RA can cause the ends of the bones within a joint to wear down erosions. An X-ray, ultrasound, or MRI magnetic resonance imaging scan can look for erosions. Imaging results can also show how well treatment is working. Search arthritis. Working with your doctor to ensure you get appropriate medical treatment is essential, but you can also take measures on your own to manage your RA and ease pain and fatigue. Diet, exercise, smoking cessation and mental health are all key to good health overall and controlling RA.
Get help setting health goals and managing pain with the free Vim app. Healthy Eating. A balanced, nutritious diet consisting of the recommended amounts of all the food groups helps promote wellness and makes it easier to maintain a healthy weight. Daily movement. Use the stairs instead of taking the elevator. Park in a spot that makes you walk a bit to enter a building. Take the longer way to a meeting in your office. Balancing activity with rest. It's important to try to stay physically active even during a flare, but rest is also especially important when RA is active and joints feel painful, swollen or stiff.
Rest helps reduce inflammation and fatigue that can come with a flare. Taking breaks throughout the day protects joints and preserves energy. Heat treatments , such as heat pads or warm baths, tend to work best for soothing stiff joints and tired muscles.
Cold is best for acute pain and swollen joints. It can numb painful areas and reduce inflammation. Topical products. These creams, gels or stick-on patches can ease the pain in a joint or muscle. Stress Reduction and Complementary Therapies. There are different ways to relax and stop focusing on pain. They include meditation , deep breathing, and thinking about images in your mind that make you feel happy.
Massage can help reduce pain, relax sore muscles and ease stress or anxiety. Acupuncture involves inserting fine needles into the body along special points to relieve pain. However, talk with a doctor before taking any supplement to discuss side effects and how it may affect other medicines you are taking.
Positive Attitude and Support System. Cultivate a network of friends, family members and co-workers who can help provide emotional support. Take time to do things that you enjoy to lift your mood, which can help relieve pain. Every gift to the Arthritis Foundation will help people with arthritis across the U. Join us and become a Champion of Yes. Morning stiffness, persisting more than one hour but often lasting several hours, may be a feature of any inflammatory arthritis but is especially characteristic of rheumatoid arthritis.
Its duration is a useful gauge of the inflammatory activity of the disease. Similar stiffness can occur after long periods of sitting or inactivity gel phenomenon. In contrast, patients with degenerative arthritis complain of stiffness lasting but a few minutes.
Symmetrical joint swelling is characteristic of rheumatoid arthritis that has been persistent for a period of time. However when only a few joints are affected at the beginning of disease, symmetry may not be seen and should not preclude the diagnosis of RA. Careful palpation of the joints can help to distinguish the swelling of joint inflammation from the bony enlargement seen in osteoarthritis, with the swelling often described as being doughy or spongy in RA in contrast to firm knobby enlargement in osteoarthritis.
Wrists, elbows, knees, ankles and MTP are other joints commonly affected where swelling is easily detected. Occasionally inflamed joints will feel warm to the touch. Inflammation, structural deformity, or both may limit the range of motion of the joint. Over time, some patients with RA develop deformities in the hands or feet.
RA spares the distal joints of the fingers DIPs and the spine with the exception of the cervical spine especially the atlanto-axial joint at C1-C2 , which may become involved especially with longer standing disease.
Used by permission of the American College of Rheumatology. Permanent deformity is an unwanted result of the inflammatory process. Persistent tenosynovitis and synovitis leads to the formation of synovial cysts and to displaced or ruptured tendons. Extensor tendon rupture at the dorsum of the hand is a common and disabling problem. Advanced changes in RA shown below include ulnar deviation of the fingers at the MCP joints, hyperextension or hyperflexion of the MCP and PIP joints, flexion contractures of the elbows, and subluxation of the carpal bones and toes cocked -up.
Although the joints are almost always the principal focus of RA, other organ systems may also be involved. Extra-articular manifestations of RA occur most often in seropositive patients with more severe joint disease. Extra-articular manifestations can develop even in disease when there is little active joint involvement. Rheumatoid Nodules. The subcutaneous nodule is the most characteristic extra-articular lesion of the disease.
They are located most commonly on the extensor surfaces of the arms and elbows shown below but are also prone to develop at pressure points on the feet and knees. Rarely, nodules may arise in visceral organs, such as the lungs, the heart, or the sclera of the eye. Cardiopulmonary Disease. By getting involved, you become a leader in our organization and help make a difference in the lives of millions.
Become a Volunteer More About Volunteering. By taking part in the Live Yes! And all it takes is just 10 minutes. Your shared experiences will help: - Lead to more effective treatments and outcomes - Develop programs to meet the needs of you and your community - Shape a powerful agenda that fights for you Now is the time to make your voice count, for yourself and the entire arthritis community. Currently this program is for the adult arthritis community. Since the needs of the juvenile arthritis JA community are unique, we are currently working with experts to develop a customized experience for JA families.
Get Started. As a partner, you will help the Arthritis Foundation provide life-changing resources, science, advocacy and community connections for people with arthritis, the nations leading cause of disability.
Join us today and help lead the way as a Champion of Yes. Our Trailblazers are committed partners ready to lead the way, take action and fight for everyday victories. Our Visionary partners help us plan for a future that includes a cure for arthritis.
Our Pioneers are always ready to explore and find new weapons in the fight against arthritis. Our Pacesetters ensure that we can chart the course for a cure for those who live with arthritis. Our Signature partners make their mark by helping us identify new and meaningful resources for people with arthritis.
Our Supporting partners are active champions who provide encouragement and assistance to the arthritis community. Skin Nodules: About half of people with RA develop rheumatoid nodules. These are lumps of tissue that form under the skin, often over bony areas exposed to pressure, such as fingers or elbows. Unless the nodule is located in a sensitive spot, such as where you hold a pen, treatment may not be necessary.
