Rheumatoid arthritis is a chronic condition which benefits greatly from patients who are vigilant about their own self-care. Sufficient rest, especially during flare-ups, good diet, exercise, preventative medicine – such as having annual flu jabs and other precautions that can be taken to lessen the risk of contracting additional health problems, and attending regular reviews with your health team are all extremely important.
The general advice is that there is no one miracle diet for RA patients, however, studies have repeatedly shown that those who stick to a Mediterranean Diet – rich in fresh fruit, vegetables, olive oil and fish – have less progression of symptoms than patients who opt for a diet of more processed food with a greater emphasis on meat. A year-long trial published in The Lancet followed the effect of a vegetarian diet on 27 patients. They were initially sent to a health farm for four weeks, put on a subtotal fast for 7-10 days, then a gluten-free vegan diet for 3-5 months and then changed onto a lactovegetarian diet for the remainder of the year. A control group ate an ordinary diet throughout the year but also spent four weeks in a convalescent home. During the first month the health farm group showed much improvement in the pain, swelling and stiffness of their joints. These benefits were still present a year later, the control group showed no improvement.
Regular exercise is extremely important for RA patients in order to improve mobility and flexibility as well as keep heart and lungs healthy. However, if some forms of exercise regularly preclude flare-ups it is best to avoid them in preference for different types of activity. It is important to avoid putting too much strain on the joints, so sports such as swimming, cycling, walking and aqua aerobics are preferable to running or high impact aerobics. It is also important to keep the joints warm. For problems with the hands see the study involving playing musical instruments in the section on creative therapies.
When you begin to exercise, it is important to do something you enjoy as then you are more likely to continue with the activity. Set yourself realistic goals to begin with so that you progress slowly.
There are a range of specific exercises that you can do to manage pain in various areas of the body. See the website for Arthritis Research UK for more information.
This involves a series of gentle exercises that are done in a warm water pool. Warmth is extremely important for patients with RA and during a flare-up hydrotherapy may be one form of exercise that can be continued with and will still give benefits.
Well fitted, warm and comfortable footwear is particularly important for RA sufferers who have problems with their feet, ankles or knees. A full review of what to look for in footwear and insoles is given on the Arthritis Research UK website.