There may be times when your rheumatoid arthritis (RA) symptoms get worse and other times when you feel great.
Your doctor will work with you to help ease your symptoms with medicine and other treatments. But you have the power to help yourself manage your RA every day. Here are some ways to do it.
Take Care of Yourself
Taking care of yourself and staying on top of the disease is a big part of RA treatment. Take your medicine as directed. Try not to skip a dose. Tell your doctor about any side effects. Talk to them or your pharmacist if you have questions.
Even when your pain and stiffness is less of a problem, keep up with your medical appointments. Check in with your doctor two to four times a year.
If you don't already see a rheumatologist, consider asking for a referral. This is a doctor who specializes in arthritis. They can review your treatment plan and see if it needs any tweaks. Studies show that people with RA who see a rheumatologist several times a year do better.
Exercise
When you have joint pain and stiffness, you may not want to move around. But you should try to stay as active as possible. It actually helps ease your symptoms and prevent long-term problems.
Exercise for rheumatoid arthritis usually includes:
- Stretching. Stretch when you get started to warm up. Stretch when you’re done to cool down.
- Low-impact aerobic exercise. These are exercises that keep your heart strong without hurting your joints. Walking, riding a bike, and swimming are good choices for people with RA. You may also try a machine like a stationary bike or treadmill.
- Strengthening. These exercises help keep your muscles strong. You might use resistance bands that gently strengthen your muscles. You can also use light weights.
Slow, gentle, flowing exercises like Pilates, tai chi, and yoga help boost your balance and flexibility. They may even ease your pain.
Research by the Arthritis Foundation shows that yoga poses, breathing, and relaxation lower joint tenderness and swelling for some people with RA. Studies show that tai chi reduces long-term pain. Pilates makes the core of your body stronger, taking pressure off your joints.
All of these exercises are good for your mind and your body. They can bust stress while they build strength.
If you have a lot of pain when you exercise, stop. Talk with your doctor or therapist before you start again.
See a Physical or Occupational Therapist
They can help you become stronger and more flexible. Your doctor can give you a referral.
Therapists can show you the safest ways to move your body for everyday tasks, like lifting a box, to help protect your joints. They can also teach you exercises to do at home safely. You want to build strength, but you don't want to overdo it and trigger a flare.
An occupational therapist shows you ways to do specific tasks at home or at work. A physical therapist helps keep you moving. No matter which type you choose, it's best to see someone who has experience working with people who have arthritis.
Diet
Although there have been many studies about diet and rheumatoid arthritis, there’s no strong proof that a special diet helps.
But it’s always smart to eat a balanced, healthy diet. It helps fight inflammation. Fish like salmon, trout, tuna, and sardines are full of omega-3 fatty acids that curb chemicals called cytokines, which ramp up inflammation. Studies show that omega-3s may ease joint pain and shorten the time you have stiffness in the morning.
You also need colorful fruits and veggies, which have antioxidants that fight damaging free-radical molecules in your body. And go for whole grains like oatmeal, brown rice, and barley. People who eat whole grains tend to have lower levels of C-reactive protein, a sign of inflammation.
Avoid saturated fat, cholesterol, and sugars.
Your doctor may also recommend:
- Vitamins or minerals. You may need the extra nutrients.
- No alcohol. Drinking alcohol may be a problem with some medicines for RA.
If you need help with your diet, your doctor may suggest that you see a nutritionist or dietitian.
Keep a Healthy Weight
Nearly two-thirds of people who have RA are overweight or obese. Getting to a healthier weight can lead to fewer complications and a better chance of remission.
Fat cells release cytokines. More fat cells means more cytokines, and more cytokines means more inflammation. That makes RA symptoms worse and causes more damage to your body.
Extra weight can even make some medications that treat RA less effective. Studies show that biologics and biosimilars work for only about half of people who are overweight, compared with 75% of people at a healthy weight. Some disease-modifying antirheumatic drugs (DMARDs) also don’t work as well when you’re overweight.
And whether you have RA or not, adding pounds to your frame puts pressure on your joints. The ones that bear weight feel the most strain, like your:
Combined with a disease that wears down your joints, that means double trouble.
Lower Stress
Dealing with RA can be stressful, but there are many ways to lower your stress level:
- Talk with your doctor or nurse. They may suggest counseling or have other ideas you haven’t thought of.
- Take time to rest during the day. Balancing activity and rest is an important part of self-care for RA.
