Rheumatoid Arthritis
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Self-Management Techniques
Having the appropriate diagnosis and medical treatment from your doctor is important in the success of your life with rheumatoid arthritis. Equally important are the things you can do yourself to limit the impact of RA on your life. These include staying healthy and fit by balancing exercise, activity and rest, managing stress, depression and fatigue, avoiding joint pain and injury, and using complementary treatments along with your medications.
Exercise
Exercise is an important component in staying healthy when you have RA. Moderate physical activity on a regular basis help decrease fatigue, strengthen muscles and bones, increase flexibility and stamina, and improve your general sense of well-being. Joint flexibility is especially important when you have RA because stiff joints means inability to do daily tasks, such as buttoning a shirt or starting the car. Learn more about the types of exercise that can help you.
Balancing Activity and Rest
It is important to stay active when you have rheumatoid arthritis because you want to keep your joints flexible and healthy. “Use it or lose it, “ as the saying goes. However, you don’t want to push yourself too hard and end up in bed with a flare or doing damage to your joints. So the how do you know how much is too much and find balance in your life? When you are dealing with a disease that causes depression, pain, fatigue and joint damage, how do you manage your life outside of that disease?
The best answer is to listen to your body. “If you feel fatigued, and if an activity causes you pain for more than two hours after you stop, then you need to slow down,” advises rheumatologist David S. Pisetsky, MD, PhD, in his book The Duke University Medical Center Book of Arthritis. He advises his patients to incorporate several rest periods into their days. This is especially critical if you are experiencing a flare because of the risk of potential joint damage during this time.
Rest is part of the story. The other part is good, healthy activity – not just exercise. Staying active helps you manage your stress and depression as well as helping to improve your sleep and making it less painful to move your joints. Here’s some advice on how to manage these issues.
Stress
We all have stress in our lives – both good and bad. Unfortunately, good stress and bad stress can bring on a flare of your RA, which suggests a strong mind-body connection at work. While the typical “fight or flight” response to stressful situations if beneficial most of the time, especially in emergencies, overtime stress can wear you down because your body isn’t designed to be running on high alert all the time.
It may sound trite to say it helps to put on a happy face, but there is evidence that people with optimistic outlooks and feelings of being in control tend to do better over the long-term than people with less positive feelings about their RA. It is important to learn how to face stressful situations with increased confidence that you can get through them. This will help you take the steps you need to help you to remain healthy through stressful times.
You can take steps to improve your stress-management skills. Here are three steps you can take right now to begin to manage your stress.
- Identify your stressors. These are things that add to the stress in your life. They can be good things, like planning a birthday celebration or more frustrating, like being stuck in traffic. One way to discover your stressors is to keep a stress diary, that notes times when you are stressed and your physical and emotional response to that stress. Review your diary at the end of a week and see if you notice a pattern.
- Eliminate the negative. This can be a real challenge. We all have things we feel like we have to do that may cause some negative stress. Maybe it’s a family reunion or a big presentation at work. You will never be able to eliminate all the negative stress from your life, but, using your stress diary, you may be able to recognize some stressful patterns, times of day, or regular situations. It is here you can make some real changes. Look for ways to ease these stressful situations from doing something differently to using the word “no” when people ask you to do something you don’t want to do. This step can be difficult because many times it is the first time you and other people in your life realize you can’t do everything. But after a while you will notice the feeling of freedom, which isn’t stressful.
- Develop effective coping mechanisms. Come up with some positive ways to deal with stressful situations. The ability to be flexible and to deal with change can help you become more capable of managing problems effectively without them stressing you into an arthritis flare. Following are suggestions for handling stressful situations:
- Instead of dwelling on problems, refocus your attention on solving them.
- Develop and use support systems.
- Develop a “safety valve” to use when you need to let off steam, like writing in a journal, exercising or having some quiet time.
- Take good care of your body by eating healthy
Depression
It is not uncommon for someone with a chronic illness like arthritis to become depressed or feel helpless. It isn’t unusual for someone who is living with pain, fatigue and loss of function to feel overwhelmed and anxious about the future. If you do, it is important to recognize these feelings and get help working through them.
Mild depression can be helped through social interaction, journaling, posting messages on online discussion boards, exercise or doing something you find fun, such as shopping, taking a walk or seeing a funny movie.
If your depression is something more than just the “blues,” it is not something to suffer through silently. Speak to your doctor about finding a qualified professional to work with you to help you feel better and in more control of your life.
Relaxation & Sleep
Learning to relax is an important part of dealing with stress. Here are some techniques you can use to relax.
- Deep Breathing. This is as simple as it sounds. Breathing deeply can help you calm down and unwind. And it feels great! Find a quiet place and find five to 15 minutes to practice this every day.
- Progressive Relaxation. Progressive relaxation involves lying on your back and, starting with your feet and moving up your body to your face, consciously tensing and relaxing the muscles in your body. Combine with deep breathing for extra relaxation.
- Creative or Guided Imagery. Use this with deep breathing and progressive relaxation. Either use a tape of someone speaking or just use your imagination to take your mind on a mini-vacation. Choose a place that you feel you can relax and go there mentally. See every detail and see yourself there refreshed and relaxed.
Other methods of relaxation, such as biofeedback or self-hypnosis, require instruction from a physician or psychologist.
The relaxation techniques above can also help you get to sleep and sleep better. There are other techniques to use to help you get a good night’s sleep
- Establish a nightly routine that includes things that relax you, such as reading, drinking hot milk or herbal tea or listening to soothing music.
- Be conscious of your sleep environment. Use your bedroom only for sleep and sex. Don’t keep work-related items in the bedroom.
- Take a warm bath before bed to relax your muscles. Keep it quiet. Eliminate noise or cover unwanted noise with a neutral sound from a fan, air-conditioner or “white-noise” machine. Use earplugs and a mask if you need them.
- Choose a good comfortable mattress, good quality sheets and blankets.
- Exercise throughout the day.
- Avoid stress.
- Avoid beverages and foods that contain caffeine, alcohol and tobacco and big meals close to bedtime.
- If you still can’t sleep, try taking over-the-counter sleep aids or talk to your doctor about getting a prescription to help you sleep.
Don’t forget that regular exercise will also help by making your muscles and joints stronger.
