Living Well With Rheumatoid Arthritis
Rheumatoid arthritis (RA) can be complicated to manage, and it takes more than medication. For example, if you experience RA fatigue, you may need to get better sleep as well as be more active every day, stay at a healthy weight, and ease any depression, according to a study published in March 2015 in the journal Arthritis Care & Research. However, each of those positive lifestyle changes can have wide-reaching benefits. Here are specific strategies for living better, offered by people living with RA.
Tip 1: Exercise Regularly
Physical activity is a must and can be as varied as you like. For Baltimore-based yoga instructor Jennifer Daks, 24, yoga serves as both exercise and stress management. Daks, who was diagnosed with RA at age 2, began to practice yoga after a flare in her late teens. She has since been trained in teaching yoga for people with arthritis. Whatever activity you choose, be sure to use common sense. “I recommend that anyone starting a more active lifestyle begin slowly and gradually increase the intensity and duration because you’ll be less likely to discontinue your efforts and will steadily increase your tolerance, stamina, and strength,” says Stephen Soloway, MD, a rheumatologist with Arthritis & Rheumatology Associates in Vineland, New Jersey, and a spokesperson for the American College of Rheumatology.
Tip 2: Reduce Stress
How you manage stress is highly personal, but finding a way that works for you is important because stress can make coping with RA more difficult. As Daks found, exercise can be a form of stress relief. Dr. Soloway agrees, saying he recommends low-impact exercise such as yoga and swimming for people with RA. Other stress-relief strategies include breathing exercises, walking in nature, laughing with loved ones, biofeedback, and meditation. The key is to have an option that’s easily accessible when you need it. Daks says she manages some of her stress by setting limits on her schedule when she’s tired and by distancing herself from other people’s stress when she can.
Tip 3: Manage RA Fatigue
Even if you can improve your sleep quality, you might find that you still feel fatigued. That’s because fatigue is a symptom of RA that can occur regardless of how well you’re actually sleeping. Soloway emphasizes a comprehensive plan. “Reducing fatigue requires a multifaceted approach of low-impact exercise, restful sleep, hydration, and proper control of the disease with medication as prescribed by your doctor,” he says. Set priorities and learn to say “no” when necessary so you don’t burn yourself out or have to complete important tasks during times of low energy.
Tip 4: Deal With Morning Stiffness
Morning stiffness is another hallmark of RA. Allow extra time for your morning routine so you can ease into your day. Stretch even before you get out of bed and consider taking a warm shower or bath as soon as you get up. Soloway also recommends taking an easy walk. Daks says her morning stiffness can last up to four hours if she doesn’t address it first thing in the morning. “When I wake up, I practice gentle movements to wake up my joints,” she says.
Tip 5: Eat Well
There’s no specific RA diet, but good nutrition counts. Soloway recommends a whole-foods diet. “Stay away from processed foods, prepackaged meals, white sugar, and white flour,” he says. Testing to find out whether you have any food allergies, such as lactose or gluten, for example, could be helpful. “By adhering to a healthy, plant-based diet, I’ve been able to effectively control all of my RA symptoms, and I don’t take any inflammation or pain medication,” says Ashley Diana Cox, a Charlotte, North Carolina-based vegan who blogs about food and life. Cox was diagnosed with RA when she was 27. At the time, the joints in her hands were painfully swollen, but she never imagined she’d inherit her grandmother’s RA at such a young age.
Tip 6: Organize Your RA Treatment Plan
Sticking with your treatment plan is key to managing RA, Soloway says. It helps to have a system for staying on track with appointments, medications, and your daily routine. “I have an a.m. and a p.m. pill case,” says Baltimore resident Molly Schreiber, 35, who was diagnosed with RA in 2011 and takes medications that include biologics. “The a.m. pill case is stored in my purse so I’m not at a loss if I forget to take my meds before I leave for work.” Soloway stresses how important it is to talk with your doctor about the effectiveness of your medications. Don’t just stop taking them if they don’t seem to be working. “If you don’t feel you’re seeing any improvement, it’s best to seek a second opinion,” he says.
Tip 7: Find New Ways to Manage RA Pain
While you might need an occasional over-the-counter pain medication, Soloway advises against relying on it. “Don’t use painkillers as your go-to method of managing RA pain,” he says. “Instead, optimize prescriptions from your doctor to get the best results.” Schreiber employs various strategies. “I keep a pair of gloves, a knee brace, and an elbow brace in my bag for when pain arises at work,” she says. “I also use topical treatments, like diclofenac gel or a lidocaine patch.” She also takes over-the-counter medication as needed and relies on a Fitbit to help her stay active, which reduces pain and stiffness. She also emphasizes the importance of drinking plenty of water because pain medications can dehydrate you.
Tip 8: Reach Out to Others
“I suggest being a part of RA support groups and forums and participating in RA groups on social media sites to learn and share different methods of exercise and healthy habits to feel your best,” Soloway says. When Daks has a flare, she gets support from her co-workers and students. In fact, she says, it’s powerful to be able to tell yoga students that she’s using and benefiting from the same techniques she’s teaching them. For Jamie Stelter, an Emmy-nominated traffic anchor at NY1 in New York City, support comes from her husband. “I’m the luckiest person in the world to have the most understanding, patient, and compassionate husband who listens, helps, and supports me,” Stelter says, adding that she keeps her parents involved as well and works closely with her doctors.
Tip 9: Prevent RA Complications
Talk with your doctor about what steps you can take to stay healthy and avoid complications such as heart disease, which may have a higher risk among people with RA. When researchers looked at data from nearly 25,000 adults with RA, it suggested that the longer RA was well-controlled, the less likely people were to have a heart issue, such as a heart attack. The results were published in June 2015 in the journal Arthritis & Rheumatology. Schreiber is especially proactive with her heart health. “I have bloodwork done annually and a thorough annual eye exam, check my blood pressure at home often, and make sure I keep all doctor appointments,” she says.
The Bottom Line for Living Healthy With RA
You must ultimately be your own advocate to be at your healthiest with RA, Stelter says. “Educate yourself on every aspect of your condition and ask lots of questions to lots of different people,” she says. “Rest when you need to rest, and enjoy life and run around when you feel like you can. Cook good, fresh food for yourself, and understand that when you’re good to yourself, your body will be good to you.”