Rheumatoid arthritis is often linked with debilitating chronic fatigue. Experts have some ideas about how these two conditions are connected.

References

• 1.Druce KL, Basu N. Predictors of fatigue in rheumatoid arthritis. Rheumatology (Oxford). 2019;58(Suppl 5):v29-v34. doi: 10.1093/rheumatology/kez346
• 2.Madsen SG, Danneskiold-Samsøe B, Stockmarr A, Bartels EM. Correlations between fatigue and disease duration, disease activity, and pain in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol. 2016 Jul;45(4):255-61. doi: 10.3109/03009742.2015.1095943
• 3.Reading SR, Crowson CS, Rodeheffer RJ, Fitz-Gibbon PD, Maradit-Kremers H, Gabriel SE. Do rheumatoid arthritis patients have a higher risk for sleep apnea?. J Rheumatol. 2009;36(9):1869-1872. doi: 10.3899/jrheum.081335
• 4.Shen TC, Hang LW, Liang SJ, et al. Risk of obstructive sleep apnoea in patients with rheumatoid arthritis: a nationwide population-based retrospective cohort study. BMJ Open. 2016;6(11):e013151. Published 2016 Nov 28. doi: 10.1136/bmjopen-2016-013151
• 5.Wali S, Mustafa M, Manzar D, et al. Prevalence of obstructive sleep apnea in patients with rheumatoid arthritis. J Clin Sleep Med. 2020;16(2):259-265. doi: 10.5664/jcsm.8178
• 6.Senra H, McPherson S. Depression in disabling medical conditions - current perspectives. Int Rev Psychiatry. 2021 Apr 6:1-14. doi: 10.1080/09540261.2021.1887823
• 7.Lopes FHA, Freitas MVC, de Bruin VMS, de Bruin PFC. Depressive symptoms are associated with impaired sleep, fatigue, and disease activity in women with rheumatoid arthritis. Adv Rheumatol. 2021 Mar 16;61(1):18. doi: 10.1186/s42358-021-00176-6
• 8.Agrawal S, Misra R, Aggarwal A. Anemia in rheumatoid arthritis: high prevalence of iron-deficiency anemia in Indian patients. Rheumatol Int. 2006 Oct;26(12):1091-5. doi: 10.1007/s00296-006-0133-4
• 9.Singh H, Arya S, Talapatra P, Lather K, Mathur R, Singhania A, Chaudhary V. Assessment of fatigue in rheumatoid arthritis (by Functional Assessment of Chronic Illness Therapy-Fatigue score) and its relation to disease activity and anemia. J Clin Rheumatol. 2014 Mar;20(2):87-90. doi: 10.1097/RHU.0000000000000073
• 10.Escobar ME, Gerhardt C, Roesler E, Kuroda MP, Silva MB, Skare TL. Anemia versus disease activity as cause of fatigue in rheumatoid arthritis. Acta Reumatol Port. 2010 Jan-Mar;35(1):24-8. PMID: 20518145

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The recommendation to get regular exercise if you have rheumatoid arthritis (RA) is backed up by plenty of scientific research. Experts say there are at least 4 ways exercise may help ease the signs and symptoms of RA.

