non-pharmacological management of rheumatoid arthritis

Last edited 09/2018

Non-pharmacological interventions, such as dynamic exercises and occupational therapy, should be considered as adjuncts to drug treatment in patients with early arthritis (1)

Diet and complementary therapies

• inform people with RA who wish to experiment with their diet that there is no strong evidence that their arthritis will benefit. However, they could be encouraged to follow the principles of a Mediterranean diet (more bread, fruit, vegetables and fish; less meat; and replace butter and cheese with products based on vegetable and plant oils)
• inform people with RA who wish to try complementary therapies that although some may provide short-term symptomatic benefit, there is little or no evidence for their long-term efficacy
• if a person with RA decides to try complementary therapies, advise them:
• these approaches should not replace conventional treatment
• this should not prejudice the attitudes of members of the multidisciplinary team, or affect the care offered (2)

In patients with early arthritis, smoking cessation, dental care, weight control, assessment of vaccination status and management of comorbidities should be part of overall patient care (1).

Reference:

1. Combe B et al. 2016 update of the EULAR recommendations for the management of early arthritis. Ann Rheum Dis. 2017;76(6):948-959.
2. National Institute for Health and Care Excellence (NICE) 2018. Rheumatoid arthritis in adults: management