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Rheumatoid arthritis Q&As

Published by Bupa's health information team, August 2008.

Answers to questions about rheumatoid arthritis

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

 

If I have rheumatoid arthritis, should I see an occupational therapist? How do I find one?

Yes. It may be a good idea if you are having problems with everyday activities. You will need to be referred to an occupational therapist by your GP, rheumatologist or through social services.

Explanation

Occupational therapists are health professionals trained to help you maintain your independence by making everyday activities easier for you. They work both in hospitals and in the community. You will need to be referred to an occupational therapist by your GP, rheumatologist or through social services. You may be referred when you are first diagnosed. If you find you are in need of an occupational therapist, you can ask for a referral. Under the NHS and Community Care Act 1990 you are entitled to a needs assessment from social services.

An occupational therapist will first assess your condition. He or she will then look at your needs in your home, and also with transport, hobbies and work, before offering practical advice on the following.

  • Rethinking how you go about your daily activities. An occupational therapist can help you to reposition yourself during various activities such as washing, cooking and cleaning. He or she can advise you on making sure you get enough rest and on how to look after your joints.
  • Gadgets and home adaptations. There are many options, such as bath rails, grabbers, walkers, raised toilet seats, stair lifts, and specially adapted kitchen and household equipment, such as kettles, vegetable peelers and irons. You can try out various gadgets at your local Disabled Living Centre. There are also adaptations for cars. If you need more help getting around, an occupational therapist can offer advice on scooters and wheelchairs. You can also get advice from mobility centres (see Further information for details). If you are in work, an occupational therapist can advise you on how to get some practical help in your workplace.
  • Splints. You can wear these to ease the strain (and pain) on your hand and wrist joints. Two types of splints are used. Activity splints are usually made of elastic and are used to protect joints while you are carrying out activities. Resting splints are made of more rigid material. They are often custom-made and keep your joints stable while you are resting.

Further information

Sources

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Will rheumatoid arthritis affect my whole body?

It's difficult to say, as rheumatoid arthritis affects everyone differently.

Explanation

Rheumatoid arthritis affects people very differently. Your symptoms may vary in their severity at different times. Some people only have mild symptoms, while others are more severely affected during flare-ups. Once it progresses, rheumatoid arthritis can spread to other joints. However, with the modern approaches that use more effective therapies early, this spread can be minimised in many people.

It's possible that inflammation may affect parts of your body other than your joints, for example, inflammation can affect the eyes, making them dry and irritated. However, this is rare if treatment is started early. Other organs may also be affected, such as your tear glands, salivary glands and blood vessels. Occasionally, the lungs may also be affected and even more rarely, the heart.

Most people with rheumatoid arthritis will have other general problems such as stiffness, tiredness and feeling generally unwell.

However, medication will help control your rheumatoid arthritis. Your physiotherapist and occupational therapist can also give you practical advice on how to make lifestyle changes to help ease your symptoms.

Further information

Sources

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Will eating oily fish or taking fish oil supplements help rheumatoid arthritis?

Possibly, for some people. There is some evidence that fish oil supplements are beneficial in certain forms of arthritis, including rheumatoid arthritis.

Explanation

Fish oils contain omega-3 polyunsaturated fatty acids. Some research has suggested that these fatty acids may have a beneficial effect in inflammatory forms of arthritis, including rheumatoid arthritis, reactive arthritis, psoriatic arthritis and ankylosing spondylitis. The evidence suggests that omega-3 fatty acids may help to reduce the inflammation associated with these forms of arthritis. However, the effects of these are modest and are only likely to help mild rheumatoid arthritis. Studies haven't shown that omega-3 fatty acids are useful for osteoarthritis.

Omega-3 fatty acids are found in their most beneficial form for inflammatory types of arthritis in oily fish, such as salmon, herring, kippers, mackerel, pilchards and trout. They are also found in avocados, nuts and seeds, and hemp, flaxseed, walnut and rapeseed oils. If you take a fish oil supplement, you should choose pure fish oil, not fish liver oil. Fish liver oils, including cod liver oil, also contain vitamins A and D. It's important for everyone, particularly pregnant women, not to have too much vitamin A. Get advice from your doctor if you are pregnant or planning to become pregnant.

Increasing the amount of omega-3 fatty acids in your diet may cause harmful substances called free radicals to form in your body. Free radicals cause damage to body tissues. They are formed naturally as your body ages, but they can also be created by other factors, such as radiation or exposure to particular environmental chemicals. Free radicals can be dealt with by eating foods rich in so-called antioxidants - this includes brightly coloured fruit and vegetables and vitamin E-rich foods, such as seeds, nuts, sweet potatoes and avocados. You can also take vitamin E supplements.

Omega-6 fatty acids aren't thought to have any benefit in rheumatoid arthritis and can in fact increase inflammation. Most people get plenty of omega-6 fatty acids in their diet, so it may be wise to cut down. Key sources of omega-6 fatty acids include: sunflower oil, corn oil, and products made from these oils, such as margarine.

Further information

Sources

  • Omega-3 polyunsaturated fatty acids. Arthritis Research Campaign. July 2006. www.arc.org.uk
  • Healthy eating and arthritis. Arthritis Care. October 2007. www.arthritiscare.org.uk
  • Can cod liver oil protect me from osteoarthritis? Food Standards Agency. www.eatwell.gov.uk, accessed 3 March 2008
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This information, published by Bupa's health information team, is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: August 2008

 

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