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
...erventions...
...examples of interventions included...
Exercis...
...al exerciseMovement of the body requiring energy...
...rcisePerformance of physical activity in reg...
...seExercise intended to improve card...
...rciseExercise performed in water, containing el...
...nce exerciseExercise intended to increase...
...nd-body exerciseExercise that combin...
...ehabilitation...
...cupational therapyEvaluation and treat...
...ensive physical therapyEvaluation and t...
...xercisesExercises of the hand to improve...
...ietar...
...d dietSpecific formally defined diets ev...
...yle dietDiet pattern that emphasizes intake...
...lementSubstances used to add nutrients, bot...
...ght lossIntentional loss of body weight. Exa...
...tional integrative thera...
Self-management programStandardized program to g...
...ve behavioral therapyPsychological therapy to...
...ody approachesPractices engaging both min...
...punctureStimulation of specific bod...
Massage therapyRubbing and kneading of...
...modalitiesUse of heat and cold for medical...
...ectrotherapyUse of electrical energy for m...
...ve stimulationImplantation of a device t...
...iropracticDiagnosis and manipulation of mala...
...onCounseling on tobacco cessation, tob...
Recommendations for the Management of RAa
Recommendations for the Manage...
...rvention definitions and examples are provided in...
...Exercise recommendations...
...strongly recommend consistent engagement i...
...tionally recommend consistent engagement...
...ditionally recommend consistent eng...
...onditionally recommend consistent...
...y recommend consistent engagement in min...
...abilitation interventions
...y recommend participation in comprehensiv...
...ally recommend participation in comprehensi...
...th hand involvement, we conditionally recommend...
...r patients with hand and/or wrist involv...
...ts with foot and/or ankle involvement,...
...ients with foot and/or ankle involvement, we co...
...atients with knee involvement, we co...
...onally recommend use of joint protection tec...
...itionally recommend use of activity pacin...
...conditionally recommend use of assistive devi...
...recommend use of adaptive equipment over no ada...
...recommend use of environmental adaptatio...
...o are currently employed or desire to become e...
...s who are currently employed or desire to become e...
...et recommendations...
...onally recommend adherence to a Me...
...nally recommend against adherence to a...
...ionally recommend following establish...
...l integrative interventions...
...ditionally recommend use of a standardized se...
...onally recommend use of cognitive behav...
...tionally recommend use of acupunctur...
...ly recommend use of massage therapy over no mas...
...onally recommend use of thermal mod...
...nditionally recommend against using electrotherap...
...conditionally recommend against using chiropractic...