Specific advice

• Rest and splinting. This is necessary where practical for any acute flare-up of arthritis.

• Exercise. It is important to have regular exercise especially walking and swimming. Have hydrotherapy in heated pools.

• Referral. Referring to physiotherapists and occupational therapists for expertise in exercise supervision, physical therapy and advice regarding coping in the home and work is important.

• Joint movement. Each affected joint should be put daily through a full range of motion to keep it mobile and reduce stiffness.

• Diet. Although there is no special diet that seems to cause or cure RA there is evidence that avoiding animal fats (dairy products and some meats) and using fish oils is beneficial. 12 A nourishing well-balanced diet is common sense and obesity must be avoided.

Therapies used in the management of rheumatoid arthritis are presented in Table 31.6 .

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