How to cope with rheumatoid arthritis
The nagging pains and physical limitations of the more than 100 forms of arthritis are common to millions of people. Rheumatoid arthritis is among the most debilitating of all forms, causing joints to ache and throb and eventually become deformed. Sometimes these symptoms make even the simplest activities — such as opening a jar or taking a walk — difficult to manage.
Unlike osteoarthritis, which results from wear and tear on joints, rheumatoid arthritis is an inflammatory condition.
There is no cure for rheumatoid arthritis. But with proper treatment, a strategy for joint protection and changes in lifestyle, you can live a long, productive life with this condition.
Signs and symptoms
The signs and symptoms of rheumatoid arthritis may come and go over time. They include:
* Pain and swelling in your joints, especially in the smaller joints of your hands and feet
* Generalized aching or stiffness of the joints and muscles, especially after sleep or after periods of rest
* Loss of motion of the affected joints
* Loss of strength in muscles attached to the affected joints
* Fatigue, which can be severe during a flare-up
* Low-grade fever
* Deformity of your joints over time
* General sense of not feeling well (malaise)
Rheumatoid arthritis usually causes problems in several joints at the same time. Early in rheumatoid arthritis, the joints in your wrists, hands, feet and knees are the ones most often affected. As the disease progresses, your shoulders, elbows, hips, jaw and neck can become involved. It generally affects both sides of your body at the same time. The knuckles of both hands are one example.
Small lumps, called rheumatoid nodules, may form under your skin at pressure points and can occur at your elbows, hands, feet and Achilles tendons. Rheumatoid nodules may also occur elsewhere, including the back of your scalp, over your knee or even in your lungs. These nodules can range in size — from as small as a pea to as large as a walnut. Usually these lumps are not painful.
In contrast to osteoarthritis, which affects only your bones and joints, rheumatoid arthritis can cause inflammation of tear glands, salivary glands, the linings of your heart and lungs, your lungs themselves and, in rare cases, your blood vessels.
Swelling or deformity may limit the flexibility of your joints. But even if you have a severe form of rheumatoid arthritis, you will probably retain flexibility in many joints.
Treating rheumatoid arthritis typically involves using a combination of medical treatments and self-care strategies. The following self-care procedures are important elements for managing the disease:
* Exercise regularly.
Different types of exercise achieve different goals. Check with your doctor or physical therapist first and then begin a regular exercise programme for your specific needs. If you can walk, walking is a good starter exercise. If you cannot walk, try a stationary bicycle with little or no resistance or do hand or arm exercises. A chair exercise programme may be helpful. Aquatic exercise is another option, and many health clubs with pools offer such classes.
It is good to move each joint in its full range of motion every day. As you move, maintain a slow, steady rhythm. Do not jerk or bounce. Also, remember to breathe. Holding your breath can temporarily deprive your muscles of oxygen and tire them. It is also important to maintain good posture while you exercise. Avoid exercising tender, injured or severely inflamed joints. If you feel new joint pain, stop. New pain that lasts more than two hours after you exercise probably means you have overdone it. If pain persists for more than a few days, call your doctor.
* Control your weight. Excess weight puts added stress on joints in your back, hips, knees and feet — the places where arthritis pain is commonly felt. Excess weight can also make joint surgery more difficult and risky.
* Eat a healthy diet. A healthy diet emphasising fruit, vegetables and whole grains can help you control your weight and maintain your overall health, allowing you to deal better with your arthritis. However, there is no special diet that can be used to treat arthritis.
* Apply heat. Heat will help ease your pain, relax tense, painful muscles and increase the regional flow of blood. One of the easiest and most effective ways to apply heat is to take a hot shower or bath for 15 minutes. Other options include using a hot pack, an electric heat pad set on its lowest setting or a radiant heat lamp with a 250-watt reflector heat bulb to warm specific muscles and joints.
* Apply cold for occasional flare-ups. Cold may dull the sensation of pain. Cold also has a numbing effect and decreases muscle spasms. Do not use cold treatments if you have poor circulation or numbness. Techniques may include using cold packs, soaking the affected joints in cold water and ice massage.
* Practice relaxation techniques. Hypnosis, guided imagery, deep breathing and muscle relaxation can all be used to control pain.
* Take your medications as recommended. By taking medications regularly instead of waiting for pain to build, you will lessen the overall intensity of your discomfort.
The degree to which rheumatoid arthritis affects your daily activities depends in part on how well you cope with the disease. Physical and occupational therapists can help you devise strategies to cope with specific limitations you may experience as the result of weakness or pain. Here are some general suggestions to help you cope:
* Keep a positive attitude. With your doctor, make a plan for managing your arthritis. This will help you feel in charge of your disease. Studies show that people who take control of their treatment and actively manage their arthritis experience less pain and make fewer visits to the doctor.
* Use assistive devices. A painful knee may need a brace for support. You might also want to use a cane to take some of the stress off the joint as you walk. Use the cane in the hand opposite the affected joint. If your hands are affected, various helpful tools and gadgets are available to help you maintain an active lifestyle. Contact your pharmacy or doctor for information on ordering items that may help you the most.
* Know your limits. Rest when you're tired. Arthritis can make you prone to fatigue and muscle weakness. A rest or short nap that does not interfere with nighttime sleep may help.
* Avoid grasping actions that strain your finger joints. Instead of using a clutch purse, for example, select one with a shoulder strap. Use hot water to loosen a jar lid and pressure from your palm to open it, or use a jar opener. Do not twist or use your joints forcefully.
* Spread the weight of an object over several joints. For instance, use both hands to lift a heavy pan.
* Take a break. Periodically relax and stretch.
* Maintain good posture. Poor posture causes uneven weight distribution and may strain ligaments and muscles. The easiest way to improve your posture is by walking. Some people find that swimming also helps improve their posture.
* Use your strongest muscles and favor large joints. Do not push open a heavy glass door. Lean into it. To pick up an object, bend your knees and squat while keeping your back straight.