Precautions for RA Patients

Rheumatoid arthritis, or RA, is a chronic autoimmune disease characterized by pain, swelling and stiffness in the joints, usually the small joints of the hands and feet. Unlike common arthritis, RA develops when your body's immune system attacks its own tissues. Because it is a disease of the immune system, how and when it manifests in patients is highly variable; it can strike with mild soreness or debilitating pain, and it can sometimes stay in remission for years at a time. There are a few precautions that RA patients can take to ensure effective management of the disease.

Remember the Disease's Variability

• The most important consideration when thinking about precautions for RA patients is to remember the variability of the disease. Not only will the disease manifest in different ways for different patients -- striking as early as age 25 or as late as the mid-50s -- but individual patients will respond to drug treatments differently as well. Patients may have a day, or days or weeks, with full range of motion and little pain or stiffness, and then suddenly wake up one morning completely fatigued and with limited ability to move. Patients should be aware of this fact when managing RA and plan accordingly: Understand that there will sometimes be limitations to your level of activity, and that balancing rest with activity will sometimes be the most important thing you can do. Although RA is a chronic disease, it is manageable through a variety of treatments.

Actively Manage Your Health Care

• Rheumatoid arthritis patients should also be active participants in their health care. Because RA is so variable, patients can frequently feel that the disease can control them; don't let it. Most RA patients have a dedicated care team composed of a variety of health professionals; make use of them. Ask questions of your doctor or other members of your care team about treatments or activities or to get help planning around RA. Understand that sometimes RA treatments will stop working. Talk to your doctor about lining up stages of treatments so that if that one stops working, you have options readily available. Talk to a physical therapist about different kinds of exercises you can do to maintain activity but not stress your joints. Many RA patients express feelings of loneliness, depression or frustration; don't hold in these feelings. Talk to a counselor about how the disease is affecting your feelings and your relationships.

Stay Active

• Another important consideration when thinking about precautions for RA patients is the importance of exercise. Maintaining physical activity -- even on days when joints are flaring up -- is of utmost importance. Try to do some kind of activity every day that gently exercises your joints within their full range of motion. On days when your joints are painful, scale back activities to include gentler ranges of motion to help keep the joint flexible. Exercise not only manages pain and your mood, but it also can help prevent osteoporosis, for which RA patients are at higher risk. Organizations such as the Mayo Clinic have recommendations for ways to keep your joints in good condition to minimize pain. Understanding the different levels of pain you may suffer, respecting the limitations of the joints, getting enough gentle exercise every day, taking care how you use your hands, using proper posture and body mechanics, balancing periods of rest and activity throughout the day, and not keeping your joints in the same position for long periods of time will help minimize RA pain.

Protect Your Bones

• Bone health is another key consideration. Because RA patients have an increased risk for osteoporosis, a proper diet rich in calcium and vitamin D will help maintain healthy bones; exercise will also help reduce the risk of osteoporosis. Some of the drugs used to treat RA can contribute to osteoporosis, but your doctor can prescribe medications that can help prevent osteoporosis.

Manage Symptoms of Anemia

• Talk to your doctor about managing anemia. Aside from joint pain, anemia is the most common symptom of rheumatoid arthritis. Studies have shown that treatments that stimulate red blood cell production help alleviate joint symptoms as well. These same studies show that patients who do not manage their anemia generally have worse outcomes than those who do.