MedifocusHealth

Rheumatoid arthritis (RA) is a chronic, life-long condition for which currently there is no know cure. It should come as no surprise to anyone who suffers from this condition to learn that RA can have a significant negative impact on the patient's quality of life. Joint pain, swelling, morning stiffness, fatigue impaired mobility, and loss of independence present difficult challenges involving almost every aspect of the patient's life including:

• Activities of daily living
• Job-related tasks and functions
• Recreational activities
• Self-care
• Personal hygiene
• Social interactions with family and friends
• Psychological and emotional well-being

Difficult issues that patients with rheumatoid arthritis (RA) often have to confront and learn to deal with include:

• Loss of independence due to restricted mobility
• Chronic pain from swollen, tender, stiff joints
• Fatigue and exhaustion requiring frequent periods of rest during the day
• Poor quality of sleep due to pain, fatigue, anxiety, and stress
• Problems with memory and/or concentration
• Self-consciousness about their physical impairment or deformity
• Humiliation and embarassment from having to ask others for help in performing routine activities of daily living
• Feelings of frustration, anger, helplesness, and depression as a consequence of chronic pain and loss of independence
• Feelings of social isolation from family and friends due to the patient's inability to participate fully in social and recreational activities
• Reduced interest in sexual activities

• Employment issues:

  • limitations in performing job-related tasks
  • frequent absence from work due to chronic pain and fatigue
  • work disability due to physical limitations and/or emotional disturbances

Helping patients with rheumatoid arthritis (RA) to better cope with the physical, emotional, and social aspects of the disease requires a multidisciplinary approach which ideally involves health care professionals with expertise in diverse aspects of the disease (e.g., rheumatologist; physical/occupational therapist; orthopedic surgeon; mental health professional; nurse). Patient education is a critical aspect of managing patients with RA and should focus on teaching patients the following aspects of dealing with the condition:

• Preventing and managing chronic pain with medications, exercise, transcutaneous electrical nerve stimulation (TENS).

• Improving mobility and function with exercises (e.g., range-of motion exercises; isometric exercises; low-impact aquatic exercises).

• Relieving morning stiffness by taking a hot shower immediately after rising in the morning.

• Applying moist heat to painful, tender, swollen joints as needed.

• Using a variety of self-help devices (e.g., canes; walkers; splints/orthoses) to assist patients in more easily performing routine activities of daily living.

• Encouraging patients to participate to the greatest extent possible in social and recreational activities.

• Educating patients to be vigilant about the warning signs of depression and the importance of seeking professional help early to prevent potentially serious consequences of untreated depression.

• Encouraging patients to join a local arthritis support group to share their experiences with other people and trade helpful tips and suggestions for better coping with their condition.