The Bread Basket May Be Doing You More Harm Than You Think
In my experience treating patients with RA, coming off gluten, dairy, and processed sugar helps at least 60 to 70 percent of people, Dr. Levitan says. Some research, he says, indicates that gluten may be pro-inflammatory whether you are sensitive to it or not. This means that in addition to ditching junk food like cookies and cupcakes, cutting back on foods like bread and pasta, even if theyre whole grain, may help.
Its a good idea to talk to your doctor before making any dramatic changes in your diet. They may be able to give you pointers on how to follow an elimination diet temporarily to see if there are any trigger foods that affect you personally.
What Happens In A Joint Affected By Rheumatoid Arthritis
If you have rheumatoid arthritis, your immune system can cause inflammation inside a joint or a number of joints. Inflammation is normally an important part of how your immune system works. It allows the body to send extra fluid and blood to a part of the body under attack from an infection. For example, if you have a cut that gets infected, the skin around it can become swollen and a different colour.
However, in the case of rheumatoid arthritis, this inflammation in the joint is unnecessary and causes problems.
When the inflammation goes down, the capsule around the synovium remains stretched and cant hold the joint in its proper position. This can cause the joint to become unstable and move into unusual positions.
The following can play a part in why someone has rheumatoid arthritis:
Complementary And Alternative Medicine For Patients With Rheumatoid Arthritis
Rheumatoid Arthritis is a chronic, inflammatory, autoimmune disease that impacts joints and connective tissue. It is often painful and disabling, and usually requires lifelong pharmacological management. Patients are usually diagnosed between the ages of thirty and fifty, although RA affects all ages. Common co-morbidities include cardiovascular disease, cachexia , depression and impairments to quality of life . Although they have greatly improved the general course of RA, drugs that are commonly used to manage the disease carry some notable side effects as well.
For all of these reasons, patients with RA often look to Complementary and Alternative Medicine for additional sources of relief. In fact, joint pain and arthritis are among the top five most common reasons that Americans seek CAM . Usually, CAM is sought in addition to allopathic treatment to ease symptoms of the disease and side effects of drug therapy. Below is an outline of the currently available research for treatments that are commonly used by RA patients, as well as a synopsis of what may be recommended as safe and possibly effective for this population.
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Adding Or Removing Some Bone Around A Joint
If you have osteoarthritis in your knees but youre not suitable for knee replacement surgery, you may be able to have an operation called an osteotomy. This involves your surgeon adding or removing a small section of bone either above or below your knee joint.
This helps realign your knee so your weight is no longer focused on the damaged part of your knee. An osteotomy can relieve symptoms of osteoarthritis, although you may still need knee replacement surgery eventually.
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Dietary And Botanical Supplements
When working with an RA population, fish oil is probably the most frequently mentioned supplement. The standard western diet contains a low proportion of omega-3 type essential fatty acids , which are said to have anti-inflammatory properties. Two EFAs in fish oil are eicosapentaenoic acide and docosahexanoic acid . The body can actually convert EPA to DHA, but individuals vary with regard to the efficiency of that conversion. EPA and DHA can also be found in vegetable sources, such as flax and algae, respectively. In a report by the National Center for Complementary and Alternative Medicine within the National Institutes of Health , it was concluded that evidence for the use of fish oil for the treatment of RA is promising, as a result of several laboratory, animal and clinical studies . Some effect has been noted for symptoms such as tender joints, morning stiffness and use of non-steroidal anti-inflammatory drugs . What is uncertain, however, is how much of this effect is placebo, as results from randomized controlled trials are inconsistent.
Glucosamine and chondroitin.
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Make Healthy Lifestyle Choices
Maintaining a healthy lifestyle will help your physical and mental well being. Doing gentle, regular exercises can help keep your joints flexible, strengthen your bones, help you maintain a healthy weight, relieve emotional stress and create a feeling of general well being. Eat a well-balanced diet with a high intake of whole grains, vegetables, fruits, legumes, nuts, fish and olive oil. There is no specific diet for people with RA and no specific foods to avoid.
Find Your Healthy Weight
Being a healthy weight is important for everyone, but especially for those suffering from joint pain.1 Excess weight places increased stress on your whole body, especially your joints.2 But heres the good newslosing even just a few pounds can help you reduce pressure on your ankles, knees, and hips.3 For your best odds of long-term weight loss success, take off the pounds slowly using a healthy eating plan and regularly engaging in physical activity.
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Topical Creams Gels And Patches
Recently, several topical over-the-counter and prescription products have emerged as options for treating RA pain. These anti-inflammatory substances can come in cream, gel, or patch form and generally have fewer side effects because they are administered locally .
These medications are sold under several brand names including Flector, Voltaren, and Pennsaid. It is also worth noting that these products are generally more effective for superficial joints like the hands, elbows, or ankles.
Other topical options for people who cannot use NSAIDs in any form can use capsaicin, lidocaine, or menthol-based creams, like IcyHot, BenGay, or Aspercreme.
