It's easy to feel powerless and vulnerable after any medical diagnosis, especially if it's a lifelong autoimmune disease such as rheumatoid arthritis (RA). Learning about new treatments, meeting new doctors, even just trying to pronounce the names of drugs to treat rheumatoid arthritis (hydroxychloro-what?) can be overwhelming.
Luckily, there's plenty you can do to take power back into your hands and control your disease. Here are seven steps to help you manage your rheumatoid arthritis and hold on to your normal life.
Establish a good working relationship with a knowledgeable doctor.
Why it's important:
Rheumatoid arthritis isn't just painful: Left untreated, the associated inflammation often causes permanent joint damage and disability. For this reason, it's essential that anyone with rheumatoid arthritis in the active stage pursue treatment in order to bring the inflammation under control. However, there's no one-size-fits-all answer when it comes to RA treatment. So it's essential to establish a good working relationship with a doctor who has experience treating rheumatoid arthritis.
What to do:
1. Find a rheumatologist.
While your general practitioner may be able to get you started on a course of treatment, a rheumatologist specializes in joint disease and immune disorders. These doctors have the most up-to-date understanding of how to use disease-modifying antirheumatic drugs, many of which have possible side effects that require regular monitoring. A good rheumatologist is also best qualified to recommend other medications for RA, including NSAIDs, analgesics, and steroids.
2. Prepare to ask questions.
Studies have shown that people with RA who participate in formal patient education programs see a reduction in pain, depression, and disability; and informal education probably helps too. Ask for clarification about how the disease works and get suggestions for dealing with its physical and emotional toll.
Rheumatoid arthritis medications can have unpleasant side effects, so be sure to ask your doctor about them. Also find out which vaccinations are safe for you, since taking immunosuppressive drugs may disqualify you from seasonal flu vaccines and other vaccines.
3. Follow up with your doctor regularly.
Regular follow-ups are important, especially when your disease is active or when you're trying a new medication. Your doctor will need to monitor your disease activity and help check for any medication side effects.
How often you see the doctor will depend on the state of your rheumatoid arthritis. For those with active disease or those starting a new medication, a follow-up appointment within four weeks is often advised. If the rheumatoid arthritis seems to be settling down, then a follow-up appointment in two to four months might be reasonable.
Also, be sure to ask your doctor for a regular bone scan, since people with rheumatoid arthritis sometimes lose bone density over time.
4. Call your doctor if you're in pain.
Many rheumatoid arthritis patients end up suffering in silence when a treatment plan isn't working, dutifully waiting for weeks until the next scheduled appointment rolls around. However, while some amount of discomfort may be unavoidable, there are often plenty of drug and non-drug therapies that can help with pain, especially while DMARD dosages are ramping up or when your rheumatoid arthritis is particularly active.
If you often find yourself in anything more than mild pain, ask your doctor about medications to help with your symptoms. Frequently, a short course of prednisone or a prescription NSAID can help with pain from inflammation.
You can also try any number of complementary treatments for symptom relief, including diet, massage, acupuncture, and mind-body techniques.
More things you can do to manage your rheumatoid arthritis
Balance exercise and rest.
Why it's important:
One of the more difficult aspects of living with rheumatoid arthritis is walking the fine line between too much exercise and too little. Both extremes can lead to worsened symptoms down the road, but with careful attention to your body -- and maybe some professional help -- you should be able to maintain a healthy level of activity.
What to do:
While it may sound counterintuitive, sometimes getting up and getting moving is the best thing for your joint pain. Exercise can strengthen weak muscles, preserve range of motion in your affected joints, and give you a nice blast of pain-reducing endorphins, in addition to all the known cardiovascular, mood, and general health benefits.
People with rheumatoid arthritis often do best with regular, low-impact exercise like walking, swimming, and biking -- activities that spare the joints unnecessary pounding while providing plenty of gentle stretching.
6. Listen to your body.
When you have rheumatoid arthritis, some days you just need to rest. Make sure to check in with your body before and after a workout. There's a difference between normal post-exercise soreness and the pain of a joint flare, so make sure you don't push yourself past your limits, and cut yourself some slack when you're feeling worse than normal.
If you're not up for your usual workout, even just getting up and doing daily activities -- gardening, shopping, and visiting friends and family -- can help you reap the benefits of moving around without pushing yourself too hard.
7. Work with a professional.
An experienced personal trainer or physical therapist can help you figure out which specific exercises you should do to strengthen your muscles and maintain flexibility and range of motion in your joints. They can also provide structure to help you stick to your workout plan and offer suggestions for stretches that might help on the bad days.
In addition, many physical therapists combine exercises with gentler approaches, such as heat and cold therapy, ultrasound, and relaxation techniques.
Occupational therapists also work with you to try to reduce your pain and inflammation, but they focus on helping you perform normal activities of daily living. Occupational therapists can get you joint splints when you need them, teach you how to use assistive devices, and help you figure out how to approach all your daily tasks -- cleaning, bathing, dressing, gardening, caregiving -- without hurting yourself.