Living with Rheumatoid Arthritis
Daily Life with Rheumatoid Arthritis
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While medications play an important role in a comprehensive rheumatoid arthritis treatment plan, lifestyle modifications, including exercise, stress reduction and healthful eating, can also dramatically improve quality of life for many RA patients.
For most patients, the first step to making appropriate lifestyle changes to improve RA symptoms is to develop a working relationship with your healthcare team. By becoming informed about the type of RA you have, what joints are affected and what physical limitations you may have, you can work with your doctor, nurses and physical therapist to determine which nondrug treatments may be beneficial for you.
Talking with your doctor is an important first step to making healthy lifestyle choices that can positively impact your RA symptoms.
Set Realistic Rheumatoid Arthritis Treatment Goals
Being newly diagnosed with RA can be frightening and stressful. Having a detailed arthritis treatment plan will help you manage your symptoms and set appropriate treatment goals. Along with your doctor, work out a plan that you clearly understand and then continually monitor your progress. While your individual plan may vary, the most common RA treatment goals include:
- Decreasing arthritis pain and other symptoms
- Slowing the progression of the disease
- Preventing joint damage
- Maintaining joint function and mobility
- Preserving independence and quality of life
Treatment goals will vary according to your age, disease state, joint involvement, current health status, past medical history and lifestyle. However, the aim of all RA treatment is to get the disease under the best possible control without compromising quality of life.
Staying Fit and Flexible with Exercise
Exercise is one part of a comprehensive rheumatoid arthritis treatment plan. Studies have shown that exercise helps people with rheumatoid arthritis maintain muscle tone, flexibility and mobility of joints. It can also help you lose excess weight, which can stress joints. In addition, exercise has been shown to improve sleep and mood and reduce stress, all of which contribute to reducing painful RA symptoms.
Recommendations for the best types of exercise for those with RA include:
- Stretching or flexibility exercises to help maintain joint mobility and range of motion
- Strengthening exercises to develop and maintain muscle tone, endurance and strength
- Aerobic exercise to improve cardiovascular fitness and help maintain a healthy body weight
Before beginning an exercise program, talk with your doctor and find out if you have any limitations. In general, arthritis patients can perform easy range-of-motion exercises and other low-impact exercise, such as swimming or cycling. It's also important to progress slowly and avoid movements that involve high impact to the joints.
If you are overweight, weight loss may reduce RA pain because extra weight increases pressure on joints, particularly in the hips, knees and ankles.
It's also important to know when to rest. If joints become painful, red or swollen, reduce your activity and work with your doctor or physical therapist to modify your program.
Finally, choose exercises or activities that are enjoyable and comfortable and can become part of your daily routine.
Eating Well and Maintaining a Healthy Weight
Although there is a growing body of research on the relationship between nutrition, diet and rheumatoid arthritis, no particular foods have been shown to either cause or cure rheumatoid arthritis.
There has been some promising research on the relationship between foods containing omega-3 fatty acids and antioxidant-rich fruits and vegetables and inflammation in the body. Foods with high levels of omega-3 include cold-water fish (salmon, mackerel and herring), eggs, canola and flaxseed oils. Antioxidant-rich fruits and vegetables include apples, beets, cranberries, blueberries, kale, spinach, broccoli and oranges. Currently, however, no clinical trials have convincingly proven or disproven their effectiveness in improving RA symptoms.
Until there is more evidence to support specific diets or supplements for RA, it is important to discuss your nutritional needs with your healthcare provider and avoid unproven nutritional practices.
For overall good health, the Arthritis Foundation recommends a healthy, balanced diet low in saturated fats and calories, and rich in fruits, vegetables and whole grains. Other nutrition recommendations for RA patients include:
- Maintain your ideal weight.
- Eat a variety of foods from the four basic food groups: bread, cereal, rice and pasta; fruit and vegetables; milk, yogurt and cheese; and meat, poultry, fish, dry beans, eggs and nuts.
- Avoid eating too much fat, saturated fat, trans fat and cholesterol.
- Eat adequate amounts of starch and fiber.
- Eat high quality, low fat sources of protein.
- Avoid too much sugar.
- Avoid too much sodium (salt).
- Avoid alcohol.
RA patients may be more likely to have some vitamin and mineral deficiencies than the general population. Although food is the preferred source of these nutrients, your doctor may recommend vitamin and mineral supplements to ensure you are getting adequate nutrition.
Use Heat and Cold Therapy to Minimize RA Flares
Heat and cold therapy are often recommended for aching or stiff joints to temporarily relieve pain and increase mobility. While there is little specific research evidence that heat and cold therapy are beneficial, many patients find that these measures ease their pain and simply feel good.
