World-renowned health economist builds “pathway to impact” for children with arthritis and their families

From cihr-irsc.gc.ca

“Most people don’t know that kids get arthritis,” says Dr. Deborah Marshall. “And they don’t understand the serious and wide-ranging effects of arthritis on child patients, their families, and communities.”

Dr. Marshall, Svare Chair, Health Economics, Value and Impact at the University of Calgary, studies the social and economic burden of juvenile arthritis and gathers data and evidence to influence health decision-making.

“In our research program, we are focused on standardizing measurements of care, measuring treatment preferences, and modelling the cost-effectiveness of personalized treatment strategies,” says Dr. Marshall. “Overall, we’re building a pathway to impact for better health and well-being for children and families.”

                                                                                               Dr. Deborah Marshall

Arthritis is one of the most common inflammatory diseases in childhood. It affects around 25,000 children in Canada. In juvenile arthritis, the immune system attacks the joints, causing pain, swelling, inflammation, and in many cases irreversible damage and long-term disability. The disease can have debilitating effects in all areas of a child‘s life.

The good news is that in the last decade a variety of treatment options have become available for children with arthritis. The gap is knowing which treatment will work optimally in each case.

Dr. Marshall with Cassie + Friends, a juvenile arthritis charity. (Photo credit : Cassie + Friends)

Dr. Marshall is the health economics lead for the successful national and international Understanding Childhood Arthritis Network (UCAN) collaboration. Through this collaboration, Dr. Marshall and her colleagues and partners are advancing science, generating knowledge, and have created a highly effective data collection and sharing ecosystem.

“It doesn’t sound very sexy, but we need to measure things,” says Dr. Marshall. “We need to be able to measure the outcomes and socioeconomic burden for patients—and we need data to tell our impact story and drive actionable change.”

Children with arthritis have a variety of treatment options. In Canada, treatments usually start with steroids, then move to a class of drugs named disease-modifying anti-rheumatic drugs, or DMARDS, and finally to biologics, which are expensive and may not be accessible, depending on where you live in the country. It can take a couple of years of trying different drugs before finding one that works best for the patient.

“It’s difficult to believe, that in the 21st century, we still use trial and error to arrive at the right drug,” says Dr. Rae Yeung, a paediatric rheumatologist, leader of the UCAN research program, and Scientific Director of the CIHR Institute of Musculoskeletal Health and Arthritis.

“With UCAN’s comprehensive data strategy, we can answer questions using data from multiple domains, including demographic, clinical, biologic, socioeconomic and patient reported outcomes. This wholistic approach allows us to develop personalized treatment plans for patients and may lead to cost savings for the health system and families.”

Most studies on juvenile arthritis have focused on medical costs. But what is often hidden are the significant social and economic costs for patients and their families. They include missing school and social activities, having to reduce work hours, and paying out-of-pocket for medications, physical therapy, and travel to see arthritis specialists in other cities.

Dr. Marshall and her team

“It’s heartbreaking to listen to patients and parents talk about the effect of arthritis on their lives,” says Dr. Marshall.

Listening to patients motivated Dr. Marshall and her team to develop research training opportunities and empower patients and their families.

Dr. Marshall is one of the founders of the Patient and Community Engagement Research (PaCER) program at the University of Calgary where participants learn how to design and implement qualitative research studies. A group of youth with arthritis who took the PaCER program conducted a study that filled an evidence gap on the experience of youth with arthritis in the transition from paediatric to adult care in Canada.

An international project led by Canada called PAVE (Producing an Arthritis Value-Framework with Economic Evidence) will develop an evidence-informed, patient and parent co-created framework that will fully capture all the ways that childhood arthritis affects families. Dr. Marshall is collaborating on PAVE with Cassie and Friends, a juvenile arthritis charity, which is the lead patient organization for the consortium.

The strong leadership of Dr. Marshall and her outstanding contributions to programs such as UCAN, PaCER, PAVE, and others helped secure the funding for One Child Every Child, a Canada-first research and translation initiative, which is supported by a major grant from the Canada First Research Excellence Fund.

