The aim of this booklet is to help you look at the things in life that matter to you, to support you in making changes to your health and wellbeing, and to build on your own capabilities and confidence
As someone living with arthritis, you’ll know that it brings its own challenges, both physical and emotional. The treatments that we have to offer patients are very effective and safe for most people who need to take them.
However, medication is only a part of how arthritis is managed.
There are many other areas of everyday life that can affect your health and arthritis, that you are able to adapt. Looking at how you live your everyday life is important, and there are six parts of our day-to-day life that you can manage and that you can change, and this can have a positive effect on your overall health.
This booklet has been created by a specialist team of healthcare professionals who want to help you live your best life with arthritis. The aim of this booklet is to help you look at the things in life that matter to you, to support you in making changes to your health and wellbeing, and to build on your own capabilities and confidence.
One of the first things that we need to do is to recognise that we sometimes need to change the way we live our lives and the choices we make. There are things within your control that you can do that will have a noticeable effect on your everyday life. Many of these are small, simple changes. . They won’t cure your arthritis, but they can improve your health and wellbeing, and the quality of your day-to-day life, both now and into the future.
Getting started is often the biggest step, so we have included ways to help you get started, check your progress, and celebrate your successes. You can use the booklet at any stage of your arthritis, and you can bring it to clinic appointments to help guide your conversations with members of your healthcare team. It may help you to talk to your healthcare team about some of the changes that you are working on, and to get advice on some of the issues on which you may need more support. It’s also important to celebrate and share the success you have had in making these changes.
The booklet also suggests other resources and websites for you to explore that will give you additional support.
Remember, we are all different, and no two people living with arthritis will have the same experience. This booklet is for you to use in whatever way works best for you.
Getting started is often the hardest challenge, but it can help you to get started if you know where you would like to be in the future
Getting started is often the hardest challenge, but it can help you to get started if you know where you would like to be in the future.
Think about your future goals and plans, in both the short- and the longterm. How do you want to feel? What do you want to do? Where do you want to go? This shouldn’t just be about your arthritis, but your life in general. Focusing on your future-self can help drive you forward towards that goal, and by making a plan of how you can reach those goals, you can begin to feel more in control of your health and your life.
The goals, plans, changes, and decisions that you make today may change as time goes on, but by working towards something you will learn new skills that will help you to master your arthritis over time and make time for what matters most to you.
Take some time to think and write down anything that’s important to you here. And remember, plans often need the support of your family, friends, work colleagues and your healthcare professionals, so don’t forget to include them.
Goal setting serves as a compass, guiding you towards improved health and wellbeing in a structured and achievable way
Setting goals should be an integral part of your overall healthcare journey. Goal setting serves as a compass, guiding you towards improved health and wellbeing in a structured and achievable way.
Here are eight reasons why it’s important for you to set goals:
1. Direction and focus
Setting clear, specific goals will provide you with a sense of purpose and direction. It will help you to focus your efforts and energy towards concrete objectives, which can be particularly motivating during challenging times.
2. Measurable progress
Goals offer a quantifiable way to track your progress. You can see how far you’ve come, which encourages a sense of accomplishment and boosts your confidence in your ability to manage your arthritis effectively.
3. Empowerment
When you actively participate in goal setting, you’ll become more engaged in your own healthcare. This fosters a sense of ownership over your own well-being and will encourage you to make informed decisions about your lifestyle and treatment choices.
4. Motivation
Goals help you stick to your treatment plans and lifestyle changes more consistently. When you have specific targets to work towards, you are more likely to adhere to medication schedules, exercise routines, dietary modifications, and other aspects of your care plan.
5. Long-term vision
Setting both short-term and long-term goals will let you envision a healthier future. This can motivate you to make sustainable changes that contribute to your overall well-being over time.
6. Psychological benefits
The act of setting and achieving goals has psychological benefits, such as reducing anxiety, increasing self-esteem, and instilling a sense of control. These positive emotions can contribute to your overall mental and emotional wellbeing.
