Rheumatoid arthritis - Living With

Living with-Rheumatoid arthritis




Rheumatoid arthritis can be life-changing. You may need long-term treatment to control your symptoms and reduce joint damage.
Depending on how much pain and stiffness you feel and how much joint damage you have, you may have to adapt the way you carry out simple daily tasks.
They can become difficult or take longer to complete.
Here are some things you can do to help keep the condition under control.

Self care

Self care is an integral part of daily life. It involves taking responsibility for your own health and wellbeing with support from those involved in your care.
It includes what you do every day to stay fit and maintain good physical and mental health, prevent illness or accidents, and care more effectively for minor ailments and long-term conditions.
People living with long-term conditions can benefit enormously from being supported to care for themselves. They can live longer, have a better quality of life, and be more active and independent.

Take your medication

It's important to take your medication as prescribed, even if you start to feel better, as medication can help prevent flare-ups and reduce the risk of further problems, such as joint damage.
If you have any questions or concerns about the medication you're taking or side effects, talk to your healthcare team.
It may also be useful to read the information leaflet that comes with the medication about possible interactions with other drugs or supplements.
Check with your healthcare team before taking any over-the-counter remedies, such as painkillers or nutritional supplements.
These can sometimes interfere with your medication.

Regular reviews

As rheumatoid arthritis is a long-term condition, you'll be in contact with your healthcare team regularly so they can make sure your condition is under good control and your treatment is right for you.
You may have your disease activity score (DAS) measured regularly, which can help your healthcare team to decide on the best treatment.
Read more about the DAS score on the National Rheumatoid Arthritis website.
The more the team knows, the more they can help you, so discuss any concerns you have with them.

Reducing your medication

Some people find their symptoms go away or get much better. If your symptoms stay better like this for at least a year without needing to take corticosteroids (steroid medication), your treatment can be reviewed.
Your doctor may suggest gradually reducing your dose of medication, and seeing if you can come off it altogether.
You'll be monitored all the time. If your symptoms return, you'll need to go back on disease-modifying drugs (DMARDs) straight away.

Keeping well

If you have rheumatoid arthritis, you may be advised to have a yearly flu jab to protect against flu.
You may also be advised to have a pneumococcal vaccination, a one-off injection that protects against a specific serious chest infection called pneumococcal pneumonia.
Get plenty of rest during a flare-up as this is when your joints can be particularly painful and inflamed.
Putting further strain on very swollen and painful joints can often make the pain and inflammation worse.

Healthy eating and exercise

Regular exercise and a healthy diet are recommended for everyone, not just people with rheumatoid arthritis. 
They can help prevent many conditions, including heart diseaseand many forms of cancer.
Exercising regularly can help relieve stress, help keep your joints mobile, and strengthen the muscles supporting your joints.
Exercise can also help you lose weight if you're overweight, which can put extra strain on your joints.
But it's important to strike a balance between rest and exercise. Rest will make inflamed joints feel more comfortable, but without movement your joints will stiffen and your muscles will become weaker.
You need to find out the best activities and the right balance for you.
When starting exercise it's always best to increase the amount of exercise you do gradually.
If a particular activity causes your joints to become warm and swollen, or it causes severe pain, then stop and rest. If not, you should be fine to continue.
If a particular activity always causes a flare-up, it's probably best to avoid it and find an alternative.
In general, exercises involving high impact, such as step exercises or contact sports like rugby and football, are more likely to cause problems.
Forms of exercise that put less strain on your joints include swimming, cycling, walking and aqua aerobics. 
If you need further help, your physiotherapist is a good person to help advise on appropriate exercises for you.

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Self-management

Taking control of rheumatoid arthritis will help you cope with its impact on your lifestyle.
Arthritis Care offers self-management training courses to teach techniques for living positively with arthritis.
Techniques include:
  • relaxation and breathing exercises to help pain control
  • goal-setting exercises
  • positive thinking
A self-management programme specifically for people with rheumatoid arthritis has been developed by the National Rheumatoid Arthritis Society (NRAS).
The course helps people learn more about their condition and provides practical tips on how to manage everyday life.

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Talk to others

Many people find it helpful to talk to others in a similar position. You may find support from an individual or group of people with rheumatoid arthritis.
Patient organisations have local support groups where you can meet others diagnosed with the same condition.
Call the NRAS helpline free on 0800 298 7650 to speak to a trained rheumatoid arthritis adviser. NRAS also has a team of medical advisers.
You can also call Arthritis Care's free confidential helpline on 0808 800 4050 (Monday to Friday, 10am to 4pm).

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Your feelings

It can be hard to deal with the unpredictable nature of rheumatoid arthritis.
Some days the pain and stiffness will be much worse than others, and there's no way of knowing when a flare-up will occur.
The difficult nature of rheumatoid arthritis can mean some people develop depression or feelings of stress and anxiety.
Sometimes these feelings can be related to poorly controlled pain or fatigue.
Living with any long-term condition makes you more likely to have a range of emotions, such as frustration, fear, pain, anger and resentment.
Speak to your healthcare team if you're struggling to deal with your condition emotionally.
They may be able to offer medication or psychological interventions to help.

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Starting and raising a family

If you're taking medicines for rheumatoid arthritis, let your healthcare team know if you want to start a family or you're worried about becoming pregnant while on medication.
Some medications, such as methotrexate, leflunomide and biological treatments, shouldn't be taken by men or women while they're trying for a baby.
The doctors and nurses will work with you to ensure your rheumatoid arthritis is controlled while you're trying to get pregnant.
Babies and young children are physically and mentally demanding for any parent, but particularly so if you have rheumatoid arthritis.
If you're struggling to cope, it may help to talk to other people in the same situation as you.
You may also be able to get additional support from your health visitor or occupational therapist to help you manage your young family.

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Sex and relationships

Pain, discomfort and changes in the way you feel can affect your sex life.
Your self-esteem or thoughts about how you look may affect your confidence.
Although many people find it difficult to talk about such private issues, there are resources that might help you.
Talking to your partner or GP about the impact of rheumatoid arthritis on your sexuality and sexual relationships may help.

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Money and benefits

If you have to stop work or work part-time because of your rheumatoid arthritis, you may find it hard to cope financially.
You may be entitled to one or more of the following types of financial support:
You may also be eligible for other benefits if you have children living at home or a low household income.

Paying for your medications

If you have rheumatoid arthritis, you're likely to need repeat prescriptions of medication to keep your condition under control.
Rheumatoid arthritis isn't listed as a medical condition that entitles a person to free prescriptions in England.
But you may be able to get your medication for free if your condition falls under the category of "a continuing physical disability which means the person can't go out without the help of another person".
You're also entitled to free prescriptions if you're 60 or over, or if you receive either: 
  • Income Support
  • income-based Jobseeker's Allowance
  • income-related Employment and Support Allowance.
If you aren't entitled to free prescriptions, you may find it cheaper to buy a prescription prepayment certificate (PPC).
This is effectively a prescription "season ticket" that covers all your prescriptions over a 3- or 12-month period.
Read more about help with prescription costs to see if you're entitled to free prescriptions.

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