Dr. Marshall also leads the value, impact and knowledge mobilization accelerator of One Child Every Child, which embeds value and impact measures into research activities to achieve maximum impact by design. With their destination clearly in mind, the team is well on the road to creating a healthier future for children in Canada and globally.

https://cihr-irsc.gc.ca/e/54595.html 

How to Lower Your Osteoporosis Risk When You Have Rheumatoid Arthritis

From everydayhealth.com

Rheumatoid arthritis (RA) is an autoimmune disease that causes swelling, pain, and stiffness in the joints. It can also increase your risk of osteoporosis, making bones fragile and prone to fractures. Some research shows that RA is associated with double the risk of osteoporosis. When you’re diagnosed and being treated for RA, it’s important to make lifestyle and treatment decisions to protect your bones. “I always talk to rheumatoid arthritis patients about the importance of bone health,” says Nilanjana Bose, MD, a rheumatologist who practices in Houston.

How RA Raises the Risk of Osteoporosis

There are several ways in which RA increases the risk of bone loss and osteoporosis. 

Chronic Joint Inflammation

RA causes the release of cytokines, proteins involved in inflammation — which leads to joint damage. But the cytokines also activate osteoclasts, bone cells that break down damaged bone tissue. Typically, the breakdown and build-up of bone is a normal process that keeps bones healthy, but if there are too many osteoclasts, it can lead to bone loss over time.

Use of Steroids to Control Pain and Inflammation

Corticosteroids, like prednisone, are often given to people with osteoarthritis during flares to reduce inflammation, pain, and swelling in joints. But long-term steroid use is a known risk factor in osteoporosis. Steroids increase the breakdown of bone and inhibit the formation of new bone tissue. The risk increases the longer you take steroids and at higher doses.

Lack of Physical Activity Due to Fatigue and Pain

It can be difficult to exercise with painful joints, and sometimes it’s better to rest during a flare to avoid making it worse. But not getting regular physical activity, especially weight-bearing movement, is a known risk factor for osteoporosis.

How to Lower Your Osteoporosis Risk

When you’re diagnosed with RA, it’s important to think about bone health, no matter your age. If you make changes to your lifestyle and choose medications with your bones in mind, it can help lower your risk of osteoporosis. 

Optimize Your RA Treatment to Reduce Inflammation

“Reducing inflammation is the crux of treatment of rheumatoid arthritis for many reasons,” says Dr. Bose. Not only does inflammation contribute to joint pain, stiffness, and damage, it can promote bone loss and other problems. “Systematic inflammation can lead to serious consequences, including heart issues and stroke,” says Bose. Reducing joint inflammation as quickly and effectively as possible can reduce all these risks, she adds. 

Research shows that treatments such as disease-modifying anti-rheumatic drugs (DMARDs) and biologics lower the risk of bone loss in people with RA. “The stronger the medicine, the better it is at reducing downstream effects,” says Bose.

Talk to Your Doctor About Alternatives to Steroids if You Take Them Regularly

Sometimes you may have to take corticosteroids for short periods of time. “We use steroids at the outset when someone presents with active disease to get it under better control faster when we’re starting them on disease-modifying drugs,” says Bose. 

Treatments like DMARDs can take several months to be effective, so steroids provide relief until they kick in. Steroids may also be used during an RA flare. But it’s important to limit your exposure to steroids as much as possible to reduce your risk of bone loss. Taking more than 5 mg a day for more than three months increases the risk. And risk is cumulative, meaning that taking steroids multiple times, even for shorter stretches, adds up.

Talk to your doctor about using corticosteroid injections rather than taking steroids orally. This may limit the effect on bones.

Talk to Your Doctor About Calcium and Vitamin D Supplements

Bones need a healthy dose of calcium and vitamin D to continue to rebuild and maintain their density. Ask your doctor to recommend that daily dose of calcium that’s right for you.

It’s not always easy to get enough calcium through diet so you may need to take a calcium supplement.

Recommended doses of vitamin D vary and levels can be checked with simple blood work, so ask your healthcare provider what dose you need. A vitamin D supplement may help.

Get Regular Weight-Bearing and Muscle-Building Exercise

Weight bearing exercise puts stress on your bones, which triggers bone-building. Exercise is also important for keeping joints flexible. But with joint pain and fatigue, it can be the last thing you want to do. 

Walking is a low-impact activity that’s easy on the joints. Yoga can also be weight bearing, and involves stretching, which can help improve the range of motion in your joints. 

Strength training and weight-bearing exercise is an effective way to build muscle and bone. It may be helpful to work with a personal trainer or physical therapist to make sure you’re not overstressing your joints and to develop a strength-training program that works for you.

