Rheumatoid arthritis self-care – tips that really work

What helps rheumatoid arthritis? Discover self-care tips for rheumatoid arthritis diet, exercise and lifestyle, plus heat and cold treatment for flare-ups.

Self-care for rheumatoid arthritis 

Help prevent rheumatoid arthritis flare-ups, or reduce how bad they are

What helps rheumatoid arthritis flare-ups?

Your questions answered by our doctors

## Self-care for rheumatoid arthritis 

“Looking after yourself well is a key part of dealing with rheumatoid arthritis,” says Dr Ann Nainan, family doctor and Healthily expert.

“You still need to take your essential medicines, known as DMARDs, to reduce the inflammation in your body that causes damage to your joints. Read more about these medicines in rheumatoid arthritis treatments. 

“But when used alongside medication, rheumatoid arthritis self-care can help prevent and ease the pain and stiffness of a flare-up.” 

## Help prevent rheumatoid arthritis flare-ups, or reduce how bad they are

“You may learn to recognise a pattern of symptoms before you get an RA flare-up,” says Dr Ann. “And these tweaks and tips could help lessen the severity of flare-ups, or even help keep them at bay.”

### Get good sleep

“Getting good-quality sleep can help reduce the number of flares you have, and encourage your body to repair better,” says Dr Ann. “If you can find ways to help make sleep easier and more refreshing, this can help you manage your RA.”

To help with sleep, you can:

- keep to a regular, relaxing wind-down routine before bed
- make sure your bedroom is dark and cool
- take your medicines and self-care seriously – to help reduce pain that can disturb your sleep
- check out our [guide to better sleep](/guides/better-sleep) for more tips

### Eat a Mediterranean diet for rheumatoid arthritis

Is there a rheumatoid arthritis diet? You may have read about ‘arthritis diets’ – but few have scientific evidence to back them up.

However, some evidence suggests that a [Mediterranean diet](/nutrition/what-is-a-mediterranean-diet) may be helpful for people with rheumatoid arthritis. 

Here’s what you need to know:

- a Mediterranean diet involves eating lots of fruits and vegetables, whole grains, pulses, nuts and fish, and a smaller amount of red meat and dairy products
- studies have found that people with RA who ate a Mediterranean diet had reduced swollen joints, less morning stiffness, and improvements in their general wellbeing
- antioxidants in fruit and vegetables have anti-inflammatory effects, which may help improve RA symptoms. Brightly colored carrots, oranges and tomatoes are particularly rich in these

#### Eat more oily fish

- as part of the Mediterranean diet, it’s recommended that you eat 2 portions (140g) of oily fish a week
- sardines, mackerel, herring, fresh salmon, snapper and tuna are good sources of omega-3 polyunsaturated fats, which are believed to help dampen down inflammation 
- evidence on taking fish-oil supplements for joint health is less clear, and experts generally say you’re better off getting omega-3s from food. One theory is that there could be other parts of oily fish that are helpful
- if you do want to take supplements, check the ingredients, as they can also contain other vitamins and products. And talk to your doctor too, as some may interact with other medication
- vegetarian or vegan omega-3 oils from plant sources – such as linseeds – may have a weaker effect. The 2 most important types of omega-3 (DHA and EPA) come from marine sources such as oily fish, but you can also find them in algae. Other vegetarian sources, such as flax and chia seeds, usually contain a type of omega-3 called ALA. So far, this appears to be less effective in reducing inflammation

Get more tips on rheumatoid arthritis diet in this video interview with a physician from Johns Hopkins Rheumatology.

# youtube:A3N5bJw-soM

### Check your nutrients

People with rheumatoid arthritis are more likely to have certain vitamin and mineral deficiencies. 

“It might make sense to be proactive and ask your doctor if a deficiency could be making your symptoms worse, and whether a blood test to check your status would be helpful,” says Dr Ann.

