RA can affect some joints
more than others — usually the ones you rely on the most.
Rheumatoid arthritis (RA) affects everyone differently, but certain joints are more often involved in the disease than others. These typically include joints that have a synovial lining, a thin membrane that covers their surfaces and that can thicken when inflamed, explains Michelle J. Ormseth, MD, a rheumatologist at Vanderbilt University Medical Center in Nashville, Tennessee.
“However,” says Dr. Ormseth, “not all joints that have a synovial lining are involved in RA, and it’s unclear why RA follows the pattern of joint involvement that we observe.” One reason the condition can be so hard to live with is that it typically affects the fingers, wrists, knees, ankles, and feet — joints that get a lot of use, explains David Lee, MD, a rheumatologist at Kaiser Permanente Riverside Medical Center in Riverside, California.
In general, you can help limit joint damage by following your medication regimen, not smoking, getting regular exercise, and eating an anti-inflammatory diet. But when it comes to soothing the joints that ache the most, these tips can help.
1. Rheumatoid Arthritis and Your Knees
Where: RA typically affects both sides of the body, so most people feel pain in both knees.
What worsens it: When you’re having a flare, repetitive use and high-impact exercises may make knee pain worse. Being overweight and sedentary increases knee pain and stiffness, whether or not you’re having a flare.
What helps: Maintaining a healthy body weight and exercising regularly can help relieve pain and stiffness. “Physical activity is not known to worsen arthritis in joints; in fact, most people with RA experience stiffness with inactivity and find relief with joint movement,” says Kim Huffman, MD, PhD, an associate professor of medicine in the division of rheumatology and immunology at the Duke Molecular Physiology Institute in Durham, North Carolina. Opt for a mix of lower-impact cardio (swimming or cycling), strength training, and flexibility exercises. Exercise can help you strengthen the muscles in your legs and increase flexibility and mobility. A physical therapist can help you develop an individualized exercise program, according to the American Academy of Orthopaedic Surgeons.
2. RA and the Forefoot
Where: The joints in the toes and the ball of the foot.
What worsens it: As Dr. Huffman notes, “RA begins as a systemic process rather than within the foot or hand itself. In other words, RA foot (and hand) manifestations don’t result from weight-bearing but from a systemic inflammatory process. However, once the inflammation is present in the foot or ankle, poor shoe wear can certainly exacerbate the pain and potential deformities. First and foremost, the foot deformities from RA (bunions, claw toes, and hammertoes) are generally regarded as a sign of disease activity, likely aggravated by poor shoe fit.” Shoes that are tight and squeeze the toes or shift weight onto the ball of the foot, such as high heels, will likely exacerbate symptoms.
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