Mechanical stress on inflamed joints can worsen the pain and increase the damage that arthritis causes. While medication can help to decrease the inflammation associated with RA, reducing the stress on your joints can help both to reduce pain and to prevent disability.
The majority of joint stress is caused by increased body weight and inappropriate exercise. Obesity, for example, places tremendous stress on the weight-bearing joints in the low back, hips, knees, ankles, and feet—all of which are commonly inflamed by RA. If you suffer from RA, you should set a goal to achieve and maintain an ideal body weight. Meeting this target can reduce your risk of heart attack, stroke, and diabetes as well as improve your joint pain and prevent disability.
Getting enough rest is another important feature of RA management. When your joints are actively inflamed, you should avoid engaging in vigorous activity. Activity in this setting, for example, can intensify joint inflammation or cause traumatic injury to structures weakened by inflammation.
While rest is very important, especially when acute joint inflammation occurs, careful exercise is also encouraged for patients with RA. Exercise is necessary to prevent wasting of the muscles and improve cardiovascular health. Thus performing modest amounts of exercise when joints are not inflamed is recommended. Some people are able to get safe exercise even during a flare of their arthritis. For example, they can exercise their arms and shoulders when their knees are inflamed or walk more when their wrists and hands hurt.
Some mechanical aids are effective in reducing joint stress:
- Splints. Splinting of acutely inflamed joints, particularly at night, reduces pain and joint stress. Splinting has a modest anti-inflammatory effect, but may increase stiffness.
- Walking Aids. Employing a cane or a walker can be an effective means of reducing stress on the hip, knee, and ankle joints. Wheelchairs and motorized mobility devices may also be appropriate, even for ambulatory patients, during flares of arthritis in their lower extremities.
- Grasping Aids. Using pliers to open bottles, twist caps, or grab the tops of pots or cooking utensils can reduce stress in your hands and wrists. Long-handled “pickups” such as those used by gardeners or cleanup crews, can decrease stress on your hands as well as your back and knees. The long handle means that you do not have to bend down to pick up things. Many tools and utensils are now sold with “built-up” foam handles that make them easier to grip and manipulate.
- Remote-Control Devices. Using remote-control devices can decrease the amount of walking you must do in your home. The remote control for the television is common enough, but remote controls can also be used to adjust the room's thermostat, open front doors, turn on and off lights, and access security systems. Using a cordless telephone or cell phone may also reduce the number of times you have to run to answer the phone.
Discuss these and other aids and devices with your rheumatologist, physical therapist, or occupational therapist. Consultations with a physical therapist and an occupational therapist are recommended for everyone early in the course of RA. These specialists can advise you on exercise and mechanical aids, suggesting which ones are most helpful and letting you know where to purchase them.