In our previous article “Best Rheumatoid Arthritis Treatment“, we discussed the health and wellness
benefits in the nutrient-dense foods found in the Mediterranean Diet and how it relates to the positive healing treatment of this debilitating disease. Living a Mediterranean lifestyle and eating Mediterranean-style foods is an incredible way to return to a healthier you, even when it comes to dealing with health issues like rheumatoid arthritis (RA). Today we will continue our discussion of other lifestyle changes, namely physical activity, sleep, and spending time in nature, which also have all been beneficial in the Treatment For Rheumatoid Arthritis Pain.
RA patients also tend to suffer from chronic fatigue, depression, and immune system complications that make them more susceptible to infections and illness. Exercise, which we’ll cover first, can counter these negative outcomes by improving emotional well-being, increasing energy levels, and boosting immune system function. Additionally, by performing consistent physical activity, cardiovascular strength improves which helps prevent heart disease and other medical complications that relate to RA, as well.
Health Benefits Of Physical Activity On RA
Hydrotherapy. If you have RA, you know that exercise is good for you. But finding the time, energy, and motivation to actually get moving can be difficult at times. This is especially true when you’re experiencing pain. One study published in the journal Arthritis & Rheumatology found that very few people with arthritis get the recommended amount of exercise each week. But, research shows that RA patients who exercise have less pain than other RA patients. Exercise can help boost your mood, improve joint function, and prevent muscle wasting and weakness. Water helps support body weight which means that
water exercises do not impact heavily on the joints.
Swimming or Aerobics. Water aerobics, and other gentle water exercises can increase flexibility, range of motion, strength, and aerobic conditioning. They can also reduce joint stress and stiffness. People with RA show greater improvements in health after participating in hydrotherapy, which is exercising in warm water, than with other activities, according to the CDC. The Arthritis Foundation has a specially-designed for sore joints, water exercise program called “aquatics” for RA patients, taught by certified instructors.
A Wiley Online Library study showed that people with RA who participated in hydrotherapy had less pain and joint tenderness. Hydrotherapy also improved their mood and overall well-being. The Arthritis Foundation has an aquatics program you can apply for, which will be specifically designed for your particular RA situation. We’ll also cover water therapy for RA under getting out in nature section.
Take A Stroll. A walk in the park or around a lake, may sound too simple, but it’s one of the easiest and most convenient forms of exercise. In addition to getting your heart rate up and benefiting your cardiovascular system, walking can loosen your joints and help reduce pain of RA, according to a study published in the BMJ Journal. Quoting the study:
Focusing on fitness in RA patients may improve cardiovascular health.
Walking is good for the body and the mind. It helps increase mobility in muscles and
joints without a lot of stressful impact. Research, such as this National Institutes Of Health (NIH) study, has shown that just 30 minutes of walking a day can boost your mood, too.
Yoga Stretching. Yoga, which combines postures with breathing and relaxation, also helps improve RA symptoms. NIH Research shows that younger individuals with RA who practiced yoga experienced improvements in pain and mood. A study done at John Hopkins University found similar results, as RA patients had fewer tender and swollen joints than they did before practicing yoga. Checkout this short video on yoga moves (1)which will help RA.
Bike Riding. If you have RA, getting your heart pumping is essential. This is because those with RA are at a higher risk for cardiovascular diseases and complications. Biking is an excellent, low-impact exercise if you have RA, that’s easier on the joints than other aerobic exercises, according to the Arthritis Foundation. Riding a bike helps maintain cardiovascular health, increases leg strength, and reduces morning stiffness. You can bike outside, join a cycling group, or use a stationary bike at the gym or in your home. Biking either way, is a low-impact activity and easy on the joints.
Tai Chi Meditation. Tai Chi or “moving meditation”, is a traditional Chinese martial art that combines slow and gentle movements with mental focus. This exercise improves muscle function and stiffness and reduces pain and stress levels in patients with RA. Participants in one study reported feeling better after practicing tai chi and had an overall brighter outlook on life. Both yoga or tai chi activities are also linked to lower depression and reduced stress levels. These activities include meditation, mindfulness, and deep breathing in addition to physical exercise.
Strength Training Infected Joints. Strengthening the muscles around the affected joints using range-of-motion (ROM) exercise can help increase strength while reducing pain and other RA symptoms. ROM exercises are usually performed 5-10 times on a daily basis, particularly in the evening helps reduce joint stiffness the next morning. The Arthritis Foundation has a slide show covering best ROM exercises for RA. Using a resistance band is one of the best ways to challenge the body and build muscle over time. Stretching exercises are great too, and should be done at least 3-5 days a week with each stretch being held for about 15- 30 seconds, like this video (2).
