Living With Rheumatoid Arthritis

Living with rheumatoid arthritis often means making changes to your lifestyle. You can do things at home, such as staying active and taking medicines, to help relieve your symptoms and prevent the disease from getting worse.

People who have rheumatoid arthritis also have an increased risk of heart disease. But healthy lifestyle changes, such as exercise and a healthy diet, may reduce your risk of heart disease.¹⁰ For more information, see the topics Healthy Eating and Fitness.

It is common to feel pain, fatigue, and joint stiffness with rheumatoid arthritis. Some activities may make your discomfort worse, while others might provide relief. Thousands of people with arthritis have benefited from developing and following plans to help them manage their symptoms. These plans often include education about the disease, exercise, diet changes, assistive devices, and other supports to help you stay as active as possible. For more information on managing your disease, see:

Arthritis: Managing rheumatoid arthritis.

You can also plan for those times when the disease symptoms may be more severe. It is important to work closely with your health professionals, who may include a physical therapist or counselor, to find ways to reduce pain.

People with rheumatoid arthritis have a high risk of developing osteoporosis because of the action of the disease itself, side effects from some treatments, and a decrease in physical activity as a result of disabling pain. To help prevent osteoporosis, get plenty of calcium and vitamin D. This calcium and vitamin D can come from dietary sources and supplements. If you do not consume significant amounts of milk and dairy products, you may need to take most of this requirement as supplements. Many health professionals also recommend that people with rheumatoid arthritis take bisphosphonates, such as alendronate (Fosamax) or risedronate (Actonel), which increase bone formation.³ For more information, see the topic Osteoporosis.

Rest when tired

Rheumatoid arthritis itself causes fatigue, and the strain of dealing with pain and limited activities also can make you tired. The amount of rest you need depends on how severe your symptoms are.

• With severe symptoms, you may need long periods of rest. You might need to rest a joint by lying down for 15 minutes several times a day to relax. Experiment until you find a good balance between daily activities that you must do or want to do and the amount of rest you need in be able to do those activities.
• Plan your day carefully, including rest periods, and pace your activities so that you don't get overtired.
• Don't feel guilty if you have to give up some tasks, such as making the bed or housework. Do the things you must do or really want to do, and find other ways to get less important things done.
• Don't rest too much. Prolonged joint inactivity can lead to more stiffness and, eventually, to weakness of underused muscles. Gently moving each joint through a comfortable range of motion each day will help prevent stiffness.

Protect your joints

You may need to change the way you do certain activities so that you are not overusing your joints. Try to find different ways to relieve your joint pain.

• Joint pain and stiffness may improve with heat therapy, which includes:
  • Taking warm showers or baths after long periods of sitting or sleeping.
  • Soaking hand joints in warm wax baths.
  • Sleeping under a warm electric blanket.
• Use assistive devices to reduce strain on your joints, such as special kitchen tools or door knobs.
• Use splints, canes, or walkers to reduce pain and improve function.

Exercise

Keep moving to maintain muscle strength, flexibility, and overall health.

• Physical therapy may be recommended by your health professional.
• Exercise can reduce pain and improve function in people with rheumatoid arthritis. Exercise for arthritis takes three forms—stretching, strengthening, and conditioning. Recent reviews of exercise studies report that both weight-bearing exercise and strength training improve or maintain the quality of life for people with rheumatoid arthritis.^{11, 12} Your specific joint problem may dictate what type of exercise will help the most. For example:
  • Swimming is a good conditioning exercise if you have joint problems in the lower extremities, such as the knees, ankles, or feet.
  • Bicycling and walking are good conditioning exercises if your joint problems are not in the lower extremities.

Eat a balanced diet

Some people with rheumatoid arthritis may not eat a healthy, balanced diet because symptoms may make it difficult to shop or cook.

The best diet for people with rheumatoid arthritis is a healthy, balanced diet that is low in saturated fat, cholesterol, and salt and high in fiber and complex carbohydrate (whole grains, beans, fruits, and vegetables).

• Although studies have been done to determine whether certain foods or special diets can improve the symptoms of rheumatoid arthritis, there is no consistent evidence that eating certain foods can help. The exception is fish. Fish oil (omega-3 fatty acids) has a modest effect in reducing inflammation and has been shown to slightly reduce swelling in rheumatoid arthritis. Although the doses of fish oil used in the studies were much higher than what a person can eat in an average serving of fish, eating fish may improve symptoms.
• Be sure to get enough calcium and vitamin D to protect your bones against osteoporosis. For more information, see the topic Osteoporosis.
• Lose weight, if you are overweight. For more information, see the topic Weight Management.