Rheumatoid Arthritis Integrative Interventions
Key Points
Key Points
Integrative Interventions for Rheumatoid Arthritis Guiding Principles:
- Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory condition that requires early diagnosis, evaluation, and management to achieve optimal outcomes.
- Rheumatoid arthritis should be treated with disease-modifying anti-rheumatic drugs and follow a treat-to-target management strategy, as detailed in the 2021 American College of Rheumatology (ACR) Rheumatoid Arthritis Pharmacologic Treatment Guidelines.1
- Persons with chronic diseases, like rheumatoid arthritis, seek many available therapies to maintain physical function, reduce pain, and improve their quality of life.
- Treatment decisions should follow a shared decision-making process. Persons with rheumatoid arthritis present with a variety of manifestations and experiences.
- Optimum rheumatoid arthritis treatment outcomes are achieved through interprofessional teams providing expert patient-centered care.
- Recommendations assume no contraindications to listed management strategies.
- Recommendations pertain to rheumatoid arthritis management.
- Recommendations do not pertain to clinical situations when patients have alternative indications for listed treatments.
- Other general health benefits may exist for listed treatments.
- Surgical interventions are not included in this guideline because there are other guideline efforts that address large joint replacement, and small joint surgeries are not frequently a part of the current management of rheumatoid arthritis.
- Disease activity and disease activity levels refer to those calculated using an ACR-endorsed RA disease activity measure.2
2. England BR, Tiong BK, Bergman MJ, Curtis JR, Kazi S, Mikuls TR, et al. 2019 Update of the American College of Rheumatology Recommended Rheumatoid Arthritis Disease Activity Measures. Arthritis Care. 2019;71:1540-1555.
Interventions
...terventio...
...s and examples of interventions included in...
...xercis...
...rciseMovement of the body requiring energy exp...
...ercisePerformance of physical activity in regula...
...robic exerciseExercise intended to improv...
...erciseExercise performed in water, c...
...sistance exerciseExercise intended to incr...
...-body exerciseExercise that combine...
...ehabilitat...
...e occupational therapyEvaluation and...
...hensive physical therapyEvaluation and...
...therapy exercisesExercises of the ha...
...etary
...defined dietSpecific formally defined diets e...
...erranean-style dietDiet pattern that...
...plementSubstances used to add nutrient...
...Intentional loss of body weight. Examp...
...tional integrative therapies...
...management programStandardized program to gui...
...itive behavioral therapyPsychological therap...
...achesPractices engaging both mind and bod...
AcupunctureStimulation of specific body p...
...erapyRubbing and kneading of muscles...
...odalitiesUse of heat and cold for medical tre...
...therapyUse of electrical energy for medical tre...
...mulationImplantation of a device to s...
...racticDiagnosis and manipulation of ma...
...ationCounseling on tobacco cessation, toba...
Recommendations for the Management of RAa
Recommendations for the Manag...
...tion definitions and examples are provide...
...se recommendations...
...ngly recommend consistent engagement in e...
...ally recommend consistent engagement in a...
...ditionally recommend consistent engagement in...
...recommend consistent engagement in re...
...lly recommend consistent engagement in mind-body...
...itation interventions...
...e conditionally recommend participation...
...onditionally recommend participation in compreh...
...s with hand involvement, we conditiona...
...nts with hand and/or wrist involvement...
...with foot and/or ankle involvement, we conditi...
...s with foot and/or ankle involveme...
...patients with knee involvement, we c...
...itionally recommend use of joint prote...
We conditionally recommend use of activ...
We conditionally recommend use of assistive d...
We conditionally recommend use of adaptive...
...ly recommend use of environmental...
...patients who are currently employed or des...
...ents who are currently employed or desi...
.... Diet recommendat...
...conditionally recommend adherence to a Mediter...
...tionally recommend against adherence...
...nditionally recommend following established diet...
...tional integrative interventions...
...nally recommend use of a standardi...
...ly recommend use of cognitive behavior...
...onditionally recommend use of acupuncture ov...
...y recommend use of massage therapy over no massag...
...y recommend use of thermal modalities...
...onditionally recommend against using...
...ditionally recommend against using chirop...