Consider Bisphosphonates if You’re at High Risk

When women are diagnosed with osteoporosis, they often take medications like bisphosphonates, which help preserve existing bone and build new bone. Sometimes people with RA, who are at high risk for osteoporosis, are offered these drugs. This may include people taking moderate to high doses of steroids or who are on them for extended periods of time, says Bose. Studies show that bisphosphonates can protect against fractures in people with RA. But bisphosphonates have potential side effects, so be sure to review with your provider if this is an option to protect your bones. 

Should You Be Screened for Osteoporosis?

You may need to be screened for osteoporosis, depending on your age, and if you’ve taken glucocorticoids. 

If you are taking or have taken glucocorticoids, your doctor may recommend a bone density test. The American College of Rheumatology recommends that if you’ve taken glucocorticoids at 2.5 mg or more a day for more than 3 months, and never had a fracture risk assessment, you should be screened. A clinical fracture risk assessment can be performed by your medical provider. If testing is recommended, your provider may recommend bone mineral density testing as soon as possible after starting steroids for adults and every one to two years thereafter if you’re staying on steroids.

The U.S. Preventive Services Task Force (USPSTF) currently recommends that women at average risk for osteoporosis have their first screening at age 65, and that women who are not yet 65 but have risk factors for osteoporosis be screened. Screening for men is not recommended unless they have risk factors. Risk factors include family history of osteoporosis or fracture, frequent falling, vitamin D deficiency, smoking, excessive alcohol intake, and some medications, such as prednisone. Your clinical provider can do a risk assessment; your doctor may recommend screening earlier, depending on the severity of your disease if the inflammation was not well treated for a period of time.

Suggested Screening Tests for Osteoporosis

A couple of tests may be used to screen for osteoporosis.

DEXA Scan A DEXA (dual X-ray absorptiometry) scan measures bone density (thickness and strength of bones) using low-level radiation. A typical screening measures three bones, your ulna (your forearm), your hip, and your spine.

FRAX Calculator This calculates your 10-year risk of having a fracture based on several questions about your health and on your DEXA results. Two of the health questions include having rheumatoid arthritis and taking glucocorticoids.

The Takeaway

• Rheumatoid arthritis (RA) raises your risk of developing osteoporosis due to factors like chronic joint inflammation and the use of corticosteroids. 
• If you have RA, it’s important to pay attention to bone health and talk with your healthcare provider about RA treatments that simultaneously address inflammation and prioritize bone health to lower osteoporosis risk. Newer therapies have shown promise in preventing bone loss, but more research is ongoing.
• If you are currently taking or have taken steroids like prednisone, discuss bone density tests with your doctor, as long-term use is a significant risk factor for osteoporosis.
• Engaging in weight-bearing exercises and considering supplements like calcium and vitamin D can help strengthen bones. But before starting any supplements or new exercise regimens, check in with your doctor.

https://www.everydayhealth.com/rheumatic-conditions/how-to-lower-your-osteoporosis-risk-when-you-have-rheumatoid-arthritis/

Try These Top-Recommended Tips for Psoriatic Arthritis Pain

From healthcentral.com

Ease the ache with expert-approved tips for managing pain and stiffness 

Psoriatic arthritis (PsA) pain is driven by inflammation that can affect joints and tendons. Inflammation may start where tendons attach to bone, known as enthesitis, leading to discomfort in areas like the shoulders, elbows and knees, says Bret Sohn, M.D., a rheumatologist at Stamford Health in Stamford, CT. As inflammation spreads into the joints, the immune system attacks synovial cells that produce joint-lubricating fluid, causing red, swollen joints and stiffness—often worse after rest or inactivity. The good news? There are effective ways to manage PsA pain, starting with the strategies here.

                                                                                             GettyImages/kieferpix

Heat Therapy: When Warmth Works Best

Heat helps chronic psoriatic arthritis pain by reducing stiffness, improving function, and suppressing inflammatory mediators. Try morning hot showers, apply heating pads before workouts, experiment with warm pool exercises, or explore paraffin wax treatments. However, avoid heat on new, acute pain—it can worsen inflammation during a PsA flare. Also, “any topical use of heat should be discussed with your physician,” says Julius Birnbaum, M.D., an associate professor of rheumatology at University of Pittsburgh Medical Center in Pennsylvania.

