Some people with rheumatoid arthritis (RA) find it helpful to use other treatments in combination with their prescription treatment. If this is something your doctor suggests, there are a few things you may want to keep in mind. If you plan to seek complementary care for pain, make sure that any healthcare providers are aware of the following complications associated with RA, and that they are using procedures that are less likely to cause aggravation of your symptoms or cause a worse problem. Your primary care doctor or rheumatologist can be a helpful source for a referral. He or she can recommend someone who understands and can review these issues and modify your treatment plan to be appropriate for your individual situation.
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NOTE: Not everyone with RA will have the following issues. Your rheumatologist and/or healthcare provider will be able to determine if these are concerns for you.
1. Could your neck be unstable?
This is one of the more serious complications that should be considered when seeking care. In some individuals, RA can affect ligaments that attach one bone to another and allow excessive slipping in the upper part of the neck. If certain stretches or mobilizations are performed too aggressively, it may cause injury.
What can be done instead? Some providers may choose to use alternative methods of care for the neck region, such as a more gentle mobilization of the joints, muscle/massage therapy, or ultrasound and electrical stimulation therapies.
2. Are your joints actively inflamed?
Joints that are red, swollen, warm, or very painful are inflamed and must be treated with care in order to prevent aggravation of the symptoms. Some of the more aggressive methods aimed at reducing joint tightness and improving range of motion are usually not warranted in these situations. Instead, gentle mobilizations and modalities aimed at reducing the swelling and inflammation are ideal. Ask your provider to tread lightly in these areas and speak up if you're feeling excessive discomfort.
3. Are your muscles actively inflamed?
Muscles can hurt for a variety of reasons, one of them being inflammation from RA. Certain muscle therapy techniques may aggravate these inflamed muscles and should be avoided. Instead, gentle stretching and modalities aimed at reducing pain and inflammation are ideal. Just like with inflamed joints, if your muscles are very sore ask your provider to be gentle and notify him or her if there is any excessive discomfort.
There are several types of care for muscle and joint pain directly or not directly related to the active RA disease process. These may include physical therapy, chiropractic care, or massage therapy. Care must be taken to identify areas of active RA and the common complications of RA in order to reduce the chances of making the situation worse. This care is meant to be complementary to—and not replace—the medical care that has been recommended by your doctor.