Editing Rheumatoid arthritis (section)

===Lifestyle===
Regular exercise is recommended as both safe and useful to maintain muscle strength and overall physical function.<ref name="pmid38921661">{{cite journal |vauthors=Athanasiou A, Papazachou O, Rovina N, Nanas S, Dimopoulos S, Kourek C |title=The Effects of Exercise Training on Functional Capacity and Quality of Life in Patients with Rheumatoid Arthritis: A Systematic Review |journal=J Cardiovasc Dev Dis |volume=11 |issue=6 |date=May 2024 |page=161 |pmid=38921661 |pmc=11203630 |doi=10.3390/jcdd11060161 |doi-access=free |url=}}</ref><ref>{{cite journal | vauthors = Hurkmans E, van der Giesen FJ, Vliet Vlieland TP, Schoones J, Van den Ende EC | title = Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis | journal = The Cochrane Database of Systematic Reviews | issue = 4 | pages = CD006853 | date = October 2009 | volume = 2009 | pmid = 19821388 | pmc = 6769170 | doi = 10.1002/14651858.CD006853.pub2 | veditors = Hurkmans E }}</ref> Physical activity is beneficial for people with rheumatoid arthritis who experience fatigue,<ref>{{cite journal | vauthors = Cramp F, Hewlett S, Almeida C, Kirwan JR, Choy EH, Chalder T, Pollock J, Christensen R | title = Non-pharmacological interventions for fatigue in rheumatoid arthritis | journal = The Cochrane Database of Systematic Reviews | issue = 8 | pages = CD008322 | date = August 2013 | pmid = 23975674 | doi = 10.1002/14651858.CD008322.pub2 | pmc = 11748118 }}</ref> although there was little to no evidence to suggest that exercise may have an impact on physical function in the long term, a study found that carefully dosed exercise has shown significant improvements in patients with RA.<ref name=":12" /><ref>{{cite journal | vauthors = Williams MA, Srikesavan C, Heine PJ, Bruce J, Brosseau L, Hoxey-Thomas N, Lamb SE | title = Exercise for rheumatoid arthritis of the hand | journal = The Cochrane Database of Systematic Reviews | volume = 2018 | pages = CD003832 | date = July 2018 | issue = 7 | pmid = 30063798 | pmc = 6513509 | doi = 10.1002/14651858.cd003832.pub3 }}</ref> Physical activity increases the production of [[synovial fluid]], which lubricates the joints and reduces friction.<ref>{{cite web |last1=Jabeen |first1=Attiya |title=The Benefits of Exercise in Rheumatoid Arthritis: A Comprehensive Guide |url=https://rheumatologydelaware.com/benefits-exercise-in-rheumatoid-arthritis/ |website=rheumatologydelaware |date=16 August 2023 |publisher=Attiya Jabeen |access-date=August 16, 2023 |archive-date=1 November 2023 |archive-url=https://web.archive.org/web/20231101043434/https://rheumatologydelaware.com/benefits-exercise-in-rheumatoid-arthritis/ |url-status=dead }}</ref> Moderate effects have been found for aerobic exercises and resistance training on cardiovascular fitness and muscle strength in RA. Furthermore, physical activity had no detrimental side effects like increased disease activity in any exercise dimension.<ref>{{cite journal | vauthors = Rausch Osthoff AK, Juhl CB, Knittle K, Dagfinrud H, Hurkmans E, Braun J, Schoones J, Vliet Vlieland TP, Niedermann K | title = Effects of exercise and physical activity promotion: meta-analysis informing the 2018 EULAR recommendations for physical activity in people with rheumatoid arthritis, spondyloarthritis and hip/knee osteoarthritis | journal = RMD Open | volume = 4 | issue = 2 | pages = e000713 | date = December 2018 | pmid = 30622734 | pmc = 6307596 | doi = 10.1136/rmdopen-2018-000713 }}</ref> It is uncertain if eating or avoiding specific foods or other specific dietary measures help improve symptoms,<ref>{{cite journal | vauthors = Hagen KB, Byfuglien MG, Falzon L, Olsen SU, Smedslund G | title = Dietary interventions for rheumatoid arthritis | journal = The Cochrane Database of Systematic Reviews | issue = 1 | pages = CD006400 | date = January 2009 | pmid = 19160281 | doi = 10.1002/14651858.CD006400.pub2 | veditors = Hagen KB }}</ref> but several studies have shown that high-vegetable diets improve RA symptoms whereas high-meat diets make symptoms worse.<ref>{{Cite journal |last1=Alwarith |first1=Jihad |last2=Kahleova |first2=Hana |last3=Rembert |first3=Emilie |last4=Yonas |first4=Willy |last5=Dort |first5=Sara |last6=Calcagno |first6=Manuel |last7=Burgess |first7=Nora |last8=Crosby |first8=Lee |last9=Barnard |first9=Neal D. |date=2019-09-10 |title=Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review |journal=Frontiers in Nutrition |language=en |volume=6 |page=141 |doi=10.3389/fnut.2019.00141 |doi-access=free |pmid=31552259 |pmc=6746966 |issn=2296-861X }}</ref>  [[Occupational therapy]] has a positive role to play in improving functional ability in people with rheumatoid arthritis.<ref>{{cite journal | vauthors = Steultjens EM, Dekker J, Bouter LM, van Schaardenburg D, van Kuyk MA, van den Ende CH | title = Occupational therapy for rheumatoid arthritis | journal = The Cochrane Database of Systematic Reviews | issue = 1 | pages = CD003114 | date = 2004 | volume = 2004 | pmid = 14974005 | doi = 10.1002/14651858.CD003114.pub2 | pmc = 7017227 | hdl = 2066/58846 | url = https://repository.ubn.ru.nl/bitstream/2066/58846/1/58846.pdf }}</ref> Weak evidence supports the use of wax baths ([[thermotherapy]]) to treat arthritis in the hands.<ref>{{cite journal | vauthors = Robinson V, Brosseau L, Casimiro L, Judd M, Shea B, Wells G, Tugwell P | title = Thermotherapy for treating rheumatoid arthritis | journal = The Cochrane Database of Systematic Reviews | issue = 2 | pages = CD002826 | date = 2002-04-22 | pmid = 12076454 | doi = 10.1002/14651858.cd002826 | pmc = 6991938 }}</ref>

