Rheumatoid Arthritis

Symptoms of rheumatoid arthritis usually include:

• Joint pain

• Swelling of the joints, which may also feel warm or hot to the touch

• Feeling stiff, often in the morning

• Feeling tired

• Feeling depressed or irritable due to the pain

• Anaemia

• Feeling as though you have flu e.g. tired, aching and with poor temperature control

Many people find that the smaller joints in their body, such as their fingers, knuckles and feet are affected first, but any joint could be affected.

Some people may find their symptoms cause difficulties bending, gripping, sitting comfortably, getting in and out of a bed or chair, using the toilet/bath/shower, or many other activities. There are rheumatoid arthritis aids to help with these activities which we talk about later in this guide, and you may wish to read more on the Arthritis Research UK website.

Some people also experience the following:

• Weight loss

• Eye inflammation

• Lumps around the joints

• Inflammation of other organs or blood vessels – this is quite rare

• Carpal tunnel syndrome

• Permanent joint damage or deformed joints

Symptoms may start slowly and many people don’t realise their aches and pains have a more serious underlying cause for some time, but it is important to obtain a diagnosis as soon as possible to avoid longer-term problems such as those listed above.

Rheumatoid arthritis sometimes takes a while to diagnose correctly because many different conditions cause similar symptoms such as stiff joints. The condition cannot be identified by just a simple test, and instead involves a physical exam, and combination of x-rays, scans and blood tests. For more information on rheumatoid arthritis diagnosis, visit the NHS website.

Medication

Medication is usually the main treatment option for people with rheumatoid arthritis, and your GP or specialist arthritis team are likely to prescribe you tablets in the form of disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate. These stop damage to the immune system. If these are not working for you, you may also be prescribed biological treatments such as etanercept or infliximab which are injected into the bloodstream.

For detailed information about rheumatoid arthritis treatment, visit the NHS website or Arthritis Care website.

Some people additionally use corticosteroid, non-steroidal anti-inflammatory drugs (NSAIDs) and painkillers to help reduce pain.

Surgery

Some people may need to undergo surgery for rheumatoid arthritis, which may include minor surgeries such as relieving pressure on the nerves or removing tissue that is badly inflamed and damaged. Some people may need to have major surgery to replace their joints, if these are so damaged that they are causing disability or constant pain; for example, a person may require a hip or knee replacement. For more information about these surgeries, see the NHS web page about hip replacement surgery or knee replacement surgery.

Alternative rheumatoid arthritis treatments

You may also be referred to a physiotherapist, who is trained to support you in keeping muscles strong and joints flexible. Complementary medicine such as massage and acupuncture, may also help relaxation, reduce stress and improve mood. Podiatrists can help with caring for your feet.

Having rheumatoid arthritis is likely to affect your life to some degree. It is a long term condition, but it is treatable. Everybody experiences the condition differently. Many people are able to work, exercise, and undertake their usual hobbies and activities. Other people may find these things more challenging, and their condition may result in some difficulties or disabilities. You may need to listen to your body more and rest when you feel tired or in pain.

The National Rheumatoid Arthritis Society provides many stories from real people who have the condition, which you may be interested in.

If you are finding daily activities around the home, such as getting around, personal care or household chores, more difficult, you may wish to have an assessment from an Occupational Therapist (OT). An OT may be able to recommend different ways to do things, with or without the use of specialist equipment, often referred to as ‘daily living aids’. NRS Healthcare are experts in daily living aids, and have a team of Occupational Therapists that can help you find the right products to meet your needs. Read on to find out more about daily living aid products for rheumatoid arthritis.

Here, we include a list of rheumatoid arthritis aids that may help with day-to-day tasks that some people find difficult due to their condition and symptoms.

Preparing food & drinks

• Spreadboard

• Chopper

• Easy grip cutlery

• Kettle tipper

• Perching stool

Carrying things round the home

• Household trolley

Getting around

• Walking stick

• Rollator

Getting in and out of chairs

• Rise and recline chairs

• Furniture raisers

Using the toilet

• Raised toilet seats

• Toilet frames and seat

Getting in and out of the bath

• Bath lift

• Bath step

Having a shower

• Grab rail

• Shower stool

Picking things up

• Reacher

Gardening

• Easy grip tools

If you are unsure what products for rheumatoid arthritis may suit your needs, please contact the NRS Healthcare Occupational Therapist product advisors by telephone: 0345 121 8111 or email: [email protected]

It is really important for a person with rheumatoid arthritis to exercise regularly, in order to keep their muscles strong and joints flexible. Many people find that low impact, aerobic exercises such as swimming, aqua aerobics or hydrotherapy are beneficial, because there is little impact on the joints whilst exercising in water. Some people feel that exercise is difficult for them because of their symptoms and pain. If this is the case for you, you may wish to visit your GP and request a referral to a physiotherapist, who will be able to find suitable rheumatoid arthritis exercises that you feel able to do.