Nutrients to keep an eye on include:

- [iron](/health-library/drugs/vitamins-and-minerals-iron) – you need iron to carry oxygen around your body in red blood cells. During an RA flare-up, you can sometimes eat less, which can lead to [iron deficiency anaemia](/health-library/conditions/anaemia-iron-deficiency), adding to tiredness and fatigue. Iron-rich foods include red meat, dried fruit, leafy greens such as kale, pulses and beans, nuts and seeds, fish, tofu and eggs. Your doctor can prescribe a supplement if you’re found to have a deficiency
- [calcium](/self-care/vitamins-and-minerals-calcium) – if you take [steroid tablets](/health-library/drugs/steroid-tablets) as a treatment for RA, they can affect your ability to absorb calcium. You need calcium for strong bones, so not being able to absorb it properly can lead to the weak bone condition [osteoporosis](/health-library/conditions/osteoporosis). It’s important to eat a [calcium–rich diet](/nutrition/healthy-bones-food-and-diet-for-strong-bones). Your doctor may prescribe supplements if you’re at risk of deficiency
- [vitamin D](/health-library/drugs/vitamins-and-minerals-vitamin-d) – low vitamin D is common in people with RA, so try to get out in daylight every day, as your body makes vitamin D from the sun. You may need to take a supplement in autumn and winter if you live in the northern hemisphere

### Try drinking green tea

- green, black and white teas all have anti-inflammatory effects – but green tea is seen as the most beneficial 
- this is because green tea is highest in an antioxidant called a polyphenol, with protective effects up to 100 times stronger than vitamins C and E
- studies have also shown it may protect cartilage and bone – although there are no large trials of people with arthritis
- remember that green tea does contain caffeine, so don’t drink it close to bedtime

### Drink coffee in moderation

- like tea, coffee also contains antioxidant polyphenols
- some studies suggest that coffee can increase the risk of rheumatoid arthritis and osteoporosis, though the evidence is unclear and other studies say it doesn’t
- in general, it’s best to limit your coffee intake to no more than 1 or 2 cups a day. And watch out for extras such as whipped cream and chocolate flakes, which make managing your weight more difficult

![Tea vs Coffee for RA flare ups](//images.ctfassets.net/iqo3fk8od6t9/4B5hkRGCInOYTXUtgpOJgt/d16c78cee15fdc2b4bf26ff85609cd5b/Tea_vs_Coffee_Map_SVG.svg)

### Strengthen your muscles

Try these tips for rheumatoid arthritis exercise:

- walking and other strength-building exercises can help in the longer term by strengthening your muscles and helping to take pressure off your joints, as well as improving your overall health
- about 8 in 10 people with RA have problems with hand and wrist function. If this is you, specific hand and wrist stretching and strengthening exercises can help – try seeing a physiotherapist for advice
![Rheumatoid arthritis weight loss](//images.ctfassets.net/iqo3fk8od6t9/RB2QM9V4h9wIdVc4CNGW2/2105612f10520f7e53f42a42be0cf976/iStock-1443604954.jpg)
### Lose some weight

When you’re walking, the pressure on your knee joints is 1.5 times your body weight – and even more when you’re walking up an incline. So this can make joint pain worse.

“It makes sense to try to lose a few pounds if you’re overweight or [obese](/self-care/what-are-the-health-risks-of-being-overweight-or-obese) and have RA,” says Dr Ann. “This can ease pain by reducing pressure on your joints, as well as reducing the inflammation that can make joint stiffness worse, and helping to make sure your medicines work as well as possible.”

You can check your [body mass index (BMI)](/self-care/what-is-my-bmi) to see if you’re a healthy weight. And if necessary, work out how you can trim your calorie intake and increase your activity levels to lose 1 to 2 lbs a week. Read more about how to lose weight safely.

### Stop smoking

“Quitting smoking may help reduce the number of RA flare-ups you have,” says Dr Ann. It can also:

- increase how well your medication works
- reduce your risk of heart disease (people with RA are at higher risk)


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## What helps rheumatoid arthritis flare-ups?