7. Prevention and maintenance
Goals are not only for addressing existing health issues but can also serve in preventing future problems. You can set goals related to maintaining a healthy lifestyle and reducing risk factors, leading to better health in the long term .
8. Continuous improvement
Health is an ongoing journey, and goals provide a framework for continuous improvement. Even after achieving initial goals, you can set new ones to keep progressing and maintaining your well-being.
In summary, setting goals is crucial as it empowers you, directs you, motivates you, and can positively impact both your physical and mental well-being, leading to better health in the long term.
Setting strong goals is not as simple as just writing down something you want to achieve. You also need to overcome some of the challenges and barriers that you’ll face when trying to achieve that goal (and many of those barriers come from within) and turn behaviours into habits.
Let’s look at an example on exercise, a behaviour we often want to change:
Goal
“I need to do some exercise.”
Thought “I hate the thought of exercise.”
Feeling
“I feel guilty, lazy, and unmotivated.”
Behaviour
“I go walking for 30 minutes on my own in the evening, spend the whole time checking my watch, get home after just 20 minutes and reward myself with a bar of chocolate.”
What did we do? We rewarded ourselves with the chocolate for the unpleasant feelings that we felt by having to do exercise and we now have a negative habit!
Let’s see how we can change this by starting a new rewarding routine:
Goal
“I want to improve my physical health.”
Thought
“Although I don’t like the idea of exercise, I know it will help my joints and that I’ll feel much better, which is important to me.”
Feeling
“I feel optimistic, confident, focused.”
Behaviour
“I go for a regular walk during my lunch break with my friend from work and we have a great chat, and reward myself with a long soak in the bath that evening.”
We can change our habits by refocusing our goals, changing our thoughts, noticing our feelings, and adapting our routines and environments to something that gives us a positive, more long-term reward. When we look at the example above, we can see that refocusing our goal and changing our thoughts brings us a much more important benefit in the long term than emotional eating does in the short term.
What’s important is that the change you make is what matters to you, not your physiotherapist or doctor. When you make a change that benefits your health, congratulate yourself on having the capability to do it. Go back to the Getting Started section and remind yourself of what matters to you and consider how you can refocus these goals and your thoughts about them to create stronger feelings and behaviours that support positive change.
Use can use the ACE checklist each evening, by asking yourself what I Achieved today, where did I Connect today, and what did I Enjoy today. This can be a positive way to end your day and notice how each of these aspects contribute to your overall sense of wellbeing and how they overlap:
ACHIEVE work, chores, study
CONNECT with friends, family, community
ENJOY play, fun, pleasure
Another great way to reflect on what matters to you is to maintain a Gratitude Diary. Note three things you are grateful for every day and take the time to notice the people in your life you are grateful for.
As a follow up, express your appreciation for the people in your life. Acknowledge their efforts, strengths, and positive qualities.
The gap between where you currently are and where you would like to be may seem daunting, and too large to cross. One way of dealing with this is by making a plan and breaking it down into a series of small stepsfocusing on one target at a time can seem much less daunting.
Use this bridge to help you think about ways in which you could do it and tick off as you go. This is a useful way to remind you what works for you. Here is an example of what it might look like:
Target
Get movement and exercise into my weekly routine
Step 1
Step 2
Step 3
Get some proper walking shoes
Rearrange my morning workload so that I can take my lunch break on time date
Ask around the office if anyone is interested in taking up walking during the lunch break
Now try to bridge the gaps in achieving your own goals. We’ve placed a bridge at the end of each chapter for you to cross. Once you have reviewed each chapter, pick one of your goals and break it down into a series of small steps.
Once you start using them, it is a great way to keep you focused and to look back on your successes, however small they seem.
