managing rheumatoid arthritis

Rheumatoid arthritis, or RA, is an autoimmune systemic inflammatory disease, which affects multiple joints in the body. Your immune system attacks healthy cells in your body by mistake, causing inflammation (painful swelling) and this tissue damage can cause long-lasting or chronic pain, unsteadiness (lack of balance), and deformity (misshapenness). RA can also affect other tissues throughout the body and cause problems in organs such as the lungs, heart, bowel, and eyes.

Early diagnosis and professionally guided management is critical to maintaining a good quality of life. Learning arthritis management strategies can provide you with the skills and confidence to effectively manage your condition.

Engage in joint-friendly activities
Participating in joint-friendly, low-impact physical activity can improve your pain, function, mood, and quality of life. These include walking, biking, dancing, and swimming. Being physically active can also delay the onset of arthritis-related disability and help people with arthritis manage other chronic conditions such as diabetes, heart disease, and obesity.

Stop smoking and control your weight
Multiple studies show that cigarette smoking increases a person’s risk of developing RA and can make the disease worse. Being obese can be associated with worsening of disease activity. Excess weight puts a strain on your body, especially your lower back, hips, knees, ankles and feet. Losing weight can help decrease your pain and increase your energy.

Be aware of your pain
If an activity causes joint pain, change the way you do it. Rest when you need to; alternate between sitting and stretching; and if you have pain in your feet, wear proper shoes.

Favor large joints
Large joints are stronger than small ones. Save your smaller, weaker joints for the specific jobs that only they can accomplish.
-Carry objects with your palm open, distributing the weight equally over your forearm.
-Carry your purse or satchel over your shoulder instead of grasping it with your hand. If your shoulder is painful, use a backpack.
-Slide objects along a counter or workbench rather than lifting them.
-Use your thigh muscles to rise from a chair instead of pushing off with your hands.

Use good body mechanics
If you position yourself correctly and use the muscles best suited for a task, you can minimize the stress on your joints.
-Carry heavy objects close to your chest, supporting the weight on your forearms. Keep your elbows close to your body.
-Pick up items from the floor by first bending your knees and hips, and stooping down. Or sit in a chair and bend over.
-Avoid twisting and awkward positions, such as reaching for objects in the back seat of a car from the front seat.
-Use your abdominal muscles to help you roll over when getting out of bed.

Arrange your work area wisely
-While sitting. Make sure you have good back and foot support. Your forearms and upper legs should be well-supported, resting level with the floor. You might want to raise your chair, to make it easier to get up from it.
-For typing or reading. If you type at a keyboard for long periods and your chair doesn’t have arms, consider using wrist or forearm supports. An angled work surface for reading and writing is easier on your neck.
-While standing. The height of your work surface should enable you to work comfortably without stooping.
Don’t give your joints the chance to become stiff, keep them active and moving.

Diagnosis and Treatment
RA is diagnosed by reviewing symptoms, conducting a physical examination, and doing X-rays and lab tests. It’s best to diagnose RA early,—within six6 months of the onset of symptoms, —so that people with the disease can begin treatment to slow or stop disease progression (for example, damage to joints).

Rheumatologists specialize in the care, diagnosis and treatment of RA patients. The signs and symptoms of RA are not specific and resemble other inflammatory joint diseases. Therefore, it is important to see a specialist. Diagnosis and effective treatments, particularly treatment to suppress or control inflammation, can help reduce the damaging effects of RA. Self-management strategies outlined above have been proven to reduce pain and disability.

Asha Shrestha, MD

Asha Shrestha, MD

Dr. Asha Shrestha is board certified in internal medicine and rheumatology.She received her Doctor of Medicine degree from Tribhuvan University in Nepal and completed her residency at Memorial Hospital of Rhode Island, Alpert Medical School of Brown University. She completed her rheumatology fellowship from Montefiore Medical Center, Albert Einstein College of Medicine. Dr. Shrestha practices at CareMount Medical’s Mount Kisco office and has privileges at Northern Westchester Hospital and Putnam Hospital Center.Learn more at CareMountMedical.com
Asha Shrestha, MD

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