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
...examples of interventions included in...
...Exercise
...eMovement of the body requiring energy expe...
...rmance of physical activity in regular and...
...rciseExercise intended to improve cardiorespir...
...quatic exerciseExercise performed in water, cont...
...exerciseExercise intended to increase...
...-body exerciseExercise that combines...
...Rehabilitation...
...hensive occupational therapyEvaluat...
...sive physical therapyEvaluation and...
...py exercisesExercises of the hand to improve...
...Dietary...
...dietSpecific formally defined diets...
...editerranean-style dietDiet pattern...
...pplementSubstances used to add nutrients, b...
Weight lossIntentional loss of body w...
...Additional integ...
...agement programStandardized program to guide self-...
...behavioral therapyPsychological th...
...body approachesPractices engaging both...
...cupunctureStimulation of specific body points...
...Rubbing and kneading of muscles and j...
Thermal modalitiesUse of heat and cold...
...e of electrical energy for medical treat...
...nerve stimulationImplantation of a devic...
...cticDiagnosis and manipulation of malaligne...
...co cessationCounseling on tobacco cessation, tob...
Recommendations for the Management of RAa
...Rec...
...tion definitions and examples are provided...
...A. Exercise...
...ngly recommend consistent engagement in e...
...conditionally recommend consistent engagement...
...e conditionally recommend consistent enga...
...tionally recommend consistent engagement in r...
...lly recommend consistent engagement in mi...
...B. Rehabilitation interve...
...e conditionally recommend participati...
...conditionally recommend participation in comp...
...atients with hand involvement, we co...
For patients with hand and/or wrist involvement a...
...r patients with foot and/or ankle involve...
For patients with foot and/or ankle invol...
...patients with knee involvement, we conditiona...
...ly recommend use of joint protection techniques...
...lly recommend use of activity pacing,...
...onditionally recommend use of assistive devic...
...recommend use of adaptive equipment over no ada...
We conditionally recommend use of environmental a...
...ho are currently employed or desire...
...who are currently employed or desire to becom...
...C. Diet r...
...y recommend adherence to a Mediterranean...
...y recommend against adherence to a formally define...
...itionally recommend following established dietary...
D....
...ionally recommend use of a standardi...
...ionally recommend use of cognitive behavioral...
...ally recommend use of acupuncture...
We conditionally recommend use of massa...
We conditionally recommend use of th...
...ally recommend against using electrotherap...
...lly recommend against using chiropra...