References

• 1.Tan Q, Li Y, Guo Y. Exercise Training Improves Functions of Endothelial Progenitor Cells in Patients with Metabolic Syndrome. Exercício Físico Melhora as Funções das Células Progenitoras Endoteliais em Pacientes com Síndrome Metabólica. Arq Bras Cardiol. 2021;117(1):108-117. doi:10.36660/abc.20200028
• 2.Kasapis C, Thompson PD. The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. J Am Coll Cardiol. 2005;45(10):1563-1569. doi: 10.1016/j.jacc.2004.12.077
• 3.Campbell PT, Campbell KL, Wener MH, et al. A yearlong exercise intervention decreases CRP among obese postmenopausal women. Med Sci Sports Exerc. 2009;41(8):1533-1539. doi: 10.1249/MSS.0b013e31819c7feb
• 4.Chen Z, Li B, Zhan RZ, Rao L, Bursac N. Exercise mimetics and JAK inhibition attenuate IFN-γ-induced wasting in engineered human skeletal muscle. Sci Adv. 2021;7(4):eabd9502. Published 2021 Jan 22. doi:10.1126/sciadv.abd9502
• 5.Ding Y, Xu X. Effects of regular exercise on inflammasome activation-related inflammatory cytokine levels in older adults: a systematic review and meta-analysis [published online ahead of print, 2021 Jun 12]. J Sports Sci. 2021;1-15. doi: 10.1080/02640414.2021.1932279
• 6.Park YM, Myers M, Vieira-Potter VJ. Adipose tissue inflammation and metabolic dysfunction: role of exercise. Mo Med. 2014;111(1):65-72. PMID: 24645302
• 7.Farrow M, Biglands J, Tanner S, et al. Muscle deterioration due to rheumatoid arthritis: assessment by quantitative MRI and strength testing. Rheumatology (Oxford). 2021;60(3):1216-1225. doi:10.1093/rheumatology/keaa364
• 8.Masuko K. Rheumatoid cachexia revisited: a metabolic co-morbidity in rheumatoid arthritis. Front Nutr. 2014;1:20. Published 2014 Nov 24. doi: 10.3389/fnut.2014.00020
• 9.How much physical activity do adults need? Centers for Disease Control and Prevention. Last reviewed October 7, 2020. Accessed October 4, 2021. https://www.cdc.gov/physicalactivity/basics/adults/index.htm
• 10.Avina-Zubieta JA, Thomas J, Sadatsafavi M, Lehman AJ, Lacaille D. Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis. 2012;71(9):1524-1529. doi:10.1136/annrheumdis-2011-200726
• 11.Shimojo G, Joseph B, Shah R, Consolim-Colombo FM, De Angelis K, Ulloa L. Exercise activates vagal induction of dopamine and attenuates systemic inflammation. Brain Behav Immun. 2019;75:181-191. doi: 10.1016/j.bbi.2018.10.005
• 12.Felger JC, Lotrich FE. Inflammatory cytokines in depression: neurobiological mechanisms and therapeutic implications. Neuroscience. 2013;246:199-229. doi: 10.1016/j.neuroscience.2013.04.060
• 13.Fakra E, Marotte H. Rheumatoid arthritis and depression [published online ahead of print, 2021 Apr 28]. Joint Bone Spine. 2021;88(5):105200. doi: 10.1016/j.jbspin.2021.105200
• 14.Gautam S, Tolahunase M, Kumar U, Dada R. Impact of yoga based mind-body intervention on systemic inflammatory markers and co-morbid depression in active Rheumatoid arthritis patients: A randomized controlled trial. Restor Neurol Neurosci. 2019;37(1):41-59. doi: 10.3233/RNN-180875
• 15.Brady SM, Fenton SAM, Metsios GS, Bosworth A, Duda JL, Kitas GD, Veldhuijzen van Zanten JJCS. Different types of physical activity are positively associated with indicators of mental health and psychological wellbeing in rheumatoid arthritis during COVID-19. Rheumatol Int. 2021 Feb;41(2):335-344. doi: 10.1007/s00296-020-04751-w
• 16.Rongen-van Dartel SA, Repping-Wuts H, Flendrie M, Bleijenberg G, Metsios GS, van den Hout WB, van den Ende CH, Neuberger G, Reid A, van Riel PL, Fransen J. Effect of Aerobic Exercise Training on Fatigue in Rheumatoid Arthritis: A Meta-Analysis. Arthritis Care Res (Hoboken). 2015 Aug;67(8):1054-62. doi: 10.1002/acr.22561
• 17.Zielinski MR, Systrom DM, Rose NR. Fatigue, Sleep, and Autoimmune and Related Disorders. Front Immunol. 2019;10:1827. Published 2019 Aug 6. doi: 10.3389/fimmu.2019.01827

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RA inflammation affects more than joints. The signs and symptoms of RA and conditions related to it may be felt all over the body, including in the ears, eyes, skin, lungs, and heart. Below is a description of 9 unusual symptoms that may be related to your rheumatoid arthritis.