Cold Therapy Brings Relief

For acute arthritis pain and swelling—like after exercise, during a flare-up, or in the initial few days after an injury—applying a cool compress can help. “Cold therapy can reduce inflammatory proteins in a joint and provide modest pain relief in these situations,” says Dr. Sohn. Cold also constricts blood vessels, which reduces blood flow to the area to relieve swelling, and it interrupts pain signals as they travel across nerve fibres. Press an ice pack (or a bag of frozen veggies in a pinch) to the sore area for 15 minutes a few times a day.

Topical Relief Options

                                                         GettyImages/simarik

Topical pain relievers may irritate psoriasis plaques, experienced by one in three people with PsA. “Topical treatments aren’t typically recommended for PsA joint pain,” says Dr. Sohn. However, many people with psoriatic arthritis also have osteoarthritis, which can contribute to symptoms. In those cases, topical NSAIDs such as diclofenac or ketoprofen may help, particularly for knee or hand pain. These creams contain the same active ingredients as oral NSAIDs but with lower gastrointestinal, cardiovascular, and kidney risks because they aren’t absorbed through the digestive system.

Gentle Movement Reduces Pain Over Time

When you’re uncomfortable, you might feel inclined to take it easy and avoid strenuous activity. But regular, consistent movement actually helps calm inflammation. And strengthening your muscles eases the burden on your joints. “In general, exercise and physical activity can reduce pain and improve overall function for people with psoriatic arthritis,” says Dr. Sohn. “Studies demonstrate that physical activity correlates inversely with disease activity, meaning that more activity is associated with less pain and inflammation.” Consider low-impact workouts like yoga, tai chi, swimming, cycling, or walking.

Pacing Your Activities Protects Joints

The benefits of movement outweigh the risks, but it’s important to avoid overdoing it. “Excessive mechanical stress, especially at the spots where tendons attach to bone, may trigger or worsen the inflammatory process in people with psoriatic arthritis. There’s no clear threshold where beneficial exercise ends and harmful overloading begins,” says Dr. Sohn. That’s why it’s important to start slow and ramp while listening to your body: Be consistent with your exercise routine, but don’t push through pain. Break workouts or strenuous tasks into shorter intervals with regular breaks and rest days in between.

Easing Morning Stiffness

                                                     GettyImages/GoodLifeStudio

People with psoriatic arthritis often experience “gelling,” a type of stiffness after rest that can last more than 30 minutes, says Birnbaum. Medications and gentle movement help, but small routine changes can also make mornings easier. The Arthritis Foundation suggests using heat overnight or setting an electric blanket to warm up before waking. Keep topical or oral NSAIDs by your bed. When your alarm goes off, take or apply medication, then do gentle stretches in bed to get your joints moving before standing. A brief warm shower can also help loosen stiff muscles and joints.

Supportive Tools and Daily-Life Modifications

Assistive devices can make everyday tasks easier when you have sore joints or lower range of motion. An occupational therapist can help you identify tools that suit your specific needs. “Examples include splints or braces, adaptive footwear, or a TENS (transcutaneous electrical nerve stimulation) unit to relieve pain,” says Dr. Sohn. You can also adapt your home environment with modifications like safety grips and grab bars in the bathroom, an electric jar opener or toothbrush, a sock puller, a grabber tool for out-of-reach items, or a voice-to-text function on your computer or phone.

Pain Management During a Flare

During a psoriatic arthritis flare, staying in close contact with your rheumatologist is key. An individualized plan may include a short course of NSAIDs or steroids, or adjustments to your current medications, says Dr. Sohn. Rest is also essential, since added physical stress can prolong recovery. Avoid heat on painful areas, which may worsen swelling; use ice packs or topical NSAIDs instead. Finally, note what was happening before the flare—such as stress, injury, or dietary changes—to help identify triggers and reduce the risk of future flare-ups.