Can Supplements Help Improve Rheumatoid Arthritis Symptoms
Its important to discuss supplements with your doctor before starting them, because many herbal supplements are not rigorously studied by the FDA and may potentially interfere with other prescription medications. That said, numerous dietary supplements have been proposed for RA treatment, and research suggests that some of them appear promising.
Fish oil, for instance, contains high levels of omega-3 fatty acids, and studies have suggested that this substance may help relieve tender joints and morning stiffness, reducing the need for anti-inflammatory drugs. But fish oil should be used with caution because it can interact with blood pressure medication.
A review published January 2017 in the journal Nutrients found that marine oil supplements can help reduce pain in patients with RA.
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Diagnosis Of Rheumatoid Arthritis
- Ordering laboratory tests.
- Ordering imaging studies, such as x-rays or ultrasound.
It can be difficult to diagnose rheumatoid arthritis when it is in the early stages because:
- The disease develops over time, and only a few symptoms may be present in the early stages.
- There is no single test for the disease.
- Symptoms differ from person to person.
- Symptoms can be similar to those of other types of arthritis and joint conditions.
As a result, doctors use a variety of tools to diagnose the disease and to rule out other conditions.
Ways To Improve Prognosis
Despite the unpredictability of rheumatoid arthritis progression, patients can ensure a positive outlook by doing the following:
- Maintaining a healthy lifestyle including diet
- Quit smoking and other poor lifestyle habits like drugs and alcohol
- exercising regularly including walking, cycling, and swimming
- Engaging in physical and occupational therapy to help adapt daily routines to any mobility challenges
- Adhering to a personalized medical treatment plan which can include taking DMARDs and other medications
All of these methods are aimed at improving or maintaining the patients quality of life, managing disease symptoms, reducing pain, and very importantly, establishing a positive outlook for the patient.
In some cases, doctors may recommend surgery to completely replace joints or to rebuild them. This can alleviate pain and improve mobility in some cases. While surgery is a viable option, the rates of surgical joint replacements in rheumatoid arthritis patients are declining. This is largely due to the massive improvements in other treatment options, and early detection rates in modern times.
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How Is Rheumatoid Arthritis Managed
You can manage rheumatoid arthritis by taking medicines as prescribed to treat pain and joint inflammation. You can also help reduce symptoms by exercising and maintaining a healthy weight. Aim to do 30 minutes of moderate exercise most days of the week. This can be at one time or broken up into shorter sessions.
You may also need to make changes at home to help you manage daily tasks like cleaning or gardening. An occupational therapist can help you make adjustments if pain or joint stiffness makes certain tasks hard to complete. They can recommend tools to reduce strain on your joints, such as long-handled dustpans so you dont need to bend over, or book holders to reduce the strain on your hands and wrists.
You might find that rheumatoid arthritis makes you frustrated and upset. Rheumatoid arthritis can cause poor sleep, which can also make you feel down. Discus your feelings with friends and family and explain to them what they can do to support you. This may help you feel better and reassured that help is available, if needed. If you are struggling with a low mood or not managing to sleep, your doctor will be able to support you and work with you to build a plan to help.
Surgery And Other Procedures
If a joint is severely affected, you may need surgery. The most successful surgeries are those on the knees and hips.
Sometimes people with RA need total joint replacement with an artificial joint. Surgeries may relieve pain, correct deformities, and modestly improve joint function. In some cases, total knee or hip replacement can restore mobility and improve quality of life.
Adopt Healthier Lifestyle Habits
Its very important to maintain a healthy lifestyle. Eat a good diet, consider anti-inflammatory foods, and exercise regularly . Talk with your primary doctor and/or rheumatologist about alternative treatments for rheumatoid arthritis, such as acupuncture or relaxation therapy. Reducing your to reduce your rheumatoid arthritis pain is also an important, and many times undervalued, treatment option.
Its not that a healthy lifestyle will cure rheumatoid arthritis rather, a healthy lifestyle will help you get through each day better and help you better deal with the effects of RA.
It is helpful to keep a medical diary noting medications that work, drug side effects, severity of symptoms, flare-ups, and remissions.
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Whats The Best Diet For Rheumatoid Arthritis
Another key component to addressing rheumatoid arthritis integratively is through finding and customizing your therapeutic diet. Keep in mind that any diet that quells inflammation and lowers autoimmune reactivity is likely to be helpful for RA. These are some of the diet options that RA patients may find useful to help manage symptoms:
- Elimination diet
- Low FODMAP diet
- Low nightshade diet
So, how do you decide which diet framework to try? The most fundamental place to start with changing your diet is an elimination diet. The point of an elimination diet is to eliminate common trigger foods that may cause inflammation and set off an autoimmune reaction, and then to identify which ones are problematic for you specifically. Once your symptoms are under control, you may try adding back in certain foods like dairy products, for example, monitoring how you feel and ultimately building up to a diet that is as broad as possible while continuing to reduce inflammation and symptoms.