Heat reduces muscle tension and stimulates blood circulation, and moist heat will warm the joints faster than dry heat. Cold therapy reduces soreness, inflammation and swelling and is helpful to temporarily relieve joint pain caused by an arthritis flare. Here are some guidelines for using heat and cold therapy.
Tips for Safely Using Heat Therapy
- Safe heat sources include hot towels, showers or baths, hot water bottles, and electric heating pads.
- To prevent burns, do not use heat for excessive lengths of time, and be careful to check your skin for redness often while applying heat.
Tips for Safely Using Cold Therapy
- Avoid applying ice or cold packs directly to the skin.
- Use a bag of frozen peas, or wrap ice in a thin towel before applying to the skin.
- To avoid frostbite, do not apply cold for more than 15 minutes at a time.
- Allow your skin to return to normal temperature and color before using cold again.
Quality Sleep Can Lessen RA Pain
Research suggests that a lack of sleep and rheumatoid arthritis pain are tightly linked. RA patients who don't get enough sleep or have poor sleep quality report more fatigue and moodiness, as well as increased pain and stress. One study showed that rheumatoid arthritis patients who don't sleep well have a diminished ability to cope with stress. Experts recommend that RA patients get seven to eight hours of sleep each night.
One way RA patients can ensure they get adequate, sound sleep is to develop an end-of-day ritual to prepare for sleep. Two hours before bedtime, begin preparing for sleep by slowing down activity, noise, lights and stimulation. Your bedroom should be quiet, comfortable, dark and cool. By programming yourself to have a good night's sleep, it is much more likely that you'll wake up rested – and possibly with less RA pain.
Other ways to ensure a good night's rest:
- Sleep on a firm mattress.
- Use an orthopedic pillow.
- Use an electric blanket during the winter.
- Avoid alcohol, caffeine and sugar before bed.
- Avoid highly complex tasks before bed.
Control Stress to Alleviate RA Symptoms
Although stress does not cause rheumatoid arthritis, it can make this condition more difficult to manage and even increase the amount of pain you feel. While there are many different ways to manage stress, experts suggest the following as the most helpful:
- Balance activity with rest
- Perform relaxation exercises
- Participate in regular exercise programs
- Join an arthritis support group
Other relaxing activities that may reduce stress include practicing yoga, reading, listening to music, enjoying a favorite hobby, meditation, guided imagery and biofeedback. These activities may only make up a small part of your day, but they can act as powerful stress reducers.
For those with a great deal of stress from pain, work, family issues or other life events, cognitive behavior therapy may also be very helpful.
Finally, it's important to realize that there may be times when you need to ask for help from family and friends. While this can be difficult, research shows that a strong support system can actually help improve RA symptoms. So don't be afraid to ask for help when you need it.
Will Acupuncture and Massage Help RA?
Complementary therapies like acupuncture and massage may help some people with rheumatoid arthritis ease pain and cope with the disease.
There is a small amount of clinical evidence that acupuncture reduces the sensation of pain in arthritis patients, particularly those with osteoarthritis. Acupuncture is a form of Chinese medicine believed to correct imbalances in the patterns of energy flow in the body by inserting special needles in specific areas.
Massage is a means of reducing and relaxing muscle tension and increasing blood flow to a specific area of the body. Massage often helps patients through a very acute, severe episode of pain. However, massage on its own does not appear to have a prolonged effect on RA symptoms.
While you may be interested in trying alternative treatments to help manage your RA symptoms, some of them should not be combined with standard treatments. It's important to discuss the benefits and limitations of any complementary therapies with your doctor before deciding to add them in your treatment plan.
Use the Right RA Medications the Right Way
Many over-the-counter and prescription medications are used to control the pain and swelling of rheumatoid arthritis. If your treatment plan includes medications, it is important to take them as prescribed. RA medications help to relieve pain, improve mobility, and slow down or perhaps even stop damage to the joints. Going on and off medications or taking more or less than prescribed may actually lessen their effectiveness and make your RA symptoms worse. One of the best ways of controlling RA is early and aggressive treatment, so it's essential to follow your doctor's recommendations.
RA medications fall into three main categories:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids:These are medications that treat pain and inflammation.
- Disease-modifying anti-rheumatic drugs (DMARDs):These are medications that slow the progression of the disease.
- Biologic therapies:These are highly targeted medications that are engineered to target specific proteins in the body including those related to inflammation.
It's a good idea to keep a diary of your symptoms and let your doctor know about any changes in your condition, positive or negative, that might affect treatment choices.
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