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
...rventions...
...s and examples of interventions includ...
...xercise...
...cal exerciseMovement of the body requiring en...
...Performance of physical activity i...
...ic exerciseExercise intended to imp...
...ciseExercise performed in water, containin...
...erciseExercise intended to increase muscul...
...y exerciseExercise that combines movement, men...
Rehabilitatio...
Comprehensive occupational therapyEvaluati...
...e physical therapyEvaluation and treatment b...
...and therapy exercisesExercises of the hand to imp...
Dietar...
...d dietSpecific formally defined die...
...iterranean-style dietDiet pattern that emphasiz...
...etary supplementSubstances used to add nut...
...ntentional loss of body weight. Examples...
...onal integrative therapies...
...nagement programStandardized program to guid...
...ognitive behavioral therapyPsychological t...
...oachesPractices engaging both mind and...
...cupunctureStimulation of specific body point...
...yRubbing and kneading of muscles and...
...modalitiesUse of heat and cold for medical...
...ctrotherapyUse of electrical energy for medic...
...al nerve stimulationImplantation of a...
...gnosis and manipulation of malalig...
...cessationCounseling on tobacco cessation,...
Recommendations for the Management of RAa
...ions for the Management of RAa...
...ntion definitions and examples are provided...
...Exercise recommend...
...y recommend consistent engagement i...
...conditionally recommend consistent engagement in...
...tionally recommend consistent engagement in aq...
...ditionally recommend consistent eng...
...onally recommend consistent engagement...
...ilitation interventions...
...nally recommend participation in comprehen...
...conditionally recommend participation in co...
...s with hand involvement, we conditio...
...ts with hand and/or wrist involvement...
...or patients with foot and/or ankle in...
...nts with foot and/or ankle involveme...
...nts with knee involvement, we conditionally...
...onally recommend use of joint protection...
...lly recommend use of activity pacing, ene...
...lly recommend use of assistive device...
...nditionally recommend use of adaptive equipme...
...ionally recommend use of environmental...
...ho are currently employed or desire to become emp...
...or patients who are currently employ...
...iet recommendations...
...recommend adherence to a Mediterranea...
...lly recommend against adherence to a formally def...
...itionally recommend following establi...
...nal integrative interventions...
...recommend use of a standardized self...
...y recommend use of cognitive behavior...
...recommend use of acupuncture over no a...
...onally recommend use of massage therapy o...
...onally recommend use of thermal modalities over...
...lly recommend against using electrotherapy. (...
...itionally recommend against using chiropr...