Step 4
Step 5
Step 6
Do a trial walk around the office block (on my own) and see how long it takes me
Start a routine of walking with two work colleagues on Monday, Wednesday, and Friday end
Review how I feel after walking consistently for a few weeks and consider new ways to make exercise part of my weekly routine
Getting more active will help you live a longer and healthier life, and will reduce the likelihood of getting other conditions
We always hear about the importance of regular exercise, and although living with arthritis can present challenges, incorporating regular exercise into your routine can greatly benefit your condition. Here’s why exercise is important for arthritis:
1. Joint flexibility and range of motion
Engaging in exercises that focus on joint movement helps maintain and improve flexibility. This can reduce stiffness and enhance your overall range of motion, making daily activities easier and more comfortable.
2. Strengthens muscles
Strengthening the muscles around your affected joints provides better support. Strong muscles can help alleviate some of the stress on the joints, reducing pain and improving joint stability.
3. Weight management
Regular physical activity can aid in managing your weight. Maintaining a healthy weight is essential for arthritis management, as excess weight puts added strain on your joints, exacerbating pain and inflammation.
4. Pain relief
Contrary to what you might think, exercise can actually help to alleviate arthritis pain. It prompts the release of endorphins, natural pain-relieving chemicals in the body. Low-impact exercises like swimming, walking, and cycling are gentle on the joints and can provide effective pain relief.
5. Improved circulation
Exercise improves blood circulation, which can help reduce inflammation and promote healing in the affected joints. Better circulation also ensures that vital nutrients reach the joint tissues.
6. Maintains bone health
Weight-bearing exercises, like walking or light strength training, can contribute to maintaining bone density. This is particularly important for individuals with arthritis, as some medications and reduced mobility can impact bone health.
7. Enhances mood
Engaging in regular physical activity can have positive effects on your mental and emotional well-being. It can help reduce stress, anxiety, and depression often associated with chronic conditions like arthritis.
8. Better sleep
Regular exercise can improve sleep quality, which is crucial for managing arthritis. Restorative sleep allows your body to recover and reduces pain sensitivity.
9. Maintains independence
By maintaining your physical abilities and joint function, you’re more likely to maintain your independence and quality of life. This means you can continue performing everyday activities without relying on others as much.
10. Prevents deconditioning
Inactivity can lead to muscle weakness and joint stiffness, which can worsen arthritis symptoms over time. Regular exercise helps prevent this deconditioning, allowing you to maintain your physical abilities
Simply put, getting more active will help you live a longer and healthier life, and will reduce the likelihood of getting other conditions such as type 2 diabetes, high blood pressure, heart disease and cancer.
Remember, before starting any exercise regimen, it’s important to consult your healthcare provider, particularly a physiotherapist or rheumatologist. They can recommend exercises that are suitable for your specific type of arthritis, joint condition, and overall health.
Starting slowly, listening to your body, and gradually increasing the intensity and duration of your exercises can help you experience the benefits of physical activity while minimising the risk of exacerbating your arthritis symptoms.
There are several things that you can do – and avoid – to help live a more active lifestyle. These include:
Being active
• Aim to exercise at a moderate intensity for at least 30 minutes a day, five days a week (where you increase your breathing rate but can still hold a conversation). For example, a brisk walk where you cover a mile in 15-20 minutes. or…
• Exercise at a vigorous intensity for at least 75 minutes a week, (where you breath fast and have difficulty talking). For example, jogging or running a mile in 10 minutes. or…
• A combination of both.
Building strength
• Perform strength and balance activities for at least two days a week.
Minimising sitting time
• Stand up every 20 minutes.
• Ask yourself how much time do you spend sitting? Try to break up periods of inactivity.
• Make sure to walk at least 7000 steps per day. Added health benefits the closer you get to 10,000 steps.
The FIIT principle is a straightforward guideline for revising and improving any workout plan. FIIT stands for frequency, intensity, time, and type of exercise. You need to think about these four elements to create workouts that fit your goals and fitness level.
For instance, working out 3 to 5 days a week with a mixture of low, medium, and high-intensity exercise for 30 to 60 minutes per session, and performing cardio and strength training. Working out these details and progressing them over time helps create an effective program.
F Frequency
Try to incorporate movement into everyday life. Everything counts, so collect minutes throughout the day! Try to find what works for you each day.
