How to Choose the Best Course of Treatment to Manage Rheumatoid Arthritis

Patients can integrate energy conservation techniques into daily living activities by spacing out strenuous tasks, taking frequent rest breaks—including naps—and using good ergonomic and body-sparing positioning.

If necessary, a therapist can fabricate a hand splint. Splints can be custom-molded or prefabricated and be worn during daily activity or at night to neutralize deformity. Night splints can include wrists, as well as fingers and thumbs, and place joints in stress-free positions. A hand therapist can also guide patients on proper exercises to maintain joint flexibility, provide strategies to manage pain and edema, and demonstrate tools and equipment to protect joints.

“It is important to actively move the joints throughout the pain-free range,” Mr. Indalecio says. “Moving a joint 10 times daily through the full arc of motion will help prevent loss of motion. But pushing hard on a painful joint may contribute to its destruction over time.”

Heating swollen joints via warm compresses, heating pads and a paraffin bath can increase range of motion and decrease morning stiffness, he continues. Although studies on wearing compression gloves at night for arthritic hands are inconclusive, Mr. Indalecio says many patients report pain relief and increased dexterity when using them. Gloves are most frequently worn at night.

Smartphone apps built for RA self-management can track symptom changes and help patients accurately inform rheumatologists of their status over time and, thus, help guide treatment. Some comprehensive and user-friendly apps include RheumaTrack RA (from axovis GmbH), MyRA (from Crescendo Bioscience Inc.) and My Pain Diary (by Damon Lynn). The first two are free, and the latter costs $4.99 to download.

Food’s Integral Role

It’s also important to advise patients to make food choices that reduce inflammation, rather than cause it, says Dana Pitman, MS, RD, CDN, registered dietician at HSS. Be aware that some drugs may increase or decrease appetite, thereby affecting nutritional status.

Ms. Pitman

In addition, monitor drug and nutrient interactions, because foods can affect how the body absorbs or uses drugs, Ms. Pitman advises. The former can make a drug less effective or inhibit the excretion of drugs—potentially causing a toxic buildup.

Specifically, corticosteroids can lead to high blood sugar and increased bone loss with long-term use. To offset steroid-induced high blood sugar, patients should drink 2 L of water daily; avoid packaged sweets, desserts and sugar-sweetened beverages; eat lean protein and non-starchy vegetables and no more than two to three servings of fruit per day; and consume small amounts of healthy fats, such as olive oil, avocados and nuts.