Recreational activities such as yoga and Tai Chi incorporate both ROM and stretching movements into their routines. A physical therapist who works with people with RA should be able to offer guidance on suitable exercises. RA can sometimes lead to limited use of the hands besides being very painful.
Bending the wrists up and down, slowly curling the fingers, spreading the fingers wide on a table, and squeezing a stress ball can all help increase strength and flexibility in the hands. Patients often find their ability to grip and lift items improves because of their increased muscle strength. According to a BMJ Journal study, significant improvement in hand function in the SARAH method, but more research is needed.
Choose Variety Of Physical Activity. RA pain typically occurs in waves of flare-ups and periods of remission, in pain intensity. Base your daily exercise routine on the level and location of the pain and use various techniques that best suits the specific situation, such as combining hypo-therapy and walking or may be tai chi and strength training specific joints.
Using variety should prevent any overuse injuries, which can aggravate symptoms and counter the benefits of the exercise. Listen to the body, if physical activity causes discomfort or a flare, it is best to reduce the session. For example, do 10 minutes instead of 30. People should also take time off when necessary
Problems With Healthy Restful Sleep With RA
People with RA frequently report reduced health-related quality of life, the impact one’s health has on physical, emotional and social well-being. There are numerous causes for poor health and well being, but people with RA have identified sleep disturbances as a key contributor to their well-being. Sleep problems are common concerns in rheumatology patients and have been independently linked to increased pain perception and fatigue severity.
The question is, are your RA symptoms affecting your sleep, or is your trouble sleeping making your symptoms worse? The answer may be both. Once you start dealing with lack of sleep, a vicious cycle can start!
When you’re fatigued, your brain lacks the ability to dampen pain signals, so the pain is perceived to be worse,
says Dr. Schiopu, MD, of Michigan Medicine Rheumatology at the University of Michigan. Evidence supports an increased prevalence of primary sleep disorders, including sleep apnea, in some rheumatic-disorder populations, particularly RA. Besides increased flares, RA patients with sleep disruptions tend to have more trouble with depression, pain severity and performing normal daily functions than RA patients who didn’t have sleep problems.
In a 2011 University of Pittsburgh study reviewed by the NIH, 61 percent of the randomly selected RA patients in the study were deemed poor sleepers and experienced these issues. Also, in the deepest stages of sleep, the body releases growth hormones to repair tiny muscle tears that occur during the day. A 2010 study published in the Journal of Clinical Sleep Medicine revealed that among 162 participants with RA, poor sleep quality had a significant link to worse symptoms of depression, more intense pain, more fatigue, and greater functional disability.
Obstructive sleep apnea is a significant public health concern and contributes to increased cardiovascular morbidity and mortality. Patients with obstructive sleep apnea have also been found to have elevations in circulating acute-phase markers and pro-inflammatory cytokines.
Sleep apnea in rheumatic disorder patients may influence the severity of reported symptoms of pain and fatigue, accelerate the risk of cardiovascular events and possibly influence levels of circulating inflammatory markers and mediators. The CDC recommends that adults and children should get a minimum of 7 to 8 hours of sleep a night. RA may be preventing you from doing that, so, let’s take a look at what might help you fall asleep and stay asleep:
How To Get Restful Sleep With RA
Physical Activity. Gentle exercise is a meaningful way to reduce or improve RA symptoms with Treatment For Rheumatoid Arthritis Pain. Exercise can also help a person to sleep and can improve mood and well-being. Well, how about that, physical activity, what we just covered above! There are clearly some correlations between exercise, sleep and nature, which will become very evident to you soon. As you know, the CDC recommends 2 1/2 hours of moderate exercise every week.
However, people with RA should start slowly and build up the amount of activity they do according to their ability. It is better to do a small amount of exercise than nothing at all. Walking, swimming, cycling, and stretching are all examples of exercise that will not put too much strain on the joints or the body. A 2011 study published in the Journal of Aging Research and reviewed by the NIH, found that exercise significantly improved the joint pain, stiffness, and fatigue that are classic symptoms of RA as well as psychological well-being. Quoting the study:
The importance for the inclusion of exercise training in the treatment of RA is now clear and proven.
Avoid Long Naps. A short nap of less than 20 to 30 minutes early in the day shouldn’t affect your sleep at night. But if you frequently take long naps, especially later in the day, you might find yourself lying awake at night, the National Sleep Foundation says.
