Treatment aim 3 - to minimise disability as much as possible

• As far as possible, try to keep active. The muscles around the joints will become weak if they are not used. Regular exercise may also help to reduce pain and improve joint function. Swimming is a good way to exercise many muscles without straining joints too much. A physiotherapist can advise on exercises to keep muscles around joints as mobile and strong as possible. They may also advise on splints to help rest a joint if needed.
• If such things as your grip or mobility become poor, an occupational therapist may advise on adaptations to the home to make daily tasks easier.
• If you develop a joint deformity then surgery to correct it is sometimes an option. If severe damage occurs to a joint, operations such as knee or hip replacements are an option.

Treatment aim 4 - to reduce the risk of developing associated diseases

As mentioned, if you have RA you have an increased risk of developing diseases such as heart disease, stroke, osteoporosis, and certain cancers. Therefore, you should consider doing what you can to reduce the risk of these conditions by other means. For example, if possible:

• Eat a good healthy diet and exercise regularly.
• Lose weight if you are overweight.
• Do not smoke. (In addition to increasing the risk of cancer, heart disease and stroke, smoking may also make symptoms of RA worse.)
• If you have high blood pressure, diabetes, or a high cholesterol level, they should be well controlled on treatment.

See leaflet called 'Osteoporosis' for more details.

Immunisations

To prevent certain infections, you should have:

• An annual 'flu jab if you are over the age of 65 years, or are taking immunosuppressive drugs, or are taking steroids equivalent to 20 mg or more of prednisolone each day for more than a month.
• A 'one-off' pneumococcal immunisation if you are over the age of 75 years, or are taking immunosuppressive drugs, or are taking steroids equivalent to 20 mg or more of prednisolone each day for more than a month.

Other treatments

Some people try complementary therapies such as special diets, bracelets, acupuncture, etc. There is little research evidence to say how effective such treatments are for RA. In particular, beware of paying a lot of money to people who make extravagant claims of success. For advice on the value of any treatment it is best to consult a doctor, or contact one of the groups below.

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