- Try to relax. Simple deep breathing can make you feel better.
- Learn special techniques like yoga and meditation. They may help you relax.
- Reach out for support from friends, family, and co-workers.
- Join a class or support group. There may be arthritis programs in your area. You can connect with others who have RA online or on social media.
Be Smart About Daily Tasks
Rheumatoid arthritis doesn't have to change your daily to-do list. Some simple fixes can make it easier to get things done.
Streamline your approach
Have a plan. When you have RA, you may have less energy. So it helps to be organized. If you want to get things done tomorrow, plan how you'll do it now. Keep your goals realistic, and don't forget to schedule breaks.
Save your energy. What slows you down? Putting on your shoes? Getting ready in the morning? Once you know the things that get you stuck, you can come up with ways to make them easier.
Divide up the day. Spend 30 minutes on a task, and then do something else. Focusing too much on one thing could leave you feeling achy and fatigued. If you switch things up, you'll get more done.
Pace yourself, especially on good days. Even if you wake up feeling like you can do anything, squeezing in too much can backfire. If you overdo it -- going on a hike or gardening all afternoon -- your fatigue the next day could set you back. Tackle a high-energy task or two in the morning, take a short nap at lunchtime, and do lighter work in the afternoon.
In the kitchen
Use a stool. Don't stand while you cook. Sit and rest. You can wash dishes from a stool too.
Cook simpler meals. Stick with easy recipes, especially after work. Use shortcuts like pre-cut vegetables. Save dishes with lots of steps for weekends or nights when a family member can help. Or split up the cooking over 2 days.
Put a ring on it. Wear a plain, inexpensive ring on your thumb and use it like a bottle opener for containers of yogurt, sour cream, or other things. Position it under the lid's edge, and lift up with your hand to pop off the top.
Roll large loads. Do you need to move a heavy pot of water from the sink to the stove? Try a plant stand with wheels. Use a measuring cup to fill the pot, then push the plant stand to the stove and slide the pot onto the burner.
Push a button to dice. Use a food processor to slice, shred, or chop.
Repurpose simple kitchen tools. Get creative. For instance, when you make egg salad or deviled eggs, a handheld square butter-cutter can easily trim a peeled hard-boiled egg to the perfect size for salad. An egg slicer can perfectly cut mushrooms. Use an apple corer to slice or chop potatoes, squash, cucumbers, or pears.
Plan ahead. Do some prep work when you feel good. For example, measure out fresh herbs in tablespoons or teaspoons, and then place them in ice cube trays. Fill the trays with water, milk, or cream, and freeze. Put your "herbsicles" in clearly marked bags. Later, you won't need to clean and cut herbs, just grab what you need for your recipe.
Go electric. If it's tough to stir, reach for a tool that will do it for you. Use a small handheld electric blender instead of a spoon. Look for one that also has a whisk.
Bathing and dressing
Go gadget shopping. Think about what's hard or painful in the bathroom, and pick up a few aids. Is it hard to squeeze out toothpaste? Look for an automatic dispenser. Do you have hip pain? A raised toilet seat can be much more comfortable. Wide-handled toothbrushes and hairbrushes, grab bars, and soap in pump bottles can make things easier. An occupational therapist can help you with the tasks of daily life.
Use a shower chair. Even if you think you don't really need one, it may help you relax while you bathe without putting more stress on your joints. A showerhead that you can adjust or hold can help too.
Change your wardrobe. Make getting dressed smoother by choosing clothes that are easier to put on, or adapt the clothes you have. Bigger buttons, Velcro fasteners, elastic shoelaces, and rings for zipper pulls can make it faster to dress. So can tools like a long-handled shoehorn.
Around the house
Lift carefully. Use both hands when you pick up a gallon of milk or a jug of laundry detergent. Slide a heavy object instead of lifting it, when possible. Get laundry baskets with wheels.
Don't lug cleaning supplies up and down the stairs. Keep a supply closet on each floor. Instead of carrying your vacuum, think about a lightweight rechargeable vacuum for each floor.
Garden without pain. Instead of crouching or kneeling, sit on a low stool while you're working outside. Some benches have wheels that make them easier to move. Try working on raised beds instead of on the ground. Look for ergonomic garden tools that are easier to use.
Shop online. It’s easier and faster than trekking to the mall. Save your energy for the things you enjoy doing. If using a keyboard hurts, consider getting voice recognition software to do your online buying.
