Successfully Managing Rheumatoid Arthritis
If you’re female, you have a significantly increased risk of developing rheumatoid arthritis (RA)—about 75 percent of people with RA are women.
“While it is well known that RA is more common in women than in men, the reason for this is not understood,” says Susan Goodman, MD, a rheumatologist at Weill Cornell-affiliated Hospital for Special Surgery and associate director of the Hospital’s Inflammatory Arthritis Center. “There may be a relationship between sex hormones and RA, since women frequently report a decrease in RA activity during pregnancy. In addition, women who breastfeed have a lower risk of developing RA.”
RA Symptoms
RA is an autoimmune disorder—a condition in which the body’s immune system mistakenly attacks healthy cells or tissue as though it were fighting off an infection, causing serious inflammation of the joints.
WHAT YOU CAN DO
A diet that combats inflammation and supports joint health includes:
Foods that contain omega-3 fatty acids, such as fatty fish, including salmon, tuna, and sardines, and walnuts, flaxseeds, and chia seeds.
Foods high in antioxidants; examples include vibrantly-colored fruits and vegetables such as kale, strawberries, carrots, and beets, as well as green tea, nuts, red wine, and dark chocolate.
Cruciferous vegetables such as broccoli, cauliflower, Brussels sprouts, and cabbage that contain the phytonutrient sulforaphane.
The small joints in the hands and feet are the most commonly affected areas, but RA can cause pain, stiffness, and limited motion in any joint. RA can even affect organs, such as the lungs or eyes.
Other symptoms of RA include joint stiffness, especially in the morning, loss of energy and appetite, and low-grade fevers. Women with RA also may develop rheumatoid nodules, which feel like firm lumps, often in the hands and elbows.
If you experience any of these symptoms, see your doctor as soon as possible. If you are diagnosed with RA, see a rheumatologist who specializes in treating RA. If you do have RA rather than the most common type of arthritis, osteoarthritis, Dr. Goodman says it’s critical that you get an accurate diagnosis, because the treatments for the two conditions are very different.
Medications for RA
One of the most common classes of medications used to treat RA are disease-modifying antirheumatic drugs (DMARDs). DMARDs block inflammation, altering the course of the disease and preventing or decreasing joint damage.
“Patients in whom a diagnosis of RA is suspected should be promptly referred to a rheumatologist so DMARD therapy can be initiated,” says Dr. Goodman. Traditional DMARDs include methotrexate, hydroxychloroquine (Plaquenil), and sulfasalazine (Azulfidine).
Other drugs called “biologics” target chemicals called cytokines that drive inflammation and produce the symptoms of RA. Biologics include adalimumab (Humira), etanercept (Enbril), infliximab (Remicade), golimumab (Simponi) and abatacept (Orencia).
“These medications, which are given by injection, are typically used when a patient has severe RA that responds incompletely to the traditional DMARDs. Tofacitinib (Xeljanz) is the first targeted therapy that is given orally in pill form,” says Dr. Goodman.
“While it is important to begin treatment promptly, it is just as important to ensure that the treatment is achieving its goals and that disease activity is suppressed,” notes Dr. Goodman. If you have RA, you will need to see your rheumatologist at regular intervals so your response to treatment can be monitored.
Other medications include nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen and naproxen) and prednisone, a corticosteroid medication. However, Dr. Goodman notes that these medications alone will not achieve the goal of remission, and all patients with RA should be taking disease-modifying drugs.
Lifestyle Choices
Lifestyle strategies are crucial, since they aid in RA management and help prevent related health issues.
One of your most powerful weapons to fight RA is adequate sleep; the more rundown you are, the more active your RA. Stress has also been linked with RA symptom flares, so practicing relaxation techniques such as deep breathing, meditation, and visualization can help.
Although no specific dietary pattern has been shown to have a direct effect on RA, a healthy diet that includes plenty of whole, plant-based foods may reduce inflammation that feeds RA flare-ups. (For more information about diet, see “What You Can Do.”) Limit your consumption of highly processed foods, such as sodas, snack foods, and sweets, which can have a pro-inflammatory effect.
Exercising can be difficult for RA patients, but low-impact activities such
as walking, warm-water aerobics, and yoga can help reduce stiffness and stress related to RA while protecting your joints.
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