Nodules sometimes disappear on their own or with treatment with disease-modifying antirheumatic drugs DMARDs. Rashes : When RA-related inflammation of the blood vessels called vasculitis affects the skin, a rash of small red dots is the result. In more severe cases, vasculitis can cause skin ulcers on the legs or under the nails. Controlling the rash or ulcers requires controlling the underlying inflammation.
Drug effects: Corticosteroids, prescribed to reduce inflammation, can cause thinning of the skin and susceptibility to bruising. People taking biologics, a sub-category of DMARDs designed to stop inflammation at the cellular level, may develop a rash at the injection site. Bones Thinning: Chronic inflammation from RA leads to loss of bone density, not only around the joints, but throughout the body, leading to thin, brittle bones.
Exercise, a high-calcium diet and vitamin D can all help bones, but in some cases your doctor may need to prescribe a drug to stimulate bone growth or prevent bone loss. They can be used in combination with painkillers. When your symptoms get worse, this is known as a flare-up.
These can happen at any time, but can happen after you have been stressed or had an infection. It may be that you need to review your treatment. Heated items that could help your joint pain include a hot water bottle or electric heat pad.
Wrap these in a towel, then place on a painful joint. You could also try having a hot or warm shower or bath. Other heated items that people have found useful are wheat bag, heat pads, deep heat cream, or a heat lamp. Make sure these items are warm but not hot, as you could risk burning or scalding yourself. Gentle heat will be enough. A towel should be placed between the heated item and the skin for protection. Check your skin regularly, to make sure it is not burning. Some people find that using an ice pack can help their joint pain.
You can buy one from a pharmacy, or you can make one at home, by wrapping ice cubes in a plastic bag or wet tea towel. You may find it difficult to be physically active in the first place, especially if you are having a flare-up.
However, if you find the right activities, help and support, you can be active in a way that suits you. Not keeping active can lead to stiff joints and weak muscles. It could also cause you to gain weight. As you get used to it, this will get better.
However, if a type of exercise always causes a flare-up, it's probably best to find another one. High-impact exercises such as step exercises, or contact sports, such as rugby and football, are more likely to cause problems.
Swimming, walking, gentle cycling and aqua aerobics generally put less strain on your joints. Yoga and tai chi are generally thought to be suitable for those with rheumatoid arthritis. However, there are many different styles, so it is best to check the style is suitable for your condition before you sign up to a class. You should also break up long periods of sitting with light activity, to avoid being sedentary for extended periods. A physiotherapist can suggest suitable exercises for you and support you in keeping active.
People with rheumatoid arthritis should have access to specialist physiotherapy to help manage their condition and improve their fitness, flexibility and strength.
You should also have follow-up reviews. Find a physiotherapist on The Chartered Society of Physiotherapy website. You may also find that hydrotherapy helps to ease your symptoms. This involves doing special exercises in a warm-water pool, under the supervision of a trained physiotherapist. Any member of your healthcare team should be able to refer you to an NHS physiotherapist if they think you might benefit from hydrotherapy.
In some parts of the UK, you can also refer yourself to a physiotherapist , who will assess whether hydrotherapy would be suitable for you. Check with your GP or call your local rheumatology department to find out if an NHS physiotherapist in your area will accept self-referrals.
It can help to improve the pain in your joints, and you may also find it relaxing. Ask your doctor or physiotherapist if they think hydrotherapy would be suitable for you. If these problems are left untreated, they can lead to the infections spreading and, eventually, to ulcers forming.
It is therefore important to see a podiatrist , who specialises in general foot care. They can give advice on footwear, information on how to treat foot problems yourself, and can provide special insoles. They can also monitor your foot and general health, and will refer you to a consultant if they find any issues. There may be a podiatrist in the rheumatology department where you receive your care, or you may get a referral to an NHS podiatrist.
GPs can also refer you to community-based services. You can find a private podiatrist on the College of Podiatry website. Complementary treatments can be useful when used alongside prescribed medicines for the treatment of rheumatoid arthritis. However, they should not replace your prescribed medicines and you should talk to your rheumatology team before starting a complementary treatment.
Generally complementary treatments aren't considered to be evidence-based and are therefore not usually available on the NHS. Occupational therapists can help you keep doing the activities you need or want to do — at home or at work. They will work with you to find different ways of doing things. Ask your GP about occupational therapists that are local to you. If you regularly see a social worker, nurse or other health care professional, they can help you contact an occupational therapist through health or social services.
Be prepared to describe any difficulties you have and how they are affecting your life, or the lives of those who care for you. You may want to know how long it will be until you get an appointment, so remember to ask if there is a waiting list. You can also see an occupational therapist privately. You will be able to get an appointment quicker, but it will cost you money.
Find an occupational therapist that works privately on the Royal College of Occupational Therapist website. If you have trouble doing everyday tasks, you may find it useful to use certain aids and adaptations. Aids can help you manage everyday tasks such as bathing, dressing, and cooking.
These can include shoe horns, rails or handles, and shower seats. Adaptations are bigger items that can help you move around your home. These items include wheelchairs, fixed ramps and baths with built-in handles.
You can request a needs assessment from your council to see if you would be eligible for aids and adaptations. Aids and minor adaptations you receive form your local council should not be means-tested, meaning that no matter how much money you have, the local authority has to provide you with them. If you live in Wales, Scotland or Northern Ireland, contact your GP or local council for information about access to these items. If you are living with rheumatoid arthritis, you may also be living with one or more other conditions.
Depression is the most common condition among people with rheumatoid arthritis, affecting one in six people. If you are feeling low, talk to your GP, who can signpost you to the appropriate services. You can also call the arthritis helpline for free on , where our trained advisors can give you help and support.
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