Rheumatoid arthritis (RA) is a chronic inflammatory disease of the joints.
RA most often affects the distal joints symmetrically, such as both hands, wrists, and knees.
This explanatory guide will help you do that in a proactive and measured way.
Putting in the time to learn how best to do all this is well worth the effort.
Lack of movement during the night can have you waking up as stiff as steel.
Incorporating meditation, which unites both body and mind, may also be effective.
Sleep woes may also be related to depression in a complex interplay between the body and the mind.
(If you do experience depression, its important to speak with your physician.)
But how to manage all these prescriptions can be a complex undertaking.
Once a medication (or combination) has been prescribed, carefully follow all directionsso you dont make mistakes.
Common mistakes include unintentionally doubling (or tripling) up onNSAIDdrugs and taking methotrexate daily rather than weekly.
(Financial assistancemay be available to you.)
Neverstop taking your medson your own, even if youre feeling better.
This is an area fraught with misinformation, so its prudent to use a buyer-beware approach.
Home remedies worth pursuinginclude warm baths and other heat treatments.
Omega-3 fatty acidsare a jot down of polyunsaturated fat known to be anti-inflammatory.
Severalherbs and spicesare also thought to have anti-inflammatory properties, including ginger, thyme,cinnamon, andturmeric.
Unfortunately, good-quality studies showing thatany specific eating plancan benefit RA are hard to come by.
This diet is similar to the heart-healthy Mediterranean diet experts have long recommended.
Exercising With Rheumatoid Arthritis
Contrary to popular belief, exercise does not make rheumatoid arthritis worse.
Of course, youll want to check with your physician before you jump in any new workout plan.
Both are essential for helping to manage your RA.
People with the disease tend to do best with low-impact activities like walking or swimming.
Other great exercises include water aerobics, the Chinese meditative movement oftai chi, and gentle forms ofyoga.
Some changes that have a big effect can be had for less than $20.
The smallest assistis a simple cane, which can stabilize you and minimize the risk of a fall.
Traveling When You Have Rheumatoid Arthritis
Traveling by plane requires some advanced preparation.
Ideally, youll want to book a nonstop flight to minimize the time and energy involved.
In every instance, though, youll want to think about what you need and plan for it.
Incorporate sometravel-friendly gadgetsto ensure your vacation will be a success.
These experts do not replace your primary care physician, whom you should continue seeing.
The specialist with the most expertise regarding rheumatoid arthritis and its most cutting-edge treatments is a rheumatologist.
Rheumatologist
A rheumatologist is a doctor whose practice revolves around inflammatory diseases.
These physicians commonlytreat rheumatoid arthritisalong with osteoarthritis, lupus, Sjogrens syndrome, and other similar conditions.
Although demand for these doctors is up, the number of physicians specializing in rheumatology is actually declining.
An important way to maintain this is by regularly performingstretching and strengtheningmoves.
Astudyconcluded that RA hand function, pain, and range of motion all improve following resistance exercises.
Your therapist can help yourest your joints by fitting you with braces or splints.
An OT can also recommend certain supportive devices to make many of these activities easier.
PTs and OTs are both licensed professionals who must pass a national exam to be certified to practice.
Some are affiliated with a hospital, while others practice on their own.
If those conditions are mild or fleeting, you may be able to navigate through them on your own.
But clinical depression or anxiety that persists is actually considered to bea complicationof having RA.
Like RA itself, mental health conditions may need to be assessed and treated by a professional.
Mental-health issues are common in people with RA.
Experts who have examined thelink between the two conditionshave not yet provided an answer.
People with RA experience higher rates of depression than the general public.
The link between diseases seems especially pronounced in older people.
Even thoughdepression and RAare linked, your rheumatologist may not ask you about your mental state.
Many rheumatologists admitted in asurveythat they are unsure what to do about their patients depression.
When it comes to managing low mood, you could take a number ofhelpful stepson your own.
These include getting sufficient rest, exercising,meditating, and finding a community that uplifts you.
Still, you may need to seek out a mental-health professional.
Managing Anxiety and RA
Sure, everyone gets anxious sometimes.