Building Your Personalized Pain Plan

                                                              GettyImages/pocketlight

During a psoriatic arthritis flare, staying in close contact with your rheumatologist is key. An individualized plan may include a short course of NSAIDs or steroids, or adjustments to your current medications, says Dr. Sohn. Rest is also essential, since added physical stress can prolong recovery. Avoid heat on painful areas, which may worsen swelling; use ice packs or topical NSAIDs instead. Finally, note what was happening before the flare—such as stress, injury, or dietary changes—to help identify triggers and reduce the risk of future flare-ups.

https://www.healthcentral.com/slideshow/psa-pain-management-strategies?ap=nl2060&rhid=67ec2b8321f52bf01b0cca01&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGfeujDbp0w1RsMzNzh6lxjMhu61Su7IvOjPGvG8FbB2SNxLvoby-Xi6hXEelboMDuNM6QAI9nNrz2gZsnawo4q_8Ll3k8k7RheIPl3gWJYotowe3g

AI Brings Tomorrow’s X-Rays to Life, Helping Doctors Fight Arthritis Sooner

From scitechdaily.com

An AI system developed at the University of Surrey can predict future knee X-rays, helping reveal how osteoarthritis may worsen over time. By turning complex predictions into clear images, it gives doctors and patients a better chance to act early. 

Researchers at the University of Surrey have created an artificial intelligence system that can estimate what a patient’s knee X-ray may look like one year into the future. The technology could significantly change how people with osteoarthritis understand their condition and make decisions about treatment and lifestyle changes.

Turning Data Into Visual Predictions

The findings were presented at the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI 2025). The study explains how the Surrey team uses advanced machine learning to produce a realistic “future” knee X-ray together with a score that estimates how likely the disease is to progress. When viewed together, these results give both doctors and patients a clearer and more visual sense of what may lie ahead.

                                                     AI predicts osteoarthritis progression. Credit: University of Surrey

A Global Condition Meets Large Scale AI

Osteoarthritis is a degenerative joint disease affecting more than 500 million people worldwide and is the leading cause of disability among older adults. The new system was trained on nearly 50,000 knee X-rays from almost 5,000 patients, making it one of the largest osteoarthritis datasets ever used for this purpose.

According to the researchers, the AI predicts disease progression more accurately than similar tools while operating around nine times faster and in a more compact form, which could help it move into everyday clinical use sooner.

Showing Patients What the Numbers Mean

David Butler, the study’s lead author from the University of Surrey’s Centre for Vision, Speech and Signal Processing (CVSSP) and the Institute for People-Centred AI, said:

“We’re used to medical AI tools that give a number or a prediction, but not much explanation. Our system not only predicts the likelihood of your knee getting worse – it actually shows you a realistic image of what that future knee could look like. Seeing the two X-rays side by side – one from today and one for next year – is a powerful motivator. It helps doctors act sooner and gives patients a clearer picture of why sticking to their treatment plan or making lifestyle changes really matters. We think this can be a turning point in how we communicate risk and improve osteoarthritic knee care and other related conditions.”

How the Technology Builds Trust

The system relies on a type of generative AI known as a diffusion model. It creates a projected future knee X-ray and marks 16 key points within the joint. By showing exactly which areas the AI is tracking for change, the system becomes more transparent and easier for clinicians to understand and trust.

Beyond Knees and Osteoarthritis

The researchers believe this approach could eventually be adapted to other long-term health problems. Similar tools might one day help predict lung damage in smokers or monitor the progression of heart disease, giving patients and doctors visual insight that supports earlier action. The team is now looking for partners to help bring the technology into real clinical settings.

A Shift Toward Clearer Medical AI

Gustavo Carneiro, Professor of AI and Machine Learning at Surrey’s Centre for Vision, Speech and Signal Processing (CVSSP), said:

“Earlier AI systems could estimate the risk of osteoarthritis progression, but they were often slow, opaque, and limited to numbers rather than clear images. Our approach takes a big step forward by generating realistic future X-rays quickly and by pinpointing the areas of the joint most likely to change. That extra visibility helps clinicians identify high-risk patients sooner and personalize their care in ways that were not previously practical.”

Reference: “Risk Estimation of Knee Osteoarthritis Progression via Predictive Multi-task Modelling from Efficient Diffusion Model Using X-Ray Images” by David Butler, Adrian Hilton and Gustavo Carneiro, 20 September 2025, Medical Image Computing and Computer Assisted Intervention – MICCAI 2025.
DOI: 10.1007/978-3-032-05185-1_52

https://scitechdaily.com/ai-brings-tomorrows-x-rays-to-life-helping-doctors-fight-arthritis-sooner/

Autoimmune Flares in Winter: Why They Happen and How to Reduce the Risk

From bannerhealth.com

Winter can bring cosy evenings, holidays and outdoor fun. But for people with autoimmune conditions, it can also be tough on the body. 

