Living with rheumatoid arthritis
There are a number of things you can do that will help you stay in control of rheumatoid arthritis.
The outlook for people with rheumatoid arthritis (RA) is far better than it once was. Treatment advances have made it easier to prevent or at least slow the progression of joint damage. And according to the American College of Rheumatology (ACR), most people are able to control their symptoms and function at or near normal levels.
Even so, RA remains serious. Medication is the mainstay of treatment. But there are other components to managing the disease effectively.
Here are six things you can do to control RA:
1. Educate yourself. RA can be physically and mentally taxing. Knowing how it might affect you allows you to prepare and evaluate your options for dealing with any difficulties you might face. That may help you feel less controlled by the disease.
"We try to make it very clear that we want our patients to be informed and to be making their medical and personal decisions from an informed posture," says ACR member Nortin M. Hadler, MD.
2. Work closely with your doctor. No single treatment approach is effective for everyone with RA. The disease affects people differently, creating unique challenges.
That means it's important to have a doctor you trust and feel comfortable turning to when you need guidance or have concerns—about symptoms, your medicines or overcoming obstacles the disease presents.
In addition to providing direct assistance, your doctor may call on others, such as psychologists or occupational therapists, to help you.
3. Stay active—within reason. Exercise can do a lot for you, from helping you maintain a positive attitude to enabling you to lose weight and sleep better. For people with RA, it's also particularly important for strengthening muscles and aiding mobility.
"When joints get inflamed, muscles get weaker," Dr. Hadler says. "If you don't do something to break a vicious cycle, you have joint inflammation, muscle weakness and more incapacity."
Exercise that's gentle on your joints, such as water aerobics, is best—especially during RA flare-ups. But keep in mind, there may be times when you feel exhausted. At these times, it's good to rest.
Remember that occasional, short rest breaks are generally better than long periods of time spent in bed, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
4. Build flexibility into your day. The unpredictable nature of RA can make it difficult to live by a schedule. As a result, the freedom to change course can be helpful.
For example, if you work outside the home, it may be helpful to talk with your boss about leaving work early when you're not feeling well and working longer on those days when you're at your best.
"Patients with rheumatoid arthritis can remain highly functional, but they'll have more difficulty if they don't control the pace of effort," Dr. Hadler says.
5. Maintain a healthy weight. A normal body mass index is important for everyone, but it's especially important for people who have damage to weight-bearing joints.
With your knees, for example, walking quickly or going down stairs puts a force of several times your body weight across the joints. Losing just 10 pounds effectively takes 30 or 40 pounds off your knees, according to Dr. Hadler.
A balanced diet and exercise can help.
6. Team up. RA can affect your self-image, your income, your relationships and many other aspects of life. And suffering increases with isolation, Dr. Hadler says.
Being around others facing similar circumstances may be beneficial. Taking part in support groups may lead to better coping skills and decreased pain, the NIAMS reports. Support groups may also help ease any sense of fear and resentment about the disease.
Some groups are led by professionals and may focus on things like education or learning relaxation techniques. Others are led by people with RA and enable you to learn from the experiences of people facing similar circumstances.
Reasons for optimism
Whatever you do, know that there's a good chance you can keep RA in check.
Years ago, it was common to see severe, debilitating arthritis. But that's now the exception. Greater knowledge and better treatments offer reasons for hope.