those heating blankets, and it really helped me. Try drinking something warm… that helps, too.”
Another member shared, “I keep a small space heater for my feet, and I always have some of the fingerless gloves with me in the winter. I have short ones and a pair that go up my arm. I found this has helped me keep my hands warm and less achy. A friend made me a bag with rice in it that I can warm up and use when I am really cold. My electric blanket is a must in the winter when we are watching TV. I also made sure my car had seat warmers, and that has really helped me out.”
These approaches may be particularly helpful when combined with pain relievers. As one member wrote, “I have to take pain meds and get warm under blankets.”
If you experience severe bone pain and cold sensations, check your vitamin D levels. People who are deficient in this vitamin often have more severe manifestations of RA and other rheumatic diseases and may also be more sensitive to pain.
If your levels are low, your doctor may recommend taking vitamin D supplements, ask you to try cod liver oil, or talk to you about supplementing your diet with foods high in vitamin D. Raising vitamin D levels may help you feel significantly better.
Some medications used to treat RA may also deplete the body of certain vitamins. Talk to your health care provider if you’re concerned about this issue.
On myRAteam, the social network for people with rheumatoid arthritis and their loved ones, more than 187,000 members come together to ask questions, give advice, and share their experiences with others who understand life with RA.
What does RA pain feel like for you? Do you have any remedies to recommend? Share your experiences and thoughts in the comments below or by posting on myRAteam.