No Caffeine In Afternoon. Skip caffeine in the afternoon. Your morning coffee can be a great pick-me-up, but drinking caffeinated coffee or other beverages such as tea, hot chocolate, and energy drinks in the afternoon and early evening can keep you up at night. According to the National Sleep Foundation, it takes about 8 hours for caffeine to wear off, so plan your sipping accordingly. Avoid a large meal or late night snacks as well.
Avoid Alcohol. Alcohol may help you relax and fall asleep, but it’s more likely to act as a stimulant and disrupt your sleep, according to the National Sleep Foundation.
Establish a bedtime routine. Aim to go to bed and wake up at about the same time every day, including weekends, the National Sleep Foundation advises. Also, make sure your environment is conducive to sleep, your bedroom should be quiet, dark, and cool, no TV on, but it’s okay to listen to calming music or the “sounds of nature”.
Researchers at Brighton and Sussex Medical School in England recruited 17 healthy adults who listened to five-minute soundscapes of natural and manmade environments and determined that the natural sounds group tested resulted in “mind-wandering” and relaxing, similar to a mindfulness state of relaxation. If you can’t fall asleep in a reasonable time, don’t lie in bed tossing and turning. Get up and meditate or read a few pages in a book until you get sleepy again.
Have A Warm Bath. Submerge in fairly warm water which will not only relax you emotionally but also help sooth stiffness, aches, and pains of RA.
Experiment With Sleep Positions. Try sleeping in different positions that relieve stress on particularly bothersome joints and prevent them flaring up while you’re trying to sleep. Sleeping on your side may help to improve spine alignment and result in less pain, especially if your RA is affecting your spine, says Clete Kushida, MD, PhD, a neurologist and medical director of the Stanford Sleep Medicine Center.
Shutdown Technology. Turn your laptops and smart phones off at least an hour before your scheduled bedtime. Research has proven the bright blue (white) light from electronic devices interferes with your circadian (natural) sleep cycle which is controlled by natural sunlight, not artificial light. You will learn more about your circadian sleep cycle in the nature section.
Visualization. Think about a place you’ve been before sometime in your life where you have a vivid memory of being totally relaxed and happy, and drifting off to sleep. Close your eyes and relive that moment in your mind, and the next thing you’ll know, it will be morning and you’ve just woken up.
How Nature Benefits RA
Nature is an incredible healer. Just 30 minutes a day in green spaces such as parks, forests, gardens, and other outdoor oases can help keep your physical and emotional health strong by lowering blood pressure and reducing depression, is just 2 of the ways nature can help someone live a healthier lifestyle, according to a study in a 2016 Journal Of Scientific Reports.
Although the study didn’t set out to determine if nature could help rheumatoid patients, it was found that spending time in nature provides you with a low stress, undemanding environment. This is critical for reducing mental fatigue, a very important factor in RA management. As you might imagine, this has a “flow of effects” on health and well being and not a stretch to believe sitting in nature can actually help RA.
Re-centering. Spending time in nature or in a “green space” brings back a sense of mindfulness, a sense of peace, a sense of well being, soothing the brain and psyche in a particular healthy way. The sights, movements, and sounds of trees, animals, birds, flowers, leaves, and the sky can help pacify your being at the moment and you become fully present at the moment, and your mind becomes calm and centered, not worried about the past, present, or the future.
A scientist and the founding executive director of the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School in Worcester, Massachusetts, Dr. Jon Kabat-Zinn, PhD, created what is known as Mindfulness-Based Stress Reduction (MBSR) program offered through the University of Massachusetts Medical School.
One small study published in 2014 the Annals Of Rheumatic Diseases journal, looked at a small group of women with RA; half completed an eight-week MBSR course while the other half went about their regular lives. In follow-up assessments, those who had practiced the mindfulness reported less stiffness, pain, and tenderness in their joints.
Another study published in the Journal Of Arthritis and Rhueumatism found that mindfulness did not alter RA condition activity, but participants reported less psychological distress and an improved sense of well-being, six months after completing an MBSR program. Yet another 2015 study published in the Jama Internal Medicine journal found that participants using mindfulness awareness practices (MAPS) help people with insomnia, and had better sleep quality, and as a result, less depression and fatigue, than a control group. The MBSR 8-week program is offered at U Mass through their website. For details, please visit the website.
Nature Physical Activity. The benefits of exercising out in nature are numerous. The Arthritis Foundation recommends visiting the great outdoors frequently because of the benefits of not only physical activity and burning calories and having fun, but also the relaxing and soothing benefits, and breathing fresh clean air. See the University Of Essex study referenced above, individuals who did physical activity among nature in green spaces of trees, plants, and fields, was more enjoyable, more sustainable, and perceived less strenuous, compared to the same activity inside. A ACS Publication showed similar results and said,
This review has shown some promising effects on self-reported mental wellbeing immediately following exercise in nature which are not seen following the same exercise indoors.