I Intensity
Is it moderate or vigorous? Use the ‘talk test’ to find out.
TTime
Minutes can be added throughout the day. 5mins x 6 or 10mins x 3. Aiming to get to 30mins x1
TType
Adults need a mix of aerobic and strength activities to stay healthy
We all know that regular exercise is important, but the biggest challenge is often just getting started. Here are a few tips that might help you get started:
• Build from where you are now
Work out where you are now and build gradually from there. Ask yourself how often do I walk and for how long? How much of my day is spent sitting? For example, if you regularly walk in everyday life, try walking slightly faster and for longer periods, and if you don’t walk, try taking short walks and build from there.
• Build exercise into your everyday life
How can you incorporate exercise at home, travelling and at work?
Grab the extra activity by parking or getting off the bus a couple of stops earlier. Try going for a walk at lunchtime. Take the stairs whenever possible. Stand up when on the phone or during an advert break. Do more gardening. Throw a ball with a child.
• Stretch and warm up
Warming up and cooling down for five minutes before and after any activity will help minimise pain. Gently stretching will help your joints and muscles to become more flexible and will make the activity more comfortable.
• Walk, run, dance, and play
Pick the activities that best suit you. Doing something you enjoy is more important than the exact exercise you choose.
• Build strength
Try to keep muscles, bones, and joints strong by building strength. Do activities that make your muscles work harder than usual at least twice a week. Yoga, carrying bags, digging in the garden, and using small weights are ways to build strength in the body.
Remember, starting small is the best place to start, and starting today is the best time to start!
Once you’ve started to build activities into your everyday life, you then need to keep going until they become a habit. It can take time to feel the benefits of activity. However, your health benefits from that first 10 minutes so try to start today and make it a habit.
It is recommended that we each do 150 minutes of physical activity spread across the week. If you are nowhere near this, then you have the most to gain by introducing more activity to your life (those who do the least activity have the most to gain by even small increases in their activity levels).
Even if you are tight on time, performing short 10-minute bouts of physical activity of any type provides benefit and is better than not moving at all.
Make sure you’re wearing the right gear, especially on your feet. Wear supportive footwear – laced shoes or runners with a good heel counter, arch support and shock absorption.
You can also use technology such as smart watches which will record each activity and give you useful information on how you’re progressing.
Company always helps. Grab a friend or family member and get active together. Join a local activity group, such as a couch-to5K running club.
Having different activities helps to prevent you getting bored. Try to have activities you can do indoors and outdoors.
Keeping a record of every activity is a great motivator. Remind yourself why you want to get more active and congratulate yourself how on well you did at the end of the week and the health benefits gained.
If your activity levels fall off that’s no problem, just move forward and keep going, you’ve done it before!
Use this table to record your weekly activity, or create your own tracker:
While it’s important to get active and exercise regularly, it’s also important to make sure you’re not overdoing it. Some discomfort during and immediately after activity is very normal, and it’s normal to feel sore especially if you have not been active for a long time. This soreness does not mean damage. This soreness gradually eases as you gradually build your activity.
Listen to your body. If you have pain 24 hours after an activity in your joints, you may have done too much. Allow your body to rest and recover. Just make note of what you did and do a little less next time.
Although you might think it’s best to stop all physical activity during a flare, this isn’t the case. Don’t stop physical activity altogether during a flare. Try to strike a balance between gentle activity and rest – listen to your body.
Strengthening exercises can be cut out for the joints affected but can be continued with other joints. Strenuous activity should be avoided during a flare.
Think about other things you can do – maybe walking in the pool instead of walking on the road. Maybe drop the time and intensity of physical activity. Instead of doing a 20-minute hilly walk, switch to a slower 10-minute walk on a flatter ground.
Remember: it’s good to keep moving.