References

• 1.Emamifar A, Bjoerndal K, Hansen IM. Is Hearing Impairment Associated with Rheumatoid Arthritis? A Review. Open Rheumatol J. 2016;10:26-32. Published 2016 Mar 15. doi:10.2174/1874312901610010026
• 2.Huang C-M, Chen H-J, Huang P-H, et al. Retrospective cohort study on risk of hearing loss in patients with rheumatoid arthritis using claims data. BMJ Open 2018;8:e018134. doi:10.1136/ bmjopen-2017-018134 PMCID: PMC5780710
• 3.Bortoli R, Santiago M. Chloroquine ototoxicity. Clin Rheumatol. 2007;26(11):1809-1810. doi:10.1007/s10067-007-0662-6
• 4.Reading SR, Crowson CS, Rodeheffer RJ, Fitz-Gibbon PD, Maradit-Kremers H, Gabriel SE. Do rheumatoid arthritis patients have a higher risk for sleep apnea?. J Rheumatol. 2009;36(9):1869-1872. doi: 10.3899/jrheum.081335
• 5.Shen TC, Hang LW, Liang SJ, et al. Risk of obstructive sleep apnea in patients with rheumatoid arthritis: a nationwide population-based retrospective cohort study. BMJ Open. 2016;6(11):e013151. Published 2016 Nov 28. doi: 10.1136/bmjopen-2016-013151
• 6.Pasadyn SR, Knabel D, Fernandez AP, Warren CB. Cutaneous adverse effects of biologic medications. Cleve Clin J Med. 2020;87(5):288-299. 10.3949/ccjm.87a.19119
• 7.Filippone, Lisa M. MD Diagnosis: Raynaud Phenomenon, Emergency Medicine News: August 2004 - Vol 26 - Issue 8, p 30. Accessed August 10, 2021, https://journals.lww.com/em-news/Fulltext/2004/08000/Diagnosis__Raynaud_Phenomenon.19.aspx/a>
• 8.Mercado FB, Marshall RI, Klestov AC, Bartold PM. Relationship between rheumatoid arthritis and periodontitis. J Periodontol. 2001 Jun;72(6):779-87. doi: 10.1902/jop.2001.72.6.779. PMID: 11453241/a>.
• 9.Bartold PM, Marshall RI, Haynes DR. Periodontitis and rheumatoid arthritis: a review. J Periodontol. 2005 Nov;76(11 Suppl):2066-74. doi: 10.1902/jop.2005.76.11-S.2066. PMID: 16277578.
• 10.Rodríguez-Lozano B, González-Febles J, Garnier-Rodríguez JL, Dadlani S, Bustabad-Reyes S, Sanz M, Sánchez-Alonso F, Sánchez-Piedra C, González-Dávila E, Díaz-González F. Association between severity of periodontitis and clinical activity in rheumatoid arthritis patients: a case-control study. Arthritis Res Ther. 2019 Jan 18;21(1):27. doi: 10.1186/s13075-019-1808-z. PMID: 30658685
• 11.Sun J, Zheng Y, Bian X, Ge H, Wang J, Zhang Z. Non-surgical periodontal treatment improves rheumatoid arthritis disease activity: a meta-analysis. Clin Oral Investig. 2021 Jan 29. doi: 10.1007/s00784-021-03807-w. Epub ahead of print. PMID: 33515120
• 12.Kaur S, Bright R, Proudman SM, Bartold PM. Does periodontal treatment influence clinical and biochemical measures for rheumatoid arthritis? A systematic review and meta-analysis. Semin Arthritis Rheum. 2014 Oct;44(2):113-22. doi: 10.1016/j.semarthrit.2014.04.009. Epub 2014 Apr 28. PMID: 24880982
• 13.Ortiz P, Bissada NF, Palomo L, et al. Periodontal therapy reduces the severity of active rheumatoid arthritis in patients treated with or without tumor necrosis factor inhibitors. J Periodontol. 2009;80(4):535-540. doi:10.1902/jop.2009.080447 PMID: 19335072
• 14.Turk SA, van Schaardenburg D, Boers M, et al. An unfavorable body composition is common in early arthritis patients: A case control study. PLoS One. 2018;13(3):e0193377. Published 2018 Mar 22. doi:10.1371/journal.pone.0193377 PMID: 29565986
• 15.Book C, Karlsson MK, Nilsson JÅ, Akesson K, Jacobsson LT. Changes in body composition after 2 years with rheumatoid arthritis. Scand J Rheumatol. 2011;40(2):95-100. doi: 10.3109/03009742.2010.507215
• 16.Alvarez-Nemegyei J, Buenfil-Rello FA, Pacheco-Pantoja EL. Association between body composition and disease activity in rheumatoid arthritis. A systematic review. Asociación entre composición corporal y actividad inflamatoria en artritis reumatoide. Una revisión sistemática. Reumatol Clin. 2016;12(4):190-195. doi:10.1016/j.reuma.2015.09.001 PMID: 26549160

