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
...ntervention...
...scriptions and examples of interventions in...
...xercis...
...iseMovement of the body requiring ene...
...ance of physical activity in regular and s...
...rciseExercise intended to improve ca...
...tic exerciseExercise performed in water,...
...esistance exerciseExercise intended to increase m...
...-body exerciseExercise that combines...
...abilitation...
...sive occupational therapyEvaluation and treatm...
...hysical therapyEvaluation and treatme...
...ercisesExercises of the hand to impro...
...ietary...
...mally defined dietSpecific formally defined diets...
...erranean-style dietDiet pattern that emph...
...lementSubstances used to add nutrients, botanica...
...entional loss of body weight. Examples include...
...itional integrative therapies...
...nagement programStandardized program to gui...
...ioral therapyPsychological therapy to...
...roachesPractices engaging both mind and body f...
...lation of specific body points thro...
...yRubbing and kneading of muscles and joint...
...alitiesUse of heat and cold for medic...
...rotherapyUse of electrical energy for med...
...stimulationImplantation of a device to stimulate...
...iagnosis and manipulation of malaligned...
...co cessationCounseling on tobacco c...
Recommendations for the Management of RAa
...ommendations for the Management of RAa...
...efinitions and examples are provided...
...rcise recommendati...
...ly recommend consistent engagement...
...e conditionally recommend consistent engagement i...
...recommend consistent engagement in aquatic...
...onditionally recommend consistent engageme...
...tionally recommend consistent engagement...
...itation interventions...
...e conditionally recommend participation in...
...conditionally recommend participation in compre...
...s with hand involvement, we conditi...
...ients with hand and/or wrist involvement and/or d...
...with foot and/or ankle involvement, we c...
...atients with foot and/or ankle invo...
...with knee involvement, we conditionally re...
...ionally recommend use of joint protection techn...
We conditionally recommend use of activ...
We conditionally recommend use of a...
...conditionally recommend use of ada...
...ditionally recommend use of environmental ad...
...ts who are currently employed or desire t...
...who are currently employed or desire to beco...
...recommendations...
...ly recommend adherence to a Mediterranean-s...
We conditionally recommend against adherence to...
...nally recommend following established di...
...dditional integrative interv...
...ally recommend use of a standardized self-m...
...itionally recommend use of cognitive behavioral t...
...nally recommend use of acupuncture over no acu...
...ally recommend use of massage therapy over...
...itionally recommend use of thermal modalities...
...onally recommend against using electrotherapy. (L...
...tionally recommend against using chiropra...