Rheumatoid Arthritis

Rheumatoid Arthritis:  6 Common Mistakes To Avoid.

Most people with rheumatoid arthritis can live full, active lives despite their disease. But living a good life with RA often means you need to work at managing your disease and get the help you need. Take care to avoid these six common mistakes.

Mistake 1: Not Seeing a Rheumatologist

If you’re like most people with RA, the first doctor you saw for your joint symptoms was a primary care physician. But a specialist has more training in treating RA.

Just 20 years ago, RA was often treated with medications that relieved pain but didn’t stop ongoing joint damage. Today, there are many new, effective — and highly complex — treatments for rheumatoid arthritis that do both. It’s important to see a rheumatologist, who has the training and experience to prescribe and monitor those medications.

If you haven’t seen a rheumatologist, your primary care doctor should be able to refer you to one. The American College of Rheumatology (ACR) also lists rheumatologists in your area.

Mistake 2: Becoming a Couch Potato

When you have joint pain and fatigue, it’s hard to get up and get moving. But regular exercise is one of the best things that you can do for your health. While rest is also important for managing your disease, too much inactivity can make pain, fatigue, and stiffness worse.

Even when your RA is flaring, you can — and should — do gentle range-of-motion exercises. Range-of-motion exercises help maintain joint movement and flexibility by taking joints through their full span of movements. No weights are used.
You may also be able to gently exercise in water during flares.

When your disease is less active, you should be more active. Add exercises to build muscle strength and joint stability and improve aerobic fitness.

Talk to your rheumatologist or a physical or occupational therapist about the best and safest exercises for you. Walking can be a good exercise for people with RA, and it doesn’t even require going to a gym! Warm-water aerobic exercise may be another choice to consider — the water gives sore joints some additional support.

Mistake 3: Skipping Doctor Appointments

While you may not feel the need to see your rheumatologist when your RA is less active, keeping your appointments is still important.

During regular visits, your doctor will:

Monitor the course of your disease
Determine how well your treatment is working.
Look for harmful side effects
Adjust your treatment, if necessary
In addition to seeing your doctor, you also may need periodic lab tests or X-rays. It’s important that keep those appointments, too.

Mistake 4: Not Taking Prescribed Medications

Pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) may help your joints feel better. But they do nothing to stop the joint damage that is going on inside. That requires a more powerful disease-modifying antirheumatic drug (DMARD) or biologic response modifier, or both.

Years ago, doctors started RA treatment with aspirin and other pain relievers. If the disease got worse, they then prescribed a DMARD. Today, doctors are likely to prescribe a DMARD or a biologic (or both) early on, particularly for aggressive RA.

In fact, ACR guidelines recommend that all people diagnosed with RA be given a DMARD, regardless of how active or severe their RA is. Studies have shown that starting powerful drugs earlier may be more effective in reducing or preventing joint damage.

If your rheumatologist recommends a DMARD or biologic and you don’t take it, you may be risking serious joint damage that cannot be repaired. If you have active RA and your doctor has not recommended one of these drugs, ask if you need one.

Mistake 5: Skipping Medication When You Feel Good

You may be tempted to skip your medications on days when you’re feeling better. But failing to take your medications could cause the pain — or even your rheumatoid arthritis — to get worse.

If you take medication for pain and inflammation, you should take it consistently. Missing a dose could cause the pain to return, and it may be more difficult to relieve. The same is true for joint inflammation. It’s better to keep it under control than allow it to flare and try to get it under control again.

To control your RA, some medications need to stay in your bloodstream at therapeutic levels. If you miss a dose of medication, you should take it as soon as you remember (but don’t take a double dose). If you miss a dose often — even if you are feeling better at the time — blood levels of the drug may drop and could cause a flare of your RA.
Mistake 6: Accepting Depression

Living with RA isn’t easy. It can be painful and unpredictable and make it hard to do the things you enjoy. It’s understandable that you may become sad at times, but you don’t have to accept depression as a part of your disease.

Ask your doctor to refer you to a mental health professional who works with people with chronic diseases. Counseling may help you develop better skills for coping with RA. Attending a support group, such as those offered by the Arthritis Foundation, may also help.

If you still experience feelings of depression, let your doctor know. Some people with rheumatoid arthritis benefit from taking antidepressants. Simply accepting depression can take the joy out of life and make it more difficult to manage your disease.