These 15 tips can help you cope with the joint pain and swelling, fatigue, and stress and anxiety that often come with a rheumatoid arthritis flare-up.

References

• 1.Reading SR, Crowson CS, Rodeheffer RJ, Fitz-Gibbon PD, Maradit-Kremers H, Gabriel SE. Do rheumatoid arthritis patients have a higher risk for sleep apnea?. J Rheumatol. 2009;36(9):1869-1872. doi: 10.3899/jrheum.081335
• 2.Shen TC, Hang LW, Liang SJ, et al. Risk of obstructive sleep apnoea in patients with rheumatoid arthritis: a nationwide population-based retrospective cohort study. BMJ Open. 2016;6(11):e013151. Published 2016 Nov 28. doi: 10.1136/bmjopen-2016-013151
• 3.Wali S, Mustafa M, Manzar D, et al. Prevalence of obstructive sleep apnea in patients with rheumatoid arthritis. J Clin Sleep Med. 2020;16(2):259-265. doi: 10.5664/jcsm.8178
• 4.Kelley GA, Kelley KS, Callahan LF. Aerobic Exercise and Fatigue in Rheumatoid Arthritis Participants: A Meta-Analysis Using the Minimal Important Difference Approach. Arthritis Care Res (Hoboken). 2018 Dec;70(12):1735-1739. doi: 10.1002/acr.23570
• 5.Rongen-van Dartel SA, Repping-Wuts H, Flendrie M, Bleijenberg G, Metsios GS, van den Hout WB, van den Ende CH, Neuberger G, Reid A, van Riel PL, Fransen J. Effect of Aerobic Exercise Training on Fatigue in Rheumatoid Arthritis: A Meta-Analysis. Arthritis Care Res (Hoboken). 2015 Aug;67(8):1054-62. doi: 10.1002/acr.22561
• 6.Katz P, Margaretten M, Gregorich S, Trupin L. Physical Activity to Reduce Fatigue in Rheumatoid Arthritis: A Randomized Controlled Trial. Arthritis Care Res (Hoboken). 2018;70(1):1-10. doi: 10.1002/acr.23230

Applying a cold or hot pack to a joint can help relieve rheumatoid arthritis pain, swelling and stiffness. Learn when to use cold, when to use heat, and why these simple home treatments work.

References

• 1.Kettelhut EA, Traylor J, Roach JP. Erythema Ab Igne. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538250/
• 2.Block JE. Cold and compression in the management of musculoskeletal injuries and orthopedic operative procedures: a narrative review. Open Access J Sports Med. 2010;1:105-113. Published 2010 Jul 7. doi:10.2147/oajsm.s11102

Research shows good oral health can help relieve rheumatoid arthritis symptoms. Here are 10 ways to improve your oral hygiene so you can enjoy a healthy smile and reduce RA joint pain.