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Eating a balanced diet and maintaining a healthy weight can have a huge impact on your overall health and arthritis
There are a lot of claims made about diet and arthritis, and how adding things in or taking things out of your daily diet may help you manage this painful condition. While it can be tempting to try almost anything at times, there is no strong scientific evidence available that experimenting with your diet and including or excluding particular foods will improve your arthritis. In fact, you could end up with a restrictive diet and you could be missing out on important vitamins, minerals, and key nutrients for overall health.
So, is there anything you can do? Following the simple dietary advice and tips below will be good for your overall health and may even help to reduce some symptoms.
Being overweight can increase the symptoms of arthritis, as it places extra stress on the joints. Losing weight can help to reduce the pain and inflammation of arthritis. However, it can be difficult to lose weight, so making some small changes and steps in the right direction can help.
Healthy eating steps which can help you maintain a healthy weight include:
• Eating more fibre – wholemeal grains and cereals, fruit and vegetables and beans and pulses.
• Eat more vegetables – include a range of colourful vegetables at every meal. Eat a rainbow!
• Drink water to stay hydrated – 6 to 8 glasses of fluid a day can help to keep you well hydrated.
• Limit the intake of cakes, sweets and biscuits.
• Choose stewing and baking methods over frying foods.
• Keep an eye on alcohol intake
• Keep regular exercise as part of your daily routine when you can manage it.
Using the food pyramid as a general guide can be a handy way to see if you are getting enough fruit and vegetables, wholegrains, dairy and protein rich foods in your daily diet. 2 per day
Foods and drinks high in fat, sugar and salt
Fats, spreads and oils
Meat, poultry, fish, eggs and nuts
Milk, yoghurt and cheese
Wholemeal cereals and breads, potatoes, pasta and rice
Vegetables, salad and fruit
The ‘Mediterranean Diet’ has been shown to be good for your heart. However, people with arthritis can often find that it also helps their symptoms, including a reduction in swollen and tender joints, the duration of morning stiffness and improved general well-being. This diet includes:
• Plenty of whole grains (high-fibre breads, cereals, brown rice etc.).
• Fruit (2 or more portions) each day.
• Vegetables (4 or more portions) each day – whatever types you enjoy.
• Oils (especially monounsaturated oils like sunflower and olive oil). Use a small amount of these oils in cooking and salad dressings.
• Nuts and seeds – great to add to snacks and salads.
People living with Rheumatoid Arthritis have an increased risk of heart disease, and fish oils are protective against heart disease. Omega-3 fats have been shown to help people with arthritis by reducing general inflammation, reducing the duration of morning stiffness, and reducing overall joint pain. Symptom relief can take up to 3 months so it is worth sticking with it if you are giving this a try.
• Omega-3 fats can be found in fish with darker flesh such as:
• Sardines (tinned and fresh)
• Fresh tuna (not tinned – much of the Omega-3 is removed in processing)
• Salmon, Mackerel, Trout and Herring
Two to three portions (~140g) of these oily fish per week gives maximum benefit. If you do not eat fish, you could consider taking an Omega-3 Supplement. A supplement should contain between 500- 1000mg of EPA and DHA per capsule. As fish oils can interact with some medicines, it is always important to check with your doctor before starting any new supplements.
Calcium and Vitamin D are important for bone health, and particularly so for those living with arthritis. There is an increased likelihood of developing osteoporosis associated with arthritis. To look after your bones, you need to have a good regular intake of Calcium and Vitamin D.
Foods rich in calcium include milk, cheese or yoghurts, tinned sardines and pilchards, fortified breakfast cereals, soya drinks and green leafy vegetables.
TOP TIP! Low fat milk contains just as much calcium as full fat milk. And some milks are now fortified with extra Calcium and Vitamin D too so they can give you an extra nutritional boost. Check the labels of the milk you enjoy.
Because of the lack of sunlight here in Ireland between October and March, a deficiency of vitamin D is common in the Irish population. The Department of Health in Ireland recommends that adults may need a 15-microgram daily supplement in the winter months and that those over the age of 65 should definitely take a 15 microgram supplement each day, all year round. Do chat with your doctor about Vitamin D and your bone health.