We wouldnt be human if we didnt stress about an important project or disease progression.
But experts differentiate between ordinary stress and clinical anxiety.
People with RA are more likely to experience anxiety than those without the disease.
But its certainly true that living with a chronic pain condition is stress-inducing.
Uncontrolled or undertreated disease can add another layer of anxiety.
If you decide to work with a psychotherapist, one popular anti-anxiety technique is short-term CBT.
If youve heard a friend say, But you dont look sick, youre hardly alone.
Fortunately, open communication and a little bit of education can help.
medical condition DMSO (dimethyl sulfoxide) or milk thistle, anyone?
venture to tell yourself they have your best interests at heart, even if their advice is unhelpful.
Family Planning With RA
Women with RA often worry that they wont be able to have children.
They might fret over whether needed medications will harm their pregnancy or that their baby might inherit RA genes.
Still, until that time, its imperative to use effective contraception.
Women with RA do sometimes take longer to get pregnant, but you must always assume it is possible.
When used properly, oral contraceptives are another reliable method.
Drugs and Medication for RA
Once joint damage appears, it is not possible to reverse.
Three main categories of medications are used for rheumatoid arthritis.
The first category is the disease-modifying anti-rheumatic drugs (known as DMARDs).
These drugs suppress the bodys overactive immune system or inflammatory processes.
methotrexate (Trexall) is one of the oldest in this class.
So too areJanus kinase (JAK) inhibitorslike tofacitinib (Xeljanz, Jakvinus) and upadacitinib (Rinvoq).
Another category of RA medicines are corticosteroids such as prednisone and prednisolone.
These strong anti-inflammatory drugs can swiftly reduce pain, stiffness, and swelling.
Finally, patients with RA frequently takenonsteroidal anti-inflammatory drugs (known as NSAIDs).
NSAIDs offer temporary pain relief but do nothing to stop damage in the joints.
Remember that medications are only one part of RA treatment, though.
Physical and occupational therapy andhome remediesalso have a role.
And if joint damage gets really severe, surgery may be required to repair or replace them.
RA may also take a toll on your career.
Unknown future health is something thatyoung adults with RAmay face.
Its no wonderyou may find yourself worryingabout all the ways the disease will impact your finances.
There are DMARDs, steroids, NSAIDs, analgesics, and more.
Keeping track of it all may be difficult enough; paying for it can feel overwhelming.
Depending on the meds you take, the list price can run hundreds or thousands of dollars a month.
Fortunately,financial aid and assistance programshave been created to help.
These include assistance from nonprofit charities, government programs, and drug companies themselves.
you’re free to learn about these options from your physician, other patients, and online research.
Still, this may require that both you and your employer make certain changes.
TheAmericans With Disabilities Actmandates that a workplace make reasonable accommodations.
Some careers are easier to manage than others when you have RA.
But you’re free to thrive in other types of employment too.
Try standing occasionally and lifting your feet onto a stool to take strain off your lower back.
Can You Apply for Disability if You Have RA?
If your limitations make it impossible to continue working, you canapply for disability.
This can mean either short- or long-term disability from your employer, or thefederal Social Security Disability Income program.
The software process for disability income can be daunting.
A social worker can offer valuable assistance with this process.
(Find one at thewebsiteof the National Association of Social Workers.)
Will my dreams be quashed forever?
And perhaps, how can I make a difference for others with this condition?
An important aspect of coping with RA isto get inspired by othersin the same situation.
Its crucial to have people in your daily life who act as a beacon for you.
The following stories are especially helpful.
And it is a way to make life better in the future for others with the condition.
The U.S. National Library of Medicine maintains a massive database of ongoing clinical trials, calledClinicalTrials.gov.
Hundreds of trials for RA patients can befound on that website.
The nonprofit organizationCISCRP is another source for identifying clinical trials.
What to Consider Before Joining a Clinical Trial
Clinical trials may not be appropriate for everyone.
Youll want to have a discussion with your physician before signing up for a trial.
Read Arthritis Blogs We Cant Stop Reading.
Samir Dalvi, MD, is a board-certified rheumatologist.
