The Rheumatoid Arthritis Treatment Team
Your primary care doctor may have diagnosed your rheumatoid arthritis (RA) and started you on treatment. But because RA is a progressive disease and new treatments to stop that progression are being introduced all the time, your care should also include a rheumatologist. A rheumatologist specializes in treating rheumatoid arthritis and other diseases of the bones, joints, and muscles. Your primary care doctor and your rheumatologist will work together. Your rheumatologist will design your personal RA treatment plan, and your primary care doctor will manage other aspects of your health.
Depending on your symptoms and any difficulties you're having, you might find it helpful to add other health care professionals to your RA treatment team. This can help you better manage your RA, relieve your joint pain and swelling, and treat any complications that interfere with day-to-day life. Your employer's insurance plan may refer you to a chronic disease manager (CDM) who can help you navigate around whatever challenges emerge. CDMs have the experience, the resources, and the contacts to help you thrive in the face of RA.
Your RA treatment team might include these professionals:
A personal trainer. Exercise is an extremely important part of maintaining your health when you have RA. It helps keep your joints flexible and you mobile and independent. A personal trainer can design an exercise program that you will enjoy and stick to. The right plan will protect joints and not put too much strain on them.
A physical therapist. If your joint pain is limiting your movement, a physical therapist can show you ways to move that will help reduce your joint pain. A physical therapist can also give you specific exercises to increase mobility.
An occupational therapist. If you have a hard time with daily activities, an occupational therapist (OT) can show you exercises and ways of accomplishing tasks that can help reduce the strain that RA puts on your joints. An OT may fit you for splints, braces, or other devices that will allow you to rest your joints. This specialist can also show you ways to conserve your energy when you’re feeling fatigued.
A pharmacist. The pharmacist who fills your prescriptions can tell you about possible side effects and how to minimize them. Your pharmacist can also watch for interactions with drugs you might be taking for other medical conditions. Some RA medications affect your immune system, which makes monitoring their effect on your overall health very important.
A podiatrist. Rheumatoid arthritis can affect your feet. In fact, more than 90% of people with RA experience problems with their feet and ankles that make walking difficult. A foot specialist, called a podiatrist, will evaluate your feet and suggest any needed treatment, which could include inserts for your shoes, braces, steroid injections, or, in some cases, surgery.
An orthopedic surgeon. If your joints are severely damaged and you need surgery to repair or replace them, your rheumatologist will refer you to an orthopedic surgeon. This is a surgeon trained to operate on the musculoskeletal system, including the joints. Orthopedic surgeons can perform joint replacements, reconstruct tendons, or remove inflamed synovial tissue, the membrane found inside your joints.
A psychologist or psychiatrist. Research shows that people with rheumatoid arthritis are twice as likely as others to develop depression. If you’re depressed, this not only affects your overall well-being, but it also makes you less likely to stick to your RA treatment regimen. A psychologist or psychiatrist can help you work through your depression and cope with the emotions of having a long-term disease.
A social worker. Having a long-term illness can have a huge impact on your life. It may affect your ability to work. A social worker can help you deal with the impact of RA on your life by helping you find solutions to any social and financial hardships that your disease may cause.
A nutritionist or registered dietitian. Following a healthy diet is important because some foods may worsen inflammation. A nutritionist or dietitian can design a meal plan that will give you all the nutrients you need for good health and bone and joint strength. The plan also can take into account any other conditions you might have, such as diabetes or heart disease. It will have the right number of calories for losing weight if you need to shed pounds, or for maintaining your weight if you're at your ideal. (Remember that excess weight can add stress to your joints.)
A number of studies show that people with RA who receive appropriate counseling and support do better and are able to meet their personal health goals, whether that’s losing weight, quitting smoking, or exercising regularly. If you need help, ask your primary doctor or rheumatologist for referrals.
At times, you may feel that rheumatoid arthritis is hard to manage by yourself. That's when it's good to know that you're not alone-that you have an RA team on your side.
You'll get the best RA care by putting together a team of health professionals trained in managing RA.
Your team starts with your primary care physician and your rheumatologist.
You may add to your treatment team as symptoms develop or as RA progresses. This could mean adding a physical therapist or trainer to show you how to keep exercising and a dietitian to point you towards the best anti-inflammation diet.
Think of yourself as the team coordinator. Make sure all members are talking to each other so that together they can provide you with the best care.