For most people, the best approach is to start with a less restrictive anti-inflammatory diet like the Mediterranean or Paleo diet, and to only proceed to something more restrictive like a low FODMAP diet or low nightshade diet if your symptoms do not improve after a few weeks.
The Mediterranean diet is the most studied diet for managing RA symptoms. Two systematic reviews of 90 studies found that the Mediterranean diet improved disease activity in RA patients .
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What Are The Symptoms Of Arthritis
Each persons symptoms may vary. The most common symptoms include:
Pain in 1 or more joints that doesnt go away, or comes back
Warmth and redness in 1 or more joints
Swelling in 1 or more joints
Stiffness in 1 or more joints
Trouble moving 1 or more joints in a normal way
These symptoms can look like other health conditions. Always see your healthcare provider for a diagnosis.
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Rheumatoid Arthritis Pain Management
While the overall goal of rheumatoid arthritis therapy is to prevent disease progression and further joint damage, pain management is a necessary daily practice for patients, in order to maximize their quality of life. Chronic pain can adversely affect a patients ability to work, participate in physical and social activities, and can generally interrupt day-to-day life.
Despite medications and aggressive forms of treatment, many rheumatoid arthritis patients experience ongoing pain and stiffness. The reality is, it may never completely go away. But there are specific things patients can do to manage pain and limit its impact on their lives.
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National Institute Of Arthritis And Musculoskeletal And Skin Diseases
The mission of NIAMS is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases the training of basic and clinical scientists to carry out this research and the dissemination of information on research progress in these diseases.
Toll-free in the U.S.: 1-877-22-NIAMS
Other Therapies For Ra
Taking your medication is just one thing you can do to help you feel your best. Consider assembling a team of medical specialists from a variety of fields, like psychiatry, sleep medicine, physical or occupational therapy, or nutrition, who can support you wherever you may need it. Areas they can help with:
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What Do I Do If I Think I Have Rheumatoid Arthritis
If youre experiencing joint pain and inflammation, its important that you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can start quickly. Early treatment will help you to control the inflammation, manage pain more effectively and minimise the risk of long-term joint damage and disability.
If youre diagnosed with rheumatoid arthritis or suspected of having the condition, you may be referred to a medical specialist known as a rheumatologist for further investigations and medical treatment.
What Is Rheumatoid Arthritis Again
Lets refresh: Rheumatoid arthritis is an autoimmune disease, which means the immune system turns its sights on healthy tissue in the body, causing inflammation.
This form of arthritis targets the synovial membrane, the tissue that lines joints. Typically, this lining is thin and delicate, and it produces a clear fluid that allows the joint to move freely. But when the membrane becomes inflamed, the fluid gets thick and begins builds up, putting painful pressure on the surrounding nerves. When that happens, pain, stiffness, and even redness can occur. That inflammation literally heats up the joint, making it feel warm.
But RA isnt only a disease of the joints. Its a systemic illness that can impact your heart, lungs, eyes, and more. Which is exactly why prompt treatment is so important.
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Tai Chi And Yoga For Lessening Ra Symptoms
Tai chi hasnt yet been thoroughly investigated for RA and many studies that do exist were conducted before the current drugs for RA were available so its unclear if tai chi is effective for RA, according to the National Center for Complementary and Integrative Health .
With that said, tai chi, which is a form of low-impact exercise, appears to be safe to try for RA and doesnt exacerbate RA symptoms.
Though tai chi may not reduce the inflammation-related symptoms of RA, a review published in November 2016 in the journal Canadian Family Physician found that the practice may confer some benefits for depression and anxiety, lung disease, fibromyalgia, and lower back pain all issues that people with RA may also experience.
Some individual studies have found that yoga may help people living with rheumatoid arthritis by improving physical function, increasing grip strength, and reducing inflammation specifically decreasing the number of tender and swollen joints. These studies have also shown that some forms of yoga can reduce pain, disability, and fatigue, and improve health, mood, and quality of life.
And in an Indian study published in February 2019 in the journal Restorative Neurology and Neuroscience, researchers found that practicing yoga five days a week for two months can significantly decrease the severity of physical and psychological symptoms of RA.
But systematic reviews have found mixed evidence for yoga for people with RA.
Recognizing The Signs Of A Blood Clot
Follow your orthopaedic surgeons instructions carefully to reduce the risk of blood clots developing during the first several weeks of your recovery. They may recommend that you continue taking the blood thinning medication you started in the hospital. Notify your doctor immediately if you develop any of the following warning signs.
Warning signs of blood clots. The warning signs of possible blood clots in your leg include:
- Increasing pain in your calf
- Tenderness or redness above or below your knee
- New or increasing swelling in your calf, ankle, and foot
Warning signs of pulmonary embolism. The warning signs that a blood clot has traveled to your lung include:
- Sudden shortness of breath
- Sudden onset of chest pain
- Localized chest pain with coughing
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