References

• 1.Mercado FB, Marshall RI, Klestov AC, Bartold PM. Relationship between rheumatoid arthritis and periodontitis. J Periodontol. 2001 Jun;72(6):779-87. doi: 10.1902/jop.2001.72.6.779. PMID: 11453241
• 2.Bartold PM, Marshall RI, Haynes DR. Periodontitis and rheumatoid arthritis: a review. J Periodontol. 2005 Nov;76(11 Suppl):2066-74. doi: 10.1902/jop.2005.76.11-S.2066. PMID: 16277578
• 3.Rodríguez-Lozano B, González-Febles J, Garnier-Rodríguez JL, Dadlani S, Bustabad-Reyes S, Sanz M, Sánchez-Alonso F, Sánchez-Piedra C, González-Dávila E, Díaz-González F. Association between severity of periodontitis and clinical activity in rheumatoid arthritis patients: a case-control study. Arthritis Res Ther. 2019 Jan 18;21(1):27. doi: 10.1186/s13075-019-1808-z. PMID: 30658685
• 4.Gomez-Bañuelos E, Johansson L, Konig MF, Lundquist A, Paz M, Buhlin K, Johansson A, Rantapää-Dahlqvist S, Andrade F. Exposure to Aggregatibacter actinomycetemcomitans before Symptom Onset and the Risk of Evolving to Rheumatoid Arthritis. J Clin Med. 2020 Jun 18;9(6):1906. doi: 10.3390/jcm9061906. PMID: 32570853
• 5.Gómez-Bañuelos E, Mukherjee A, Darrah E, Andrade F. Rheumatoid Arthritis-Associated Mechanisms of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. J Clin Med. 2019;8(9):1309. Published 2019 Aug 26. doi:10.3390/jcm8091309. PMID: 31454946
• 6.Konig MF, Abusleme L, Reinholdt J, Palmer RJ, Teles RP, Sampson K, Rosen A, Nigrovic PA, Sokolove J, Giles JT, Moutsopoulos NM, Andrade F. Aggregatibacter actinomycetemcomitans-induced hypercitrullination links periodontal infection to autoimmunity in rheumatoid arthritis. Sci Transl Med. 2016 Dec 14;8(369):369ra176. doi: 10.1126/scitranslmed.aaj1921. PMID: 27974664
• 7.Sun J, Zheng Y, Bian X, Ge H, Wang J, Zhang Z. Non-surgical periodontal treatment improves rheumatoid arthritis disease activity: a meta-analysis. Clin Oral Investig. 2021 Jan 29. doi: 10.1007/s00784-021-03807-w. Epub ahead of print. PMID: 33515120
• 8.Kaur S, Bright R, Proudman SM, Bartold PM. Does periodontal treatment influence clinical and biochemical measures for rheumatoid arthritis? A systematic review and meta-analysis. Semin Arthritis Rheum. 2014 Oct;44(2):113-22. doi: 10.1016/j.semarthrit.2014.04.009. Epub 2014 Apr 28. PMID: 24880982
• 9.Ortiz P, Bissada NF, Palomo L, et al. Periodontal therapy reduces the severity of active rheumatoid arthritis in patients treated with or without tumor necrosis factor inhibitors. J Periodontol. 2009;80(4):535-540. doi:10.1902/jop.2009.080447 PMID: 19335072
• 10.Atuegwu NC, Perez MF, Oncken C, Thacker S, Mead EL, Mortensen EM. Association between Regular Electronic Nicotine Product Use and Self-reported Periodontal Disease Status: Population Assessment of Tobacco and Health Survey. Int J Environ Res Public Health. 2019;16(7):1263. Published 2019 Apr 9. doi:10.3390/ijerph16071263. PMID: 30970567
• 11.Hajishengallis G, Chavakis T. Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities [published online ahead of print, 2021 Jan 28]. Nat Rev Immunol. 2021;1-15. doi:10.1038/s41577-020-00488-6
• 12.Iljazovic A, Amend L, Galvez EJC, de Oliveira R, Strowig T. Modulation of inflammatory responses by gastrointestinal Prevotella spp. - From associations to functional studies. Int J Med Microbiol. 2021 Feb;311(2):151472. doi: 10.1016/j.ijmm.2021.151472. Epub 2021 Jan 8. PMID: 33461110

