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
...terventions...
...riptions and examples of interventions incl...
...xercise...
...l exerciseMovement of the body requiring energ...
...Performance of physical activity in...
...robic exerciseExercise intended to impr...
...ciseExercise performed in water, containi...
...ciseExercise intended to increase muscular...
...exerciseExercise that combines movement, ment...
Rehabilita...
...e occupational therapyEvaluation and tre...
...ysical therapyEvaluation and treatment by a p...
...therapy exercisesExercises of the hand to imp...
...ietar...
...dietSpecific formally defined diets e...
...tyle dietDiet pattern that emphasize...
...ntSubstances used to add nutrients...
Weight lossIntentional loss of body weight. Exampl...
...onal integrative therapies...
...anagement programStandardized program to gu...
...havioral therapyPsychological therapy to...
...oachesPractices engaging both mind and body...
...upunctureStimulation of specific body points...
...rapyRubbing and kneading of muscles and joints wit...
...modalitiesUse of heat and cold for m...
...herapyUse of electrical energy for medical...
...al nerve stimulationImplantation of a devic...
...ropracticDiagnosis and manipulation of...
...essationCounseling on tobacco cessation, t...
Recommendations for the Management of RAa
Recommendations for the Manageme...
...n definitions and examples are pro...
...xercise recommendatio...
...y recommend consistent engagement in ex...
We conditionally recommend consistent...
...tionally recommend consistent engagement in...
...nditionally recommend consistent engagement...
...ditionally recommend consistent enga...
...bilitation interventions...
...tionally recommend participation in compr...
...conditionally recommend participation in compre...
...ients with hand involvement, we conditionally rec...
...ts with hand and/or wrist involvement an...
...nts with foot and/or ankle involvement, we cond...
...s with foot and/or ankle involvement, we condition...
...h knee involvement, we conditionally recommend...
...onditionally recommend use of join...
...nditionally recommend use of activity pacin...
...ly recommend use of assistive devices over no assi...
...conditionally recommend use of adaptive equip...
...recommend use of environmental adaptations ov...
...o are currently employed or desire to bec...
...or patients who are currently empl...
...iet recommendati...
...conditionally recommend adherence to...
...onally recommend against adherence to a formally...
...onditionally recommend following establ...
... Additional integrative interventions...
...nditionally recommend use of a standar...
...ditionally recommend use of cognitive b...
...recommend use of acupuncture over no a...
...e conditionally recommend use of massag...
...tionally recommend use of thermal modalities over...
...nally recommend against using electro...
...itionally recommend against using chirop...