### Pacing and rest 

When your joints are swollen and painful, try to: 

- pace yourself with your activities, so you don’t overdo it
- make time to rest after activity
- consider changing your social plans – maybe people can come to you, or you can talk on the phone

### Getting good sleep if you can

“As well as keeping to a good sleep routine, you can help prevent a flare-up disrupting your sleep by managing your pain well, which can make you more comfortable,” says Dr Ann. Try:

- applying ice to ease joint pain
- taking the pain relief your doctor recommends

### Gentle stretching

In general, it's helpful to rest when your joints are inflamed and/or you’re feeling tired. But some rheumatoid arthritis exercises, such as gentle stretching and moving around, can also ease pain and stiffness, and help keep your joints flexible. 

To see how you can gently stretch your knees and ankles, watch this video from the UK’s National Rheumatoid Arthritis Society (NRAS). 

# youtube:xLOJP5-lGzw
### Yoga

A gentle [yoga](/physical-activity/yoga-guide) class can also be helpful for improving the flexibility of your joints, and certain types can help boost hand-grip strength, too.

### Swimming or water aerobics 

Aerobic exercise can help reduce rheumatoid arthritis symptoms. Swimming and water aerobics are good choices, as the water takes pressure off your joints. 

### Taking a hot shower

If you find that morning stiffness is worse during a flare-up, a hot shower may help to ease it.

### Non-medical pain relief

During a flare-up, joint stiffness and pain usually gets worse. RA is a condition that can only be controlled by medication, but you can add in home remedies for rheumatoid arthritis that might help relieve some of your symptoms.

For example, applying an ice or heat pack:

- if a joint is inflamed, you might get some relief from applying an ice pack for 15 to 20 minutes, several times a day
- a hot water bottle wrapped in a towel or inside a furry cover can also help ease stiff and achy joints

Read more [self-care tips to treat pain without medication](/self-care/self-care-tips-to-treat-pain).

### Pharmacy treatments to ease pain

Talk to your doctor about what pharmacy treatments they could recommend to help you manage a flare-up, and how to use them as an add-on to your prescription medicines. 

They’ll usually want to manage your whole treatment plan, including pharmacy medications, to help prevent long-term damage as well as ease pain. 

Depending on your situation, they may – or may not – recommend:

- [non-steroidal anti-inflammatory drugs (NSAIDs)](/health-library/drugs/anti-inflammatories-non-steroidal) – these can help by dampening down inflammation and pain. They include ibuprofen and naproxen sodium (Aleve). Stronger NSAIDs are available on prescription
- acetaminophen ([paracetamol](/health-library/drugs/painkillers-paracetamol)) and co-codamol – these can help with pain, but won’t reduce inflammation
- [transcutaneous electrical nerve stimulation (TENS)](/health-library/treatments/tens) – this involves using a small, battery-operated machine to deliver small electrical pulses into your body. One review found that TENS may be used as an add-on therapy for RA pain in the hands

Read more about RA treatments.


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## Your questions answered by our doctors

### Can I drink alcohol with rheumatoid arthritis?

Moderate-to-low alcohol intake isn’t generally harmful, although it may increase your risk of liver damage if you’re taking a medication called methotrexate (you can read more about this in rheumatoid arthritis treatments).

### Does turmeric help with rheumatoid arthritis?

Turmeric has an anti-inflammatory effect, so it’s been suggested that it might help with rheumatoid arthritis. However, there isn’t much evidence to support this, and the few studies that have been done have tended to be small and focused on [osteoarthritis](/health-library/conditions/osteoarthritis), rather than RA.

One review of studies did find a supplement dose of 1,000mg of turmeric a day appears to improve joint symptoms in arthritis. However, its main active ingredient, curcumin, is poorly absorbed. And it can also cause side effects, including diarrhoea, constipation and nausea.

Turmeric definitely isn’t a replacement for your medication, but there’s some limited evidence that it might help improve symptoms. If you want to try a turmeric supplement, check with your doctor first, buy from a reputable source, and keep a diary of your symptoms to help you work out if it’s having any effect. 


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References

Jo Waters

Dr Adiele Hoffman

Dr Nathan Cohen

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What helps rheumatoid arthritis? Discover self-care tips for rheumatoid arthritis diet, exercise and lifestyle, plus heat and cold treatment for flare-ups.


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