If you’re taking your rheumatoid arthritis medication as directed but still feel aches and pains, try making these simple changes to help you feel better.Even if you regularly take your rheumatoid arthritis (RA) medication to slow joint damage and lessen pain, you may still experience RA symptoms like joint pain, stiffness, and swelling.
That’s because certain lifestyle choices may actually make RA symptoms worse. Consider these seven surprising factors that could be contributing to your RA aches and pains:
1. Smoking Cigarettes
“There’s evidence that people who smoke have a higher risk of developing RA and possibly even a more severe form of RA,” says Harry Fischer, MD, an associate professor of medicine at the Icahn School of Medicine, and interim chair of medicine as well as chief of rheumatology at Mount Sinai Beth Israel Hospital in New York City. A study published in the International Journal of Molecular Sciences in December 2014 describes smoking as one of the most important risk factors for developing RA, and having a severe case of this chronic inflammatory condition. The study also notes that if you have RA and smoke, you may also be less likely to benefit from anti-rheumatic medications your doctor prescribes.
“If you’ve been diagnosed with RA, stop smoking,” says Dr. Fischer.
2. Eating Foods that Promote Inflammation
There’s no specific diet for RA, but certain foods seem to contribute to inflammation, according to the Arthritis Foundation. Avoiding or limiting certain fats, oils, sugar, and other inflammatory foods and replacing them with anti-inflammatory foods is especially beneficial for people with RA, says Rachel Begun, MS, RDN, a special diets expert and culinary nutritionist in Boulder, Colorado.
Foods that contribute to inflammation include fatty cuts of meat, packaged foods with hydrogenated and partially hydrogenated oils, and foods with refined flours, empty starches, and added sugars, she says. So limiting these foods in your RA diet is essential.
Instead, load your plate with anti-inflammatory foods, like those rich in omega-3 fatty acids, including wild salmon, anchovies, or walnuts, Begun says. Choose antioxidant-rich fruits, vegetables, and whole grains, and use olive oil, avocado, nuts, and nut butters, which contain healthy monounsaturated fats. “Ginger and turmeric are two spices known for their anti-inflammatory benefits, so using them to flavor dishes is both a beneficial and delicious idea,” she says.
3. Carrying Around Extra Weight
Lugging around extra pounds isn’t good for people with RA, Fischer says, because it adds extra stress and strain on weight-bearing joints like the knees and hips. Being overweight can add to other RA health problems too, he says.
If you have joint pain, the last thing you may want to do is exercise — but don’t skip it. Keep moving with low-impact aerobic exercises such as walking or swimming, and make adjustments to protect yourself if you need to. The Centers for Disease Control and Prevention (CDC) recommends that people with RA do a blend of aerobic, muscle-strengthening, flexibility, and balance exercises. The Arthritis Foundation has videos to show you how to safely stretch hamstring, hip, calf, and other areas before and after exercising.
4. Overdoing it With Alcohol
While there’s probably no adverse effect of alcohol consumption for RA itself, booze can interfere with some medications for RA, says Fischer. Be sure to ask your doctor if you can safely drink alcohol. And if you choose to drink, don’t overdo it. That means no more than one drink a day for women and two for men, according to the Arthritis Foundation. If you have questions about how much alcohol you can drink, your doctor can provide specific guidance.
5. Forgetting About Vitamin D
Everyone needs vitamin D — the sunshine vitamin — to build strong bones, joints, and cartilage. But not getting enough vitamin D may contribute to muscle and skeletal pain in people with RA, Fischer says.
A survey across multiple centers in Europe that was published in the journal Autoimmunity Reviews in May 2017 found that vitamin D deficiency is pretty common in people with RA. An earlier study, published in Therapeutic Advances in Endocrinology and Metabolism in December 2012, linked this deficiency to more severe RA disease activity.
Sunlight stimulates vitamin D production, so aim to soak up some sun for 10 to 15 minutes every other day. To get vitamin D through your diet, add sardines, fortified milk and yogurt, and egg yolks to your diet, Begun says. If you’re low on vitamin D, talk to your doctor about taking a vitamin D supplement.
6. Getting Pregnant
Sometimes RA improves during pregnancy, possibly because of hormonal changes, Fischer says. But if you’re pregnant or are planning to have a child, it’s important to talk with your doctor first. Some medications for RA, including methotrexate, can cause serious birth defects and should be stopped months before you start trying to get pregnant, according to the American College of Rheumatology.
7. Changing Weather
If you can predict the weather based on your joint pain, you’re not alone. Temperature drops and falling barometric pressure are linked to more joint pain. You can’t change the weather, but you can be prepared. Plug in your zip code to predict your level of joint pain for the day based on the weather through this tool on the Arthritis Foundation website.