Rheumatoid Arthritis Managed With Creative Changes

Experts say there are dozens of quick, simple ways to help the 2.1 million US adults with rheumatoid arthritis (RA) rise above daily pain.

A morning T'ai Chi session, a quick afternoon nap to restore energy, and an oversized "easy-grip" pen are three ideas of many suggested by the Arthritis Foundation.

"A lot of times, the mental stress associated with rheumatoid arthritis is equal to the joint pain people feel," explains Dr. Shannon Whetstone Mescher, a physiologist and spokeswoman with the Arthritis Foundation.

"The emotional, mental part has to do with the fatigue, the lack of energy, the inability to do things that they want to do," she says. "There's the feeling that they're slowly losing their lifestyle."

Seeking Lifestyle Enhancements

One of the biggest frustrations for arthritis sufferers stems from difficulties in completing simple tasks - actions such as opening jars, grabbing items off a high shelf, or even working a computer mouse.

Experts note that RA is a disease that affects the entire body, and is one of the most common forms of arthritis.

It is characterized by inflammation of the membrane lining the joint or other internal organs, causing pain, stiffness, warmth, redness, and swelling.

The disease is usually chronic, but can also be marked by flare-ups, according to the Arthritis Foundation.

Luckily, the buying power of an aging population has led to a revolution in arthritis-friendly product design.

In fact, the Arthritis Foundation's "Ease of Use" initiative, in partnership with private industry, has helped launch dozens of innovative products. Some of these include Pilot brand Dr. Grip pens and pencils, the quick-open Folgers AromaSeal coffee container, and the Virtually Hands Free computer mouse from Designer Appliances.

But, people with arthritis can do more to ease daily pain.

Because of a phenomenon known as "gelling" - where synovial fluid gels during sleep, producing joint stiffness - morning is often the toughest part of the day for those with rheumatoid arthritis.

Alleviating that pain "is often as simple as taking a warm bath or shower just after getting up," says Dr. John Klippel, president of the Arthritis Foundation.

Exercise programs that emphasize joint flexibility are another great way of relieving joint stiffness and pain.

"We talk about 'joint-safe' forms of exercise," Dr. Klippel says. "Things like T'ai Chi and yoga not only increase muscle strength and flexibility, but there's not a lot of stress across joints."

But he emphasizes that for individuals with arthritis, exercise should be balanced with rest.

"The typical person with rheumatoid arthritis has very little energy, so one of the coping skills that they begin to learn is building rest time into their daily activities," Dr. Klippel says.

"Energy tends to ebb in mid-afternoon, so workers with arthritis may want to consider a short restorative nap at that time, if at all possible," he says.

There are other ways of dealing with the chronic pain, however. According to Dr. Mescher, studies have shown that meditation eases arthritic symptoms, as does guided imagery.

"Guided imagery is, for example, imagining yourself on a beach," she says. "It's a talk-through of some sort of relaxing activity that helps you take your mind away from the pain and stress that come with the disease."

Support Groups and Supportive Friends Help

 "One caveat I'll add to that, however, is that sometimes we've found there are unhealthy kinds of support mechanisms out there, such as groups where everyone simply complains about their disease," Dr. Mescher says.

With those types of feedback sessions, most participants "just leave feeling worse," she says.

Instead, Dr. Mescher prefers groups where arthritis patients offer each other creative solutions to the tough challenges they face every day. "That really seems to help," she says.

The very best group activities combine social support with exercise. Joining a local aquatics club, for example, gives someone with RA "several positive benefits," Dr. Mescher says. "It takes a lot of effort sometimes to get up in the morning and get out, but the class gives it a social component as well."

Above all, people with rheumatoid arthritis should not isolate themselves. The support of family and friends can make the difference, Dr. Mescher says, although there is often a learning curve.

"Be a good listener," she says. "Obviously, a loved one with rheumatoid arthritis has a lot on their mind, a lot they want to share and talk about. Do some research on your own to understand what they're going through."

In her work with caregivers interested in learning more about rheumatoid arthritis, Dr. Mescher often has them spend time with their thumbs taped firmly to their index fingers.

"Then they try and pick up different things around the house - obviously, it makes a big impact on what you're able to do, and gives you a taste of what life is like for someone with RA," she says.

Of course, medication therapy remains key in alleviating joint pain.

The pharmaceutical options now available include NSAIDs (nonsteroidal anti-inflammatory drugs) that include aspirin and ibuprofen; steroid medications like prednisone; and a newer category of drugs called disease-modifying antirheumatic drugs (DMARDs), which include methotrexate.

"Drug therapy is still the best way we know of to reduce pain and minimize the disability that comes with this disease," Dr. Klippel says.

Always consult your physician for more information.

Online Resources

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Arthritis Foundation

Centers for Disease Control and Prevention (CDC)

National Institute of Arthritis and Musculoskeletal and Skin Diseases

National Institute of Mental Health

National Institutes of Health (NIH)

National Library of Medicine

US Department of Heath and Human Services

October 2004

Rheumatoid Arthritis Managed With Creative Changes

Seeking Lifestyle Enhancements

Support Groups and Supportive Friends Help

Mood Disorders a National Focus in October

Online Resources

Mood Disorders a National Focus in October

According to the National Institute of Mental Health (NIMH), in any given one-year period, 9.5 percent of the population, or about 18.8 million US adults, suffer from a depressive illness.

For those seeking help, National Depression Screening Day is Oct. 14, and many local centers are prepared to meet with visitors wishing to be screened.

Depressive illnesses often interfere with normal functioning and cause pain and suffering not only to those who have a disorder, but also to those who care about them.

Most people with a depressive illness do not seek treatment, although the great majority - even those whose depression is extremely severe - can be helped.

Thanks to years of fruitful research, there are now medications and psychosocial therapies such as cognitive/behavioral, "talk," or interpersonal that ease the pain of depression, states the NIMH.

A depressive disorder is an illness that involves the body, mood, and thoughts. It affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things.

A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away.

People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years.

Types of Depression
Depressive disorders come in different forms, just as is the case with other illnesses such as heart disease, the NIMH states.

Major depression is manifested by a combination of symptoms that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime.

A less severe type of depression, dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.

Another type of depression is bipolar disorder, also called manic-depressive illness. Not nearly as prevalent as other forms of depressive disorders, bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression).

Sometimes the mood switches are dramatic and rapid, but most often they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of a depressive disorder.

Symptoms of Depression
Not everyone who is depressed or manic experiences every symptom, according to the NIMH. Some people experience a few symptoms, some many.

Depression

Mania

Always consult your physician for more information.