Okay, so first of all, we'll be using this blog post to help you better understand rheumatoid arthritis either for yourself or for a loved one or maybe some of the clients that you're working with.
Rheumatoid arthritis is a chronic systemic inflammatory condition. It is an immuno condition as well. So it's an autoimmune disease. What that means is, it's a, probably maladaptive might be the wrong word, but it's where your immune system is fighting itself. So it's kind of working against itself. There can be a lot of reasons why it might come to be that you have rheumatoid arthritis. But one of the main ones is a genetic link. It may be sitting dormant in your genetics and then it only requires certain triggers in your environment for it to come and be displayed. That might be for instance, if you get the bad flu or something like that. That can be a time when all of a sudden, you're more acutely aware that you have rheumatoid arthritis and let's be fair, it's not the flu that caused rheumatoid arthritis, the rheumatoid arthritis was already there, dormant in your system, and then it was brought on at the end of such a condition. That can be one of the things, there's a multitude of mechanisms that have been suggested as the proponents for this, but we won't get that into the blog today.
Now, one of the most annoying things, if you are a rheumatoid arthritis sufferer, is the fact that whilst you do always have it, you can have times of exacerbation and then relative remission. So that means that you have times when it has a flare-up as such where your symptoms feel worse, and tiredness is worse. Then you can have times where it pretty much feels like you may not have rheumatoid arthritis, or it can just always feel like it's there and just sometimes feel a whole bunch worse. Whilst everyone's experience is different, and there may be other comorbidities that you experience at the same time where there's a bit of overlap of the symptoms, or one triggers the other one to be worse at particular times. Overall, it is one where there may be no absolute cause for your rheumatoid arthritis to be flaring up. There are some ways that we can help to make the symptoms seem a whole bunch less hard to deal with and we can better manage our condition, and I'll discuss these in this blog post.
Now a little bit about me, not to talk about myself too much, but I studied my Ph.D. through the school of physiotherapy at the University of Otago, and my Ph.D. was in overcoming barriers to exercise in people with chronic illness with focus on musculoskeletal conditions. One of the groups that I worked with is people with rheumatoid arthritis. So I am equipped to know a little bit more than your average Joe about rheumatoid arthritis. I have seen a number of patients with rheumatoid arthritis. My studies were qualitative, where I got to talk to patients and practitioners, as well as quantitative, where I looked at what other studies have come up with based on all their years of research. I also did a kind of “study of studies” to find out what information you could get from all of those, as well as creating and testing an intervention as such with exercise, and then doing a multitude of tests to work out what were the most redeeming factors about an exercise regime and what could be the most effective. When I was doing all of this for my Ph.D., I realized that there hadn't really been studies (across all of the studies) into the exact dosage, frequency, type and duration of exercise that made the most significant difference, which really surprised me and it might surprise you as well. So from that, I realized that I would have to create some guidelines that were based on some exercise regimes that are designed for the general population, which wasn't ideal but we had to look at something that was already standardized and go from there.
So the ACSM guidelines were saying to be active for 30 minutes a day, and to do that every day or six days a week. From that, that exercise is like a bell curve where more sessions does not equal more benefit after about four sessions a week so every other day exercising and less benefit derived after 45 minutes. Well, all of these things are very general guidelines, and it does depend on the intensity that you're working out at. But these were the typical guidelines that I went in for structuring the exercise intervention that we created for patients with rheumatoid arthritis. Based on the study, it was found that exercising three times a week appeared to conduce the most benefits for the people with rheumatoid arthritis, and the exercise regime was set out such that the person who had rheumatoid arthritis knew how they could adapt the exercise regime, based on how they were feeling in terms of energy and their condition for the day. So they could choose to do all three components or just one or just two, and they can mix and match these, so they could end up with a shorter session or a longer session.
The goal was just to participate three times a week and this had a significant benefit.
People found quite a big difference in how their condition was feeling because being more active and then being able to take control of their session meant that they were more likely to participate and then from there their ability to perform in tests of function, not just in activities of daily living but also in fitness tests increased but some of them also found side effects of losing weight as well.
Losing weight has also been shown not just to help reduce inflammation in the body, but it also helps to reduce the impact on joints. Also, read my post on how to lose weight safely and effectively. So there were a number of factors that proved to be very beneficial for people in these groups for participating in exercise and although not specifically studied by my exercise intervention, when you do exercise, and you have this kind of structure into your week in your day to day life, sometimes almost it makes us feel more accountable to eating better and making better decisions when it comes to alcohol and that sort of thing. So we couldn't exactly rule out that maybe people also wanted to eat better as a result.
But these are things that helped people to feel much better in terms of their condition, but also their energy levels for the day they were able to accomplish more in their day-to-day life. They also experienced mood benefits as well, so they felt like they were in a better mood because they felt more in control of their condition. On top of that, they felt like they could be more pleasant towards their family which is a really nice side effect of doing exercise. Exercise also helps you to sleep better. So sleep is a really great time of the day, when the body prioritizes repair and can help to reduce inflammation when you have really good quality sleep. So that could also be a side effect of increasing activity, which is a beneficial side effect, of course.
So these things can't be ruled out as contributing factors, but addressing the following can make you feel better overall.
Exercising regularly, but also knowing how to tailor your exercise based on how you're feeling for that particular day. The courses that we run have specific exercise regimes that you can follow and teach you how to adapt based on how you're feeling. So getting some exercise from a professional.
Eating a nutritionally dense diet having a lot of fiber as well as a variety of fruits and vegetables which will help to reduce inflammation in the body, and protein to help repair muscles as well as good fats which help reduce inflammation so a nice balanced diet.
Reducing alcohol which helps to increase the quality of your sleep.
Prioritizing the right amount of rest. So not just eight hours but five really good sleep cycles, which it's hard to determine but you should be waking up feeling well rested and not feeling like you're in a whole bunch of pain as a result of not sleeping properly or fully.
Have lots of vitamin D, including during winter. Vitamin D is an essential vitamin that comes from sunlight, and you can derive components of it from your food if it's a balanced diet, especially if you're eating fresh, fresh produce.
Going outside. Getting some fresh air grounding, which will help with your mental health as well but also on top of that getting some sunlight on your skin because vitamin D actually almost acts like a hormone in the body where it helps to trigger a cascade of really important processes when it comes to your hormones. When it comes to just your general sense of well-being and the exercise outside such as walking around the block can really help with your mindset as well. So that our perceived level of stress for the day can be reduced which helps us be able to handle more things and handle them better.
Making sure that you have a really solid support system, or community of people around you that understand what you're going through and are supportive with how you're feeling each day and want to check in with you can be super important as well.
There you have it, some things that you should consider and think about that may help your rheumatoid arthritis feel better day to day. Let me know what worked for you. If you have any questions, queries, comments, or you'd like to check out an exercise regime that we have written, just reach out to us. You also might want to read my other post on things to consider in your exercise regime.
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