A diagnosis of rheumatoid arthritis (RA) can be frightening. RA is a chronic autoimmune condition that causes pain, stiffness, swelling, and limited joint movement. It is incurable, and often becomes progressively worse over time.
Fortunately, doctors and scientists are learning more about RA. As recently as November 2012, the Food and Drug Administration (FDA) approved a new medication called Xeljanz. The drug inhibits part of the immune system that can cause RA, and may help patients who fail to find pain relief from other medications.
Your doctor will likely recommend other treatments as well, which may include prescriptions, therapies, and even surgery to repair damaged joints. In the meantime, there are many steps you can take at home to help keep joints moving smoothly. You may have RA, but you don't have to let it rule your life.
What Happens as the Condition Progresses?
According to Dr. Philip Conwisar, a board certified orthopedic surgeon in California, "With the current modern medication treatments, many patients can achieve remission of rheumatoid arthritis. The key is early aggressive treatment with the proper medications."
A two-year study showed promising results. Over 40 percent of 682 people with RA from 92 treatment centers in Europe and Australia achieved clinical arthritis remission through early treatments with drugs like Enbrel and other DMARDs. Advancements in medications make the outlook for RA better than it was even five years ago.
However, progress depends on the patient. "As the disease progresses in some patients," says Dr. Conwisar, "the joints become swollen, painful, and stiff. Most commonly, the joints of the hands and wrists are involved. Larger joints such as the knees, hips, shoulders, and ankles can also be affected."
What can you do if you're facing these issues?
All healthcare experts agree—one of the best things you can do when you have RA is to exercise.
"Physical and occupational therapists are trained to help patients improve joint mobility and function of the musculoskeletal system," says Dr. Conwisar. "They can prepare a patient-specific therapy program that the patient can do on their own at home."
Naheed Ali, M.D., author of Arthritis and You, reiterates that the key is to keep moving. "Swimming and speed-walking are recommended," he says. "The former doesn't place too much weight on the joints, while the latter avoids excessive wear and tear."
Mario Siervo, M.D., Director of Medical Staff Operations at Leon Medical Centers, recommends that patients always check with their doctors. "Patients should consult with their doctor before starting a regular exercise program, as different [types of] RA require different exercises," he says. Exercises proven safe for RA patients include walking, using stationary bikes or elliptical machines, yoga, and water aerobics. Whatever you do, always check in with your body to assess how it's responding.
"It is important to listen to your body and not overexert yourself," Siervo says, "especially if joints are inflamed. Additionally, it's extremely important for patients to drink a lot of water to reduce inflammation."
Try Diet and Supplements
"A healthy diet for a patient with RA consists of a well-balanced diet low in saturated fats, high in omega-3 fats, and rich in fruits and vegetables," Dr. Siervo says. "Some examples of omega-3 fatty acid foods include: salmon, sardines, tuna, trout, olive oil, ground flaxseeds, walnuts, and almonds."
Dr. Bill Keller, vice president of Health Sciences and the chief scientific resource officer at Nature's Sunshine, was a pharmacist for 30 years before entering the supplement industry. He suffers from arthritis himself, and says patients should focus on three things: cartilage-building, anti-inflammatory support, and pain relief.
"Glucosamine and chondroitin both benefit me," he says. According to the Mayo Clinic, early human research supports benefits of glucosamine in the treatment of joint pain and swelling in RA (Mayo, 2012).
Keller also recommends hyaluronic acid (HA) and methylsulfonylmethane (MSM) to help build cartilage and synovial fluid. He suggests devil's claw to reduce inflammation. Other anti-inflammatory herbs that support arthritis are turmeric, willow bark, and andrographis.
For pain relief, Keller recommends hops cone extract, which has strong pain-relief properties. You may also want to try capsaicin, an active component of chili pepper. In a University of Oxford study, it helped 40 percent of arthritis patients reduce their pain by half.
Relax—Tips to Relieve Stress
According to scientists, the stress response system influences the immune system, and long-lasting stress can lead to proinflammatory effects. Researchers from the Karolinska Institute in Sweden studied data from 1,221 RA patients aged 18 to 65 years. They found that those experiencing high amounts of stress at work were more at risk for RA.
Another study from the University of Michigan reported similar results, concluding that there was a link between stress and flare-ups of the disease. Therefore, finding ways to relieve the stress in your life can also help you reduce flare-ups and ease pain. The Mayo Clinic recommends trying hypnosis, guided imagery, deep breathing, and muscle relaxation. Tai chi and yoga may also help.
Kathryn Tristan, research scientist in the rheumatology division at Washington University School of Medicine and author of Why Worry? Stop Coping and Start Living, says, "RA patients can be prone to worry and anxiety, which can also worsen the disease."
Tristan recommends instant stress busters to help you stay relaxed in stressful situations. First, she recommends patients take three deep breaths and focus on the present. "Forget about the unpredictable future," she says. "All you need is now."
Next, say a calming phrase, such as, "I can handle this." Repeat it several times, then focus on what you want, not what you don't want. "Stop terribilizing and assuming the worst may happen," she says. "Instead, possibilize, i.e., visualize things going the way you want and feeling happy about it."
Last but not least, smile! "Studies show whether you mean it or not, smiling releases mood-enhancing endorphins," Tristan says.