Managing rheumatoid arthritis (RA) involves a comprehensive approach that includes exercise, rehabilitation, diet, and additional interventions. The 2022 American College of Rheumatology (ACR) guidelines provide important recommendations to help improve physical function, manage pain, and enhance overall quality of life for individuals with RA.
- Regular Exercise: Engaging in regular exercise is strongly recommended as it can improve physical function and help reduce pain. Various types of exercise are beneficial, including:
- Aerobic Exercise: Regular aerobic activity is suggested, although it may not significantly reduce pain.
- Aquatic Exercise: Exercising in water can enhance physical function, but may not affect pain levels.
- Resistance Exercise: This form of exercise can aid in physical function and potentially alleviate pain, and should be supervised to prevent injury.
- Mind-Body Exercise: Practices such as yoga or Tai Chi can improve physical function, though their impact on pain levels may be minimal.
- Occupational and Physical Therapy: Participation in comprehensive occupational and physical therapy is advised to assist with pain management, enhance physical function, and support overall independence. Early referral is beneficial.
- Hand Therapy: For individuals experiencing hand issues, hand therapy exercises can improve pain and functionality.
- Splinting and Bracing: Utilizing splints, braces, or orthoses can aid in pain relief and functional improvement for hands, feet, ankles, and knees. Proper fitting and use should be guided by a therapist.
- Joint Protection: Techniques to protect joints can enhance pain management and functionality. Learning these techniques from a professional is important.
- Activity Management: Strategies like pacing activities and managing fatigue can help maintain function and conserve energy.
- Mediterranean Diet: Adhering to a Mediterranean-style diet, which emphasizes vegetables, fruits, whole grains, nuts, seeds, and olive oil, is recommended, moderate amounts of low-fat dairy and fish; and limits to added sugars, sodium, highly processed foods, refined carbohydrates, and saturated fats.This diet may offer benefits for pain relief and overall health.
- Dietary Supplements: It is generally preferable to obtain nutrients from food rather than supplements, as evidence supporting the benefits of supplements is limited.
- Weight Management: Maintaining a healthy weight is crucial, as obesity can exacerbate RA symptoms.
- Self-Management Programs: These programs can improve physical function and pain, although their availability and cost may be limiting factors.
- Cognitive Behavioral Therapy and Mind-Body Approaches: These interventions may help with depression, anxiety, and fatigue, though their effects on pain and function has not been demonstrated
- Acupuncture and Massage Therapy: While these methods may provide some pain relief, the evidence supporting their effectiveness is limited.
- Thermal Modalities: Heat and cold treatments can enhance pain relief and function and can be used at home or under professional guidance.
- Avoid Electrotherapy and Chiropractic Therapy: There is no strong evidence supporting the use of these therapies for RA, and they may carry potential risks.
- Quit Smoking: Quitting smoking is crucial, as it adversely affects RA and overall health. Support from a healthcare team is essential in this endeavor.
These recommendations are designed to complement primary RA treatments and should be discussed with a healthcare provider to ensure they align with individual needs and circumstances.
