Living Well with Rheumatoid Arthritis

27 November 2006

People with rheumatoid arthritis (RA) age 12.5 years for every decade lived and need to pay special attention to beat “accelerated aging”, according to new research by Mayo Clinic doctors.

Dr Sherine Gabriel says it’s been known for decades that people with rheumatoid arthritis die younger and have increased risks of heart and lung disease, but doctors have had trouble understanding why. The new study reveals cell damage results in impaired function and leads long term to people aging faster than expected.

Reducing Accelerated Aging from Arthritis

Conclusions to be drawn from the new study affect not just people with rheumatoid arthritis but everyone interested in maintaining youthful vitality. They include:
• Early diagnosis and intervention are extremely important for people with RA
• People with RA need to take special care of heart health
• Diet, exercise and stress control have long term benefits in reducing accelerated aging
• Quit smoking: Smoking nearly doubles the odds of rheumatoid arthritis in women who don't have genetic risk factors for the disease, says another new US study.

Rheumatoid Arthritis Diet to Beat Accelerated Aging

People with RA should eat lots of:
• Deep-sea fish, such as salmon, tuna, herring, and halibut, for fatty acids EPA and DHA which reduce joint pain and swelling and are great for cardio health.
• GLA - another important fatty acid - found in plant sources like evening primrose oil, black currants and borage seed. Also flax seed oil, borage seed oil, canola, walnut and grape seed oils.
• Turmeric, the yellow coloured spice in curry and found in Honeybalm capsules. New research shows curcumin in turmeric holds promise in preventing RA.
• Fresh fruit and vegetables
• Beans and peas
• Ginger extract
• Nettle leaf extract
• A vegetarian or low-allergen diet can help with the management of rheumatoid arthritis as well.

People with RA should eat less of:
• Hydrogenated oils
• Animal fats
• High dairy products

Nutritional supplements for people with RA

• Add a high quality multi-vitamin mineral including 99 mg potassium daily in food or supplements.
• Growing evidence indicates nutritional deficiencies may either help cause Rheumatoid arthritis or are secondary to it. One nutrient that has shown to be deficient in blood of most Rheumatoid arthritis sufferers is potassium – found specially found in apricots, avocados, bananas, blackstrap molasses, nuts, brown rice, yeast, wheat bran and dates, figs and garlic.

Exercise for people with RA to beat Accelerated Aging

Though you might think exercise will aggravate joint pain and stiffness, that's not the case. Not exercising can makes joints even more painful and stiff. That's because keeping muscles and surrounding tissue strong is crucial to maintaining support for bones. Not exercising means your muscles will become weaker, making your bones more prone to breaking.

People with RA need a good balance between exercise and rest.

Exercise is essential for:
• heart health
• to maintain healthy and strong muscles
• joint mobility
• flexibility
• endurance
• to control weight

Rest helps muscles restore themselves, and lessens inflammation
During acute systematic flares or local joint flares, patients should put joints gently through their full range of motion once a day, with periods of rest. To see how much rest is best during flares, patients should talk to their health care providers.

Recommended Daily Exercise for People with RA

• Range-of-motion exercises, e.g. stretching and dance - help maintain normal joint movement and increase joint flexibility. Can be done daily and should be done at least every other day.
• Strengthening exercises, e.g. weight lifting - help improve muscle strength, which is important to support and protect joints affected by arthritis. Should be done every other day, unless pain and swelling are severe.
• Aerobic or endurance exercises, e.g. walking, bicycle riding, and swimming - help improve the cardiovascular system and muscle tone and control weight. Swimming is especially valuable because of its minimal risk of stress injuries and low impact on the body. Should be done for 20 to 30 minutes three times a week unless pain and swelling are severe.

Tips to keep your joints safe

Start slowly to ease your joints into exercise if you haven't been active for awhile. If you push yourself too hard, you can overwork your muscles. This will aggravate your joint pain.

Consider these tips as you get started:

• Apply heat to the joints you'll be working before you exercise. Heat can relax your joints and muscles and relieve any pain you have before you begin. Heat treatments should be warm, not painfully hot, and should be applied for about 20 minutes.
• Move your joints gently at first to warm up. You might begin with range-of-motion exercises for five to 10 minutes before you move on to strengthening or aerobic exercises.
• Exercise with slow and easy movements. If you start noticing pain, take a break. Sharp pain and pain that is stronger than your usual joint pain might indicate something is wrong. Slow down if you notice inflammation or redness in your joints.
• Ice your joints after exercising. This can reduce swelling and pain. Use a cold pack on your joints for 10 to 15 minutes.
• Trust your instincts and don't exert more energy than you think your joints can handle.
• Take it easy and slowly work your exercise length and intensity up as you progress.

Don't overdo it:

You might notice some pain after you exercise if you haven't been active for awhile. In general, if your pain lasts longer than an hour after you exercise, you were probably exercising too strenuously. Talk to your doctor about what pain is normal and what pain is a sign of something more serious.

Tell your doctor if your exercise causes:

• Persistent fatigue or increased weakness
• Reduced range of motion in your joints
• Joint swelling
• Continuing pain

If you have rheumatoid arthritis, whether or not you should exercise during general or local flares is up to you and your doctor. Consider working through your joint flares by doing only range-of-motion exercises, just to keep your body moving.

Stress Control to Beat Accelerated Aging

• Develop relaxation and coping skills
• Try deep breathing exercises, listen to music or relaxation tapes, or visualize a pleasant activity such as sitting by a peaceful lake or lying on a beach.
• Exercise programs, participation in support groups, and good communication with your health care team also help to reduce stress.

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