Experts think the treat-to-target approach is the best way to treat rheumatoid arthritis and relieve joint pain. This approach is appropriate for anyone with RA, whether they are newly diagnosed or have had it for decades.

References

• 1.Drosos AA, Pelechas E, Voulgari PV. Treatment strategies are more important than drugs in the management of rheumatoid arthritis. Clin Rheumatol. 2020;39(4):1363-1368. doi:10.1007/s10067-020-05001-x
• 2.Yu Z, Lu B, Agosti J, et al. Implementation of Treat-to-Target for Rheumatoid Arthritis in the US: Analysis of Baseline Data From a Randomized Controlled Trial. Arthritis Care Res (Hoboken). 2018;70(5):801-806. doi:10.1002/acr.23343

These 9 life hacks can protect your hands from unnecessary strain and prevent arthritis hand pain from getting worse. These tips cover everything from food prep and taking medications to holding children and choosing a travel mug.

Try these home treatments to relieve hand and wrist pain caused by rheumatoid arthritis. You may also consider working with an occupational therapist to help strengthen joints in the fingers, thumbs, and wrists.

References

• 1.Murage MJ, Tongbram V, Feldman SR, et al. Medication adherence and persistence in patients with rheumatoid arthritis, psoriasis, and psoriatic arthritis: a systematic literature review. Patient Prefer Adherence. 2018;12:1483‐1503. Published 2018 Aug 21. doi: 10.2147/PPA.S167508
• 2.Park DC, Hertzog C, Leventhal H, et al. Medication adherence in rheumatoid arthritis patients: older is wiser. J Am Geriatr Soc. 1999;47(2):172‐183. doi: 10.1111/j.1532-5415.1999.tb04575.x
• 3.Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, et al. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet. 1991;338(8772):899-902. doi: 10.1016/0140-6736(91)91770-u
• 4.Tedeschi SK, Frits M, Cui J, et al. Diet and Rheumatoid Arthritis Symptoms: Survey Results From a Rheumatoid Arthritis Registry. Arthritis Care Res (Hoboken). 2017;69(12):1920-1925. doi: 10.1002/acr.23225
• 5.Vadell AKE, Bärebring L, Hulander E, Gjertsson I, Lindqvist HM, Winkvist A. Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA)-a randomized, controlled crossover trial indicating effects on disease activity. Am J Clin Nutr. 2020;111(6):1203-1213. doi: 10.1093/ajcn/nqaa019
• 6.Lourdudoss C, Di Giuseppe D, Wolk A, et al. Dietary Intake of Polyunsaturated Fatty Acids and Pain in Spite of Inflammatory Control Among Methotrexate-Treated Early Rheumatoid Arthritis Patients. Arthritis Care Res (Hoboken). 2018;70(2):205-212. doi: 10.1002/acr.23245
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• 8.Tedeschi SK, Bathon JM, Giles JT, Lin TC, Yoshida K, Solomon DH. Relationship Between Fish Consumption and Disease Activity in Rheumatoid Arthritis. Arthritis Care Res (Hoboken). 2018;70(3):327-332. doi: 10.1002/acr.23295
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These 8 anti-inflammatory foods, drinks, and spices can help you combat pain due to inflammation, such as arthritis pain.

References

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• 3.Bartels EM, Folmer VN, Bliddal H, Altman RD, Juhl C, Tarp S, Zhang W, Christensen R. Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials. Osteoarthritis Cartilage. 2015 Jan;23(1):13-21. doi: 10.1016/j.joca.2014.09.024. Epub 2014 Oct 7.
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