Some nutrients can help promote your immune system:
CVitamin C is a powerful anti-oxidant that protects you from infection by stimulating the formation of antibodies and boosting immunity. Five to seven portions of fruit and vegetables every day should meet your body’s vitamin C needs.
EVitamin E can help improve immune function. This can be found in fortified cereals, green leafy vegetables, nuts, seeds, vegetable oils such as sunflower oil and nut butters.
Zinc helps the immune system work properly and helps wounds heal. Zinc can be found in poultry, seafood, milk, nuts, red meat, and legumes (beans, peas, lentils).
There are lots of myths surrounding diet and arthritis. You may have heard about acidic foods and nightshade vegetables (such as potatoes, tomatoes, aubergines) leading to an increase in symptoms.
There is no scientific evidence to support this claim, so if you enjoy these foods there is absolutely no need to take them out of your diet.
Excluding food or food groups can lead to nutritional deficiencies. If you think that eating a certain food might be linked to your symptoms, ask your GP to refer you to a Registered Dietitian.
A Registered Dietitian will advise you on how to make safe and sensible dietary changes that will not damage your health or leave you at risk of any nutritional deficiencies. You can also find a list of Registered Dietitians who work in private practice on the home page of the INDI website www.indi.ie.
A wide range of supplements are available in pharmacies and supermarkets, and many of them can be expensive. While it may be very tempting to buy into the hype, many of the claims are unproven when it comes to supplements and arthritis.
If you do decide to take a supplement to your diet, remember, it can take several weeks for any effect to be seen. Also, always check with your doctor as some supplements can interfere with medications you may be taking, so always let your medical team know about what you are taking.
Do not take multiple supplements without checking what they contain –you could end up with too much of something in your diet. Keep a diary of any symptoms so you will notice any improvement or deterioration.
Buy supplements from an Irish pharmacy or supermarket as they will be regulated. Buying online from abroad is not recommended for supplements.
Finally, consider the costs as they may be expensive and may not be necessary.
It is often claimed that glucosamine sulphate and chondroitin may slow cartilage breakdown in osteoarthritis. However, there is little scientific evidence to support their use. As a general rule, if you do not see any improvement after two months of taking either/both of these supplements, they will probably not help, and should be discontinued.
You should always check with your doctor or pharmacist before commencing any of these products. Supplements may interact with medication, so it is important to check before you start to take anything new.
If you would like to speak to a Registered Dietitian about your diet and arthritis, ask your medical team to refer you or visit the ‘Find A Dietitian’ section on www.indi.ie.
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Learning how to plan, pace and prioritise your day-today life, giving yourself time to adjust, and being kind to yourself, are all important steps towards managing stress
We all can get stressed at times no matter how much we try to avoid it. It can happen when we come under pressure mentally, physically, or emotionally. It can be different for each of us. The cycle of managing arthritis along with the other day-to-day challenges of life can be more stressful. How we think about it and how we manage it can make a real difference to our health and our arthritis.
Arthritis can affect many aspects of our day-to-day life such as our relationships, work, finances, and pregnancy/children. You may be feeling that the diagnosis is overwhelming, and it can take a while to adjust to living with arthritis.
One of the first things to do to manage stress is to recognise it and become aware that you are feeling it. After all, if you can’t see the problem, how can you find a solution?
Begin by starting to pay attention to your body and how you are feeling. Our body can react in different ways to stress. Pay attention to your muscles, as they can become tense, and we can often mistake this for arthritis pain. You may notice that your stomach feels tight or that you are clenching your hands or jaw. Again, become aware of this as it may cause an increase in pain.
Learning to live with arthritis doesn’t happen overnight, you will need to learn new techniques that will allow you to go about life. Learning how to plan, pace and prioritise your day-to-day life, giving yourself time to adjust, and being kind to yourself, are all important steps towards managing stress.
If you know that you have a stressful time coming up, make plans in advance so all the time you invest in preparing for this pays off. Lists can be helpful, and you can write down what’s urgent and what can wait, