Can Occupational Therapy Help With Rheumatoid Arthritis Symptoms?

From everydayhealth.com

The joint pain, fatigue, and other symptoms of rheumatoid arthritis (RA) can make everyday tasks challenging. 

Pain often occurs in the small joints of the fingers, wrists and toes, and unlike some other forms of arthritis, RA typically affects joints symmetrically. “Everything from washing your hair to preparing food to taking care of children and pets can become difficult if your joints are swollen, stiff, and painful,” says Cheryl Crow, an occupational therapist and the founder of Arthritis Life, an advocacy organization for people with inflammatory arthritis, and who also has RA. 

“Fatigue and joint instability can further hinder mobility and independence,” adds Crow. “Over time, these limitations can affect one's ability to work, care for oneself, and engage in social activities.”

One approach that can help is occupational therapy (OT), teaching you strategies that allow you to be independent for longer and keep participating in activities you enjoy.

How Occupational Therapy Can Help

“The three main challenges people with RA tend to face are joint pain, fatigue, and stress or overwhelm,” says Crow. The ultimate goal of OT is to address those challenges and help people successfully function in their daily life, despite the symptoms and disability caused by RA, she says.  

Therapists often start by walking you through “a day in the life.” As experts in breaking down and analysing a person’s daily activities, they can troubleshoot what’s hard for you and use a multipronged approach to address those issues.

Most people with RA will only need about four to six sessions of OT to achieve their goals, though it’s recommended that they have “booster visits” throughout the course of their disease as their condition, and needs, may change.

One of the upsides of occupational therapy is that simple adjustments often make a big difference. “We really are obsessed with finding creative ways to improve your quality of life,” says Crow.

Activity Modifications

Some tasks may exacerbate symptoms or feel nearly impossible to achieve. An OT can suggest modifications to make them more manageable and less painful. For example, an OT might teach you an alternate way to hold your pencil or toothbrush that will put less strain on sore joints.

Even people with low disease activity report issues with tasks that require hand dexterity and strength. OTs can walk you through exercises to help build grip strength and address limitations in movement, coordination and sensation.

Therapists may also suggest simple “life hacks” such as using a jar opener or an easy-to-grip knife, says Crow.

Depending on your situation and insurance coverage, the therapist may be able to visit your home or work environment to personalize their guidance.  

“For example, we might help you rearrange your kitchen so items you use frequently are in easy reach,” says Crow.

At work, adjusting the height of a work surface or changing the adjustments on your office chair can ease joint stress and pain.

Joint Protection Techniques

“Occupational therapists can teach patients good ergonomics and body positioning so they can protect sore joints and prevent themselves from repetitive strain. For example, if your fingers are sore, we can teach you ways to use your larger joints when performing daily tasks,” says Crow.

But there has to be a balance between activity and rest for the joints, she says.

“We say, ’motion is lotion,’ and if you don't move your joints at all, they may become even more sore. An occupational therapist or certified hand therapist can help you determine when to move and when to rest sore joints,” says Crow. 

They can also perform a skilled assessment and fabricate a custom splint if needed, she says. When used appropriately, a splint can do many things, including provide support, improve alignment, allow for rest, reduce pain, and help with grip strength.

Energy Conservation

“The inflammation from rheumatoid arthritis can cause fatigue and difficulties with stamina, which can make it difficult to get everything done that you need or want to do in a day,” says Crow.

Fatigue is different from just being tired — it’s a feeling of being sapped of all energy, making it hard to find the strength or motivation to do even basic tasks.

While there’s no quick fix for fatigue, an occupational therapist can help you with energy levels in a few different ways, says Crow.

“We help you figure out ways to reduce fatigue levels, which includes ways to ‘conserve’ or minimize energy output throughout the day,” she says. OTs can also teach you how to prioritize tasks, pace yourself, and how to space out rest breaks.

But OTs also use their expertise to help you push yourself just the right amount to build stamina so that you have more energy throughout the day.

“There's a bit of a paradox with fatigue where you have to spend a little energy on exercise in order to gain more stamina, so it's not as simple as always conserving energy. We help you work through how to implement these strategies in your daily life,” says Crow.

Often that can mean "exercise snacks" or small bits of movement rather than a huge trip to the gym, she says.

Adaptive Equipment

Specialised tools can make everyday tasks easier for you to do without assistance.

Adaptive tools that you can buy right off the shelf are designed to work for most people, and tools can also be custom made by your OT or rehab company.

These include utensils, bathing devices like long-handled sponges, button hooks, and magnet closures on a bra. “These can help you perform the same tasks more easily or independently, and they’re useful if you can''t perform the task you need to do in the typical fashion,” says Crow.

These tools aren’t always specially designed for arthritis — items like step stools, lightweight cookware, and reachers are all examples of adaptive equipment that can make life easier. 

Crow uses adaptive scissors that put less strain on the base of her joint, an under-cabinet jar opener, and compression gloves.

She also uses assistive technology in the form of voice-to-text to keep from typing with sore fingers.

All-Around Life Help

RA affects more than your joints. “It can be a very expensive, time intensive, and painful condition to manage. Occupational therapists look at the big picture of the person's quality of life and strive to help them on all levels, not just pain,” she says.  

Skills learned in occupational therapy can help those with RA stay active and engage with the people and activities they enjoy. That’s important, because people with RA have a higher risk of stress, anxiety, and depression than people without rheumatoid arthritis, says Crow.

The Takeaway

• Occupational therapy (OT) can play a crucial role in helping people with rheumatoid arthritis (RA) maintain independence, manage daily activities, and reduce joint pain.
• OT offers practical strategies like activity modifications, joint protection techniques, and energy conservation to address fatigue, pain, and stiffness that often limit mobility and participation.
• Adaptive equipment and personalized tools, such as ergonomic utensils, splints, or voice-to-text technology, can make everyday tasks easier and less painful.
• OTs can help address the emotional impact of RA by teaching coping strategies, reducing stress through routine planning, and supporting overall quality of life.

 https://www.everydayhealth.com/rheumatic-conditions/can-occupational-therapy-help-with-ra-symptoms/