Arthritis Care provides a comprehensive leaflet about exercise and arthritis, which includes movement and strengthening exercises for rheumatoid arthritis.

Diet for rheumatoid arthritis

Eating healthily is essential to ensure our bodies and minds function to their best ability, so for people with a long term condition such as rheumatoid arthritis, it is important to eat a varied, balanced diet. Being overweight or obese will also put more strain on the joints, so it is advisable to keep to a healthy weight. For tips on how to eat well, visit the Arthritis Research UK website.

It is thought that a diet with lots of vitamin C, low levels of saturated fat, and high levels of good, unsaturated fats (such as those found in some fish) are beneficial to the body if it is experiencing inflammation. Some people report that certain foods cause flare-ups of their condition.

Some people take supplements for rheumatoid arthritis, such as omega 3 capsules, fish body oil, glucosamine and turmeric. There is little evidence to show that these actually improve symptoms, but people do report feeling better.

We recommend discussing with your GP before embarking on any rheumatoid arthritis diet or rheumatoid arthritis supplements regime.

Rheumatoid arthritis and employment

You may be wondering; can I still work with rheumatoid arthritis? Yes, it is entirely possible for many people to continue to work if they have this condition. You may require support and understanding from your employer, and they are legally obliged to make reasonable adjustments to the tasks required of you or your working hours due to your healthcare condition. For example, if you find your pain is worse in the mornings, you may wish to start your working day later where possible.

Visit the Fit for Work website for more advice about talking to your employer about your health. Some people do find that their condition means they are no longer able to work or stay in the job they used to do, which may be difficult to deal with or may feel like a relief. Everyone will feel differently, but if you are finding the transition difficult, you may wish to speak to your GP or a local arthritis support group. Read on for more about rheumatoid arthritis support.

These forums and support groups may provide an opportunity for people affected by rheumatoid arthritis to share experiences and discuss the condition openly.

Arthritis Care Forum – an online forum from one of the leading UK arthritis charities, where people can connect to talk about their conditions

Arthritis Forum – a patient-led group for people with various types of arthritis to share stories and experiences

Rheumatoid Arthritis Forum – a Facebook group for people around the world affected by rheumatoid arthritis, to share and support each other

Arthritis Action – a charity providing information about arthritis as well as many personalised support services for members e.g. access to healthcare professionals, diet advice and local support groups

Arthritis Care – a UK charity providing online information, an online community, local support groups and a helpline

Arthritis Research UK – a leading UK charity providing a wealth of information about all arthritic conditions and advice about all aspects of living with them, as well as funding research

Disabled Living Foundation – a charity providing independent advice about equipment for disabled people

Disability Rights UK – a UK charity providing support to people of all ages with disabilities, to access work, education, learn new skills and live independently

National Rheumatoid Arthritis Society – a UK charity specifically focussed on rheumatoid arthritis, which provides publications, online information, mobile self-management app, a support helpline and local support groups

NHS Choices – a source of medical information on rheumatoid arthritis as well as related conditions, including symptoms, treatments and diagnosis, and general health and wellbeing advice

Anaemia

– a condition caused by lack of haemoglobin and red blood cells, which may be a result of low iron levels

Autoimmune disease

– where the body’s immune system attacks healthy cells in the body, mistaking them for viruses or hazards

Biological treatments

– these are drug treatments that are used to treat the cause of illnesses like arthritis e.g. they act on the immune system rather than just trying to stop symptoms

Corticosteroid

– anti-inflammatory steroid medication such as hydrocortisone, which treats allergies and inflammation caused by conditions such as asthma, eczema and arthritis

Disease-modifying anti-rheumatic drugs (DMARDs)

– medications used to treat arthritic conditions by slowing down their progression and reducing inflammation and other symptoms

Etanercept

– a drug that some people with arthritis respond to, which blocks the proteins in the body that cause arthritis inflammation

Glucosamine

– a supplement which is taken to ease joint pain

Infliximab

– a medication for arthritis that is given by a drip in a person’s arm, for health conditions that cause inflammation such as arthritis, which block the protein being produced in the body which is causing the inflammation

Joints

– a joint is the point where bones in the body meet each other, most of which contain fluid to help them move smoothly

Methotrexate

– disease modifying medication for arthritis and cancer patients, which comes in tablet or injection form and reduces the over activity of a person’s immune system which is causing their health condition

Non-steroidal anti-inflammatory drugs (NSAIDs)

– a medication such as ibuprofen, which is used to reduce inflammation and pain by blocking proteins in the body

Omega 3

– fatty acid found in some foods such as fish, which helps reduce inflammation in the body and is available as a diet supplement

Respiratory system

– the organs in the body responsible for breathing in oxygen, taking it round the body and exhaling carbon dioxide, including, for example, the lungs

Synovial lining

– this is a protective membrane made of delicate tissue, found around the joints

Turmeric

– a spice used in Indian cooking, which is thought to have numerous health benefits including being antioxidant and fighting inflammation, which is available as a high strength tablet or powder supplement