Swimming or water aerobics in mineralized waters or hot springs have shown to be effective in relieving stiffness and pain of RA. Studies suggest that hot spring water helps relieve arthritis symptoms. In a study published in 1999 in an Israeli medical journal, reviewed by the NIH, patients with arthritis in the knees who bathed in a sulfur pool, the Dead Sea or a combination suffered less pain, stiffness and immobility than those who bathed in neither.
The Arthritis Foundation also recommended bathing and aerobics in hot springs, or even in hot water, are both beneficial relieving joint pain and for treating RA. That would also include wading or swimming in the ocean, by the way, because its water have literally over a hundred dissolved natural healthy minerals.
Vitamin D replenished. Using moderation and proper protection, being outdoors and getting some sun, will build up your reserve of all important nutrient vitamin D, which studies indicate most individuals are most likely deficient in. Vitamin D helps to calm inflammation by reducing the release of the stress hormone, cortisol. A deficiency in D aggravates autoimmune diseases like RA, by increasing inflammation causing sweeling and pain.
Studies have shown, like this NIH study, that deficiency in vitamin D is clearly linked to individuals with RA. Quoting the study:
It appears that vitamin D deficiency is highly prevalent in patients with RA, and that vitamin D deficiency may be linked to disease severity in RA.
Restorative Health Of Green. Nature doesn’t just have an effect on the mind and restoring mental clarity. Roger S. Ulrich, PhD, director of the Center for Health Systems and Design at Texas A&M University, has found that nature can help the body heal, too. In his most well-known study, Ulrich investigated the effect that views from windows had on patients recovering from abdominal surgery.
He discovered that patients whose hospital rooms overlooked trees had an easier time recovering than those whose rooms overlooked brick walls. Patients able to see nature got out of the hospital faster, had fewer complications and required less pain medication than those forced to stare at a wall. This particular research shows countless examples of the health and wellness benefits of nature.
Resetting Cicadian Rhythm. Spending too much time indoors under artificial light, disrupts your natural sleep cycle (circadian rhythm) and prevents you from getting restful, uninterrupted, restorative sleep, and compounds the symptoms of RA. Humans are programmed to receive natural sunlight beginning at sunrise, when the hormone serotonin is released, to get you moving and active for the day ahead.
As sunlight gets less intense near sundown, melatonin is naturally released, winding you down for rest and sleep. This is nature’s way and the way it was intended for human, and all creatures, for that matter, to get restful, restorative sleep.
The role that this physiological clock plays in our everyday lives and within the global ecosystem is clearly evident. However, only recently has the importance of circadian rhythm in cartilage health and joint homeostasis been brought to light. A recent study by Hand and colleagues advances our understanding of these processes further.
It was demonstrated that disruption of circadian clock regulation in mesenchymal cells not only has an impact on the development of joint structures, but on the inflammatory response and on the onset/pathogenesis of arthritis. This study and others, have suggested an intimate relationship between circadian clock rhythm, inflammation, and arthritis, since the circadian clock defferentially regulates inflammatory processes in relation to the wake/sleep cycle.
One Final Note.
It should be very obvious that there’s an intrinsic relationship between physical activity, restful restorative sleep, and spending time in nature. Restful sleep is more obtainable after routine exercise, and restorative sleep benefits from active physical activity, and nature is beneficial to both sleep and exercise. So, it should come as no surprise that the key to helping you with RA from the get-go, is spend more time in nature, getting physical activity and even sleeping in a tent.
Not only will you get more restful restorative sleep, but also more productive, perceived less strenuous, and fun exercise. And, guess what? Here’s a constructive and productive way to get physical activity outdoors right in your own backyard. Start a vegetable and fruit garden. Not only will you be helping your RA, you will be will producing the freshest, most nutrient-dense healthy foods, also beneficial for your health and RA.
For your convenience we are including the links to the reviews on the incredible nutrient-dense foods of the Mediterranean Diet discussed in the first article “Best Rheumatoid Arthritis Treatment.” In the reviews you will get product information and affiliate links to order: A List Of Healthy Foods To Eat, Buy Fresh Seafood Online, Healthy Nutrition Foods-The Ones You Never Thought Of, and Where Can I Buy Maca?
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(1) Living Healthy Chicago Video
(2) eHow Health Video