Make Your Office Work for You
Whether you’re on your feet all day or sit in front of a computer, use these tips to feel better.
Pay attention to posture. Good posture is extra important with RA. If yours is off, even if you’re sitting, it will stress your joints and can boost fatigue. Instead, imagine a string running from the ceiling to the top of your head. Lift your head, neck, and shoulders along that string. Keep your shoulders relaxed and your pelvis upright; don’t let it tilt forward or backward. And don’t lock your knees.
Mix up positions and tasks. If you work at a desk, make a point of getting up and moving around throughout the day. Stretch in your chair, go for a walk at lunchtime, and take the long way to the copier or restroom. If you can, switch between standing and sitting. If your job involves repetitive movement, such as turning bolts on machinery or typing, break it up with other duties if possible. Switch back and forth between light and heavy tasks.
Tweak your stance. If you stand for most of the day, put one foot on a step, a low stool, or a book so that it’s a little higher than the other. This helps keep your pelvis in alignment. Switch feet every now and then. Wear shoes with good cushioning and support, and keep heels an inch high or less. Special inserts (orthotics) may also help. Organize your work area so that you don't have to lift, reach, or carry too much. If you work in different areas, consider an apron or tool belt to carry the items you need.
Rethink your chair. Make sure it has lower back support. Ask for an ergonomic chair that supports your lower spine, reclines, and rotates or swivels so you can move easily from one task to another. If your chair doesn't have back support, put a pillow or rolled-up towel between your lower back and the chair. Sit straight, with your back and shoulders against the back of the chair. You may also need to adjust the height of your desk and chair. You should be able to sit with your feet flat on the floor and your knees slightly higher than your hips. Prop your feet on a stool or book, if necessary.
Rethink your computer. Try to keep your elbows at a right angle and your wrists relaxed when you type. Keyboard wrist rests add support. Tilt the keyboard down and slightly away from you to take the strain off your wrists. The computer screen should be at eye level directly in front of you, not off to the side.
Troubleshoot your telephone. Don’t cradle the receiver between your shoulder and ear. It leads to shoulder and back pain, and fatigue. If you're on the phone a lot, use a headset receiver.
Lift the right way. Use your largest and strongest joints to lift items. For instance, always use your leg muscles, bending at the knees, not the waist. Steady yourself with a heavy chair or other piece of furniture if you need to. Rely on your arms to lift rather than your hands. Use your palms or forearms; don’t grip them with your fingers. Hold your arms and the item close to your body so you don’t strain your back.
Ask a pro. Your employer may be able to set up a professional evaluation of your workspace, so ask your HR department. An occupational or physical therapist can also help you learn how to do tasks on the job with less stress to your joints.
Consider assistive devices. Gadgets like big-grip pens and long drawer handles are made for people with arthritis and other joint problems. An electric stapler or pencil sharpener may be easier to use than a manual one.
Get Out and About
Don’t let rheumatoid arthritis keep you from going out and doing the things you've always enjoyed. Whether you want to shop, eat out with friends, or go to a game, you can do it. You might just need to tweak your plans and do a little more to prepare.
Going out for the day
Plan ahead. If you’re going somewhere new, do some phone or online research so you know what to expect. If you have a walker or wheelchair, find out whether the building is easy to use. If walking is hard, ask how far it is from the parking lot to the door.
Be clear with your friends. Before you head out, be open about how your RA affects you. Ask your friends to be flexible. You may need to pare down the schedule a little and take time for breaks. Don’t keep mum and then overdo it, or you could risk a flare.
Start later. Mornings can be tough with RA, and it may take time for your stiff joints to loosen up. So plan outings for later in the morning when you can.
Get an aisle seat. Going to the movies? Sit by the aisle so you can stretch your legs.
Shopping
Carry carefully. Carry shopping bags over your forearm. You'll spare the weaker joints in your fingers and wrist. If you can, put your purchases in a backpack or bag with a shoulder or cross-body strap.
Come equipped. If shoulder pain makes it hard to reach high shelves, bring a reacher, a rod with a clamp at the end.
Don't be shy if you need help. Ask for some assistance if you feel stressed or worn out. Lots of stores have motorized scooters. Some have people on staff who can help you.
