Rheumatoid arthritis – treating the effects and not just the disease

Wendy Holden

Medical Advisor And Consultant Rheumatologist, Arthritis Action

Self-managing arthritis involves learning methods to help manage both the physical and mental symptoms of the condition. As arthritis affects everyone in a different way, self-management means that individuals can choose the strategies that best suit their needs.

Managing weight, sensible use of pain-killing medicines, gentle exercise, and therapies to help with the mind, sleep or pain-related worries are some techniques that can help with arthritis-related symptoms.

Weight management

For every extra pound over a healthy weight, it is thought that an extra five pounds goes straight through the weight-bearing joints, especially the knees, hips and ankles. This means joints are carrying an extra 5 stones in weight if someone is one stone overweight (or the weight of a very heavy rucksack!) and this can clearly make joint pain worse. 

The good news is – just losing 10% can make a huge difference, in improving pain and mobility.

Staying active

Staying active is essential, as lack of exercise leads to weaker muscles, which are then less able to support the joints, leading to pain and instability. Simple exercises to improve muscle strength can be as effective for pain as prescription painkillers. These exercises can also help improve balance and function, keeping people independent and sometimes delaying the need for surgery for much longer.

If someone is new to exercise, it is important to slowly increase the level to avoid initial pain, so setting realistic and achievable goals is vital. An ideal plan should include aerobic exercise to improve cardiovascular fitness, resistance exercise to improve muscle strength, and flexibility exercises to maintain suppleness. 

Medication, including painkillers and anti-inflammatory drugs

Medicines unfortunately can’t cure arthritis but using painkillers and sometimes anti-inflammatory medicines sensibly can often make symptoms more bearable. Joint injections can also sometimes help.

Try using painkillers before rather than after any form of physical activity, for the best effects. Anti-inflammatory medicines should ideally be used at the lowest possible dose, for the shortest time to avoid harmful side-effects.

Stay positive; sometimes the pain disappears entirely

The pain of arthritis can make people feel low or depressed, especially if it is difficult to perform usual activities or keep up with family or friends. The good news is that arthritis pain often comes and goes, sometimes even going completely. Staying positive on a bad day by knowing that the pain will settle, and simple pain-management techniques including relaxation, distraction and counting blessings can really help.

Living with arthritis does not have to mean progressive pain and disability. Self-management can help with both the physical and mental impact of arthritis and can help people continue to live an independent, active and fulfilling life.

A patient perspective: “I concentrate on staying active”

Jennifer Devonshire, 32, is a Member of Arthritis Action with Seronegative  Rheumatoid Arthritis.

“I have found my local rheumatology department only really have time and capacity to treat the disease and not its effects on my body, so self-management is vital for me.

“I concentrate on staying active, doing focused exercises recommended by my physiotherapist and podiatrist to target the muscles supporting my joints without putting pressure on them, as well as swimming, which moves my whole body while supporting the joints.

“It can be difficult to find what works best when my joints are swollen but I have a collection of very gentle things I can do even on the worst days.

“I also take supplements such a vitamin D, calcium, and omega 3 oils to help bones and joints as well as overall health. I try to stay tuned in to how my diet affects my pain levels and eat anti-inflammatory foods like fresh fruit and vegetables, rather than too much processed food.”