Educational approaches that inform people about tools and strategies available to help them cope with rheumatoid arthritis may improve a person's psychological status and level of [[clinical depression|depression]] in the shorter-term.<ref name=":4">{{cite journal | vauthors = Riemsma RP, Kirwan JR, Taal E, Rasker JJ | title = Patient education for adults with rheumatoid arthritis | journal = The Cochrane Database of Systematic Reviews | volume = 2009 | issue = 2 | pages = CD003688 | date = 2003-04-22 | pmid = 12804484 | doi = 10.1002/14651858.cd003688 | url = https://research.utwente.nl/en/publications/patient-education-for-adults-with-rheumatoid-arthritis-review(6d6c077a-30a1-4b7c-8021-f72f1a8b6a5c).html }}</ref> Educating patients who have rheumatoid arthritis has shown a positive effect on how patients engage in their plan of care; the patient will be aware of fatigue, activity limitations, and pain and know possible side effects of how to manage this pain. Lack of knowledge can often lead to fear and limit adherence. Intervention by physical therapists plays a key role in offering proper tools for self-management, motivation in activities of daily living, and any assistive device use if needed. Patients will be assisted in managing neurologic impairments and musculoskeletal stiffness to maximize strength and function. Encouraging patients to balance physical activity with their everyday living can prevent further joint damage and provide a sense of control.<ref>{{Cite journal |last=Peter |first=Wilfred F |last2=Swart |first2=Nynke M |last3=Meerhoff |first3=Guus A |last4=Vliet Vlieland |first4=Thea P M |date=2021-08-01 |title=Clinical Practice Guideline for Physical Therapist Management of People With Rheumatoid Arthritis |url=https://academic.oup.com/ptj/article/doi/10.1093/ptj/pzab127/6277051 |journal=Physical Therapy |language=en |volume=101 |issue=8 |doi=10.1093/ptj/pzab127 |issn=0031-9023}}</ref>

The use of extra-depth shoes and molded insoles may reduce pain during weight-bearing activities such as walking.<ref name=":5">{{cite journal | vauthors = Egan M, Brosseau L, Farmer M, Ouimet MA, Rees S, Wells G, Tugwell P | title = Splints/orthoses in the treatment of rheumatoid arthritis | journal = The Cochrane Database of Systematic Reviews | issue = 1 | pages = CD004018 | date = 2001-10-23 | volume = 2001 | pmid = 12535502 | doi = 10.1002/14651858.cd004018 | pmc = 8762649 }}</ref> Insoles may also prevent the progression of [[bunion]]s.<ref name=":5" />