If you have lupus, rheumatoid arthritis, multiple sclerosis or another autoimmune condition, you might notice that your symptoms worsen when the temperatures drop. Stiff joints, fatigue and pain can spike just as the days get shorter. 

So why does winter seem to trigger these flares and what can you do to reduce your risk? Samuel Cook, DO, a rheumatologist with Banner - University Medicine, shares small changes you can take to help you enjoy the season without letting winter put a damper on your health.

Why can symptoms worsen in winter?

Colder temps and pressure changes

Cold weather, shorter days and seasonal changes can all contribute to increased pain and joint stiffness. 

“Synovial fluid, which helps our joints move smoothly, gets thicker in the cold, leading to stiffness,” Dr. Cook said. “Additionally, changes in barometric (air) pressure can make the soft tissues in our joints expand and contract, which can cause more pain.”

Activity and mood

Winter also affects mood and activity levels. Less sunlight can lower vitamin D production. Studies show low vitamin D levels can worsen lupus activity and increase pain in arthritis. 

“Reduced activity and decreased sunlight can lead to some seasonal depression, which can heighten the body’s perception of pain,” Dr. Cook said. 

Stress and disrupted routines

Holiday preparations, travel and changes in sleep or diet can trigger immune system changes and worsen symptoms. 

Viral infections

Colds, flu, RSV and other common winter illnesses can trigger autoimmune flares. 

Ways to reduce winter flares

While you can’t control the weather, you can take steps to protect your body and reduce symptom flare-ups. Here are some tips that may help:

1. Dress in layers 

Cold hands, feet and joints can make stiffness worse, especially if you have rheumatoid arthritis or Raynaud’s syndrome. Keep your hands, feet and joints warm. Gloves, scarves and thermal socks are cosy but they also help prevent stiffness. 

2. Pace your activities

Winter brings a lot of extra tasks, like holiday shopping, decorating, baking and social events. Break tasks into smaller steps, rest often and don’t push through pain. 

3. Keep moving

Even though the cold can make you want to stay inside, movement is important year-round. Regular exercise helps maintain joint flexibility and reduce stiffness. Low-impact activities like swimming, yoga or walking indoors can be safer in icy conditions. 

Check out these joint-friendly exercises to keep you moving pain-free.

4. Manage stress

Stress is a silent trigger for many autoimmune flares. Meditation, deep breathing and mindfulness can calm your nervous system and may reduce flare severity. Schedule downtime during busy weeks to help your body better handle stress. 

5. Get sunlight when you can

Shorter days mean less sunlight. Get out in the sun when you can, even for a few minutes each day.

“Even short exposure to sunlight can boost your mood and vitamin D levels,” Dr. Cook said. “Vitamin D deficiency has been correlated with worse lupus activity and increased pain in arthritis.”

6. Maintain your diet and sleep

Healthy meals and quality sleep support your immune system. Avoid skipping meals, drink plenty of water and try to get seven to nine hours of sleep per night. Plan ahead with healthy snacks and easy meals during the busy holiday season to reduce stress on your immune system.

7. Keep up with medications and check-ups

“Consistently taking medications is the most important thing someone can do to prevent true flares of autoimmune disease,” Dr. Cook said. 

Don’t skip appointments due to holiday travel or a busy schedule. Routine care helps catch issues early and keeps your treatment plan on track. 

8. Practice infection prevention

Immunosuppressive medications can increase the risk of infection. During holiday gatherings, take precautions: wash your hands often, avoid close contact with sick people and consider wearing a mask in crowded areas. 

When to call your doctor

No matter how careful you are, symptoms can worsen.

“Always feel encouraged to call your health care provider when you have worsening symptoms,” Dr. Cook said. “Regardless of the cause, your provider can find ways to help make you feel better.”

Pay attention to changes in pain, fatigue and movement. Early treatment can prevent a mild flare from becoming more serious. 

Takeaway

Winter can be challenging if you live with an autoimmune disease. Cold weather, shorter days, stress and viral infections can all affect your condition. 

Take steps to reduce your risk and enjoy this time of year. Dress warmly, pace yourself, stay active, take your medicine and manage stress when you can. And if you have any questions or concerns, talk to your care team or a Banner Health specialist. 

https://www.bannerhealth.com/healthcareblog/better-me/manage-and-prevent-autoimmune-flares-in-winter