Dining out
Bring utensils. If RA affects your wrists and hands, it may be hard to lift heavy glasses or grip thin forks or knives. If that's a problem, bring your own fork, knife, and spoon. Ask for drinks in plastic or paper cups.
Take a chair. If RA in your hips makes it hard to sit, ask for a chair with arms. You’ll find it easier to get up and down. Stay out of booths, which could be tough to manage.
Avoid having to cut food. If your hands and wrists hurt, see if the kitchen will cut your food before it's served. You might be surprised by how many are willing to do so. Or order something that doesn't need cutting, like a stir-fry or pasta.
Watch your alcohol. It's easy to lose track of drinks when you're out with friends. But remember that you need to limit or avoid alcohol if you’re taking certain medications, like methotrexate.
Travel Smart
Before you go
Do your homework. Find out as much as you can about your destination and plan all the details you can, including what places you'll go, how you'll get there, and what your travel companions can do when you need a rest.
Time it right. Choose a time when you're most likely to feel your best. If you tend to get flares during the heat of the summer or the hustle and bustle of the holidays, for example, try to avoid traveling during those times.
Don't rush. Although vacations can be fun and restful, they can also be stressful. Try to have an extra day at the start of your vacation to prepare and another at the end to rest and recover before you go back to your regular schedule.
Ask about immunizations. If you're leaving the country, ask your doctor about any vaccines you may need. Remind them of what medicines you take, since some immunizations aren't advised if you take medications that weaken your immune system.
What to pack
Choose the right suitcase. Buy a suitcase or bag with wheels, and push it instead of pulling. Use both hands to take it easy on your hands and shoulders.
Pack light. Lighter bags will be easier to carry. If you must lift your suitcase -- into your car trunk or the overhead bin on a plane, for example -- find someone who can help.
Don't forget your health info. Write down a brief medical history and list of medications you take. Include contact information for your primary care doctor and rheumatologist, as well as your health insurance information.
Mind your medications. Pack more medicine than you think you'll need, and divide it among your bags. If one bag is lost, you should still have enough medicine to get by. Leave a copy of your prescriptions with a friend or family member back home. If you lose your medications or are gone longer than expected, have them send you your prescription.
On your way
Don't just sit there. Sitting for hours in a car, plane, bus, or train can lead to stiff joints. When driving, stop once an hour to stretch and walk. On a plane, train, or bus, try to get an aisle seat so you can stretch and walk around.
Avoid crowds. Avoid standing in long lines and flying in crowded planes. Ask the airline or travel agent about times with the least traffic.
Bring a doctor's note. If you use medications that require needles, bring a doctor's note or prescription in case you're asked about them at airport security.
Avoid stops. When possible, choose nonstop flights. That way, you won't have to walk long distances through unfamiliar airports.
Arrange for assistive devices. If you use a wheelchair, label it with your name, address, and destination airport -- and ask that it be loaded "last on/first off." If you use a cane, you can take it on board with you. You'll need to stow it at takeoff and landing, but you can use it during the flight.
Where to stay
Pick your room location. When you make hotel reservations, look for a room on or near the main level so you can skip the stairs.
Request a refrigerator. If you take medications that need to be refrigerated, an in-room refrigerator is a must. It can also come in handy if you need a quick snack to take medications or to boost your energy level after a day of sightseeing.
Look for amenities. A pool can help you stick to your exercise routine, a hot tub can ease sore joints, and an on-site restaurant or room service is helpful if you don't feel like going out to eat.
Don’t Skip Intimacy
Besides the joy of being intimate with your partner, there's an extra perk when you have RA: Sex is a painkiller, thanks to your body's feel-good chemicals called endorphins, and those effects can last for hours.
Be open about your RA and how it makes you feel. If you're nervous about talking about how your symptoms affect the way you want to be intimate, write your partner a letter. Share what feels good and what hurts. If you make the first move on good days, your partner will be more understanding on the days when you don't feel 100%.
Take time to enjoy foreplay. Use gentle massage to relax muscles and joints. Get creative with positions to avoid putting stress on painful joints.
Also, try props like pillows or cushions to support your hips, shoulders, neck, or back. Or add a vibrator for stimulation during foreplay.
Many women have vaginal dryness as they get older. It's also a problem if you have Sjogren's syndrome, a condition often seen with RA. Vaginal lubricants, moisturizers, or estrogen creams can help.
If you have concerns, talk to your doctor. You may want to get a referral to a sex therapist who has experience helping people with RA.
