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
...Interventions...
Descriptions and examples of interventio...
...Exer...
Physical exerciseMovement of the body r...
...erformance of physical activity in regular and str...
...seExercise intended to improve card...
...uatic exerciseExercise performed in water, contain...
...nce exerciseExercise intended to i...
...dy exerciseExercise that combines m...
...Reha...
...prehensive occupational therapyEvaluation and trea...
...ensive physical therapyEvaluation and treatment b...
...py exercisesExercises of the hand to improv...
...D...
...lly defined dietSpecific formally defined...
...n-style dietDiet pattern that emphasizes intake...
Dietary supplementSubstances used to add...
...t lossIntentional loss of body wei...
...Additional int...
...ement programStandardized program to...
...tive behavioral therapyPsychological thera...
...approachesPractices engaging both m...
...ulation of specific body points through i...
...rapyRubbing and kneading of muscles and...
...litiesUse of heat and cold for medi...
...ectrotherapyUse of electrical energy f...
...gal nerve stimulationImplantation of a device to s...
...iagnosis and manipulation of malal...
...obacco cessationCounseling on tobacco cess...
Recommendations for the Management of RAa
...Recommendations...
...definitions and examples are provided in...
...A. Exercise re...
...ecommend consistent engagement in exercis...
...onditionally recommend consistent enga...
...onally recommend consistent engagement in aquati...
...ally recommend consistent engagement in resistan...
...recommend consistent engagement in mind-body...
...B. Reha...
...conditionally recommend participa...
...e conditionally recommend participation in...
...tients with hand involvement, we condit...
...ts with hand and/or wrist involvement an...
...ith foot and/or ankle involvement, we...
For patients with foot and/or ankle involvement,...
...s with knee involvement, we conditionally recomm...
...lly recommend use of joint protect...
...nditionally recommend use of activity...
...recommend use of assistive devices over...
...ionally recommend use of adaptive e...
...e conditionally recommend use of environmental...
...patients who are currently employed or desir...
...who are currently employed or desire to becom...
...C. Diet recommend...
...itionally recommend adherence to a...
We conditionally recommend against a...
...nally recommend following established di...
...D. Additional integrat...
...ditionally recommend use of a standar...
...conditionally recommend use of cogniti...
We conditionally recommend use of a...
...y recommend use of massage therapy...
...conditionally recommend use of thermal modalitie...
...ally recommend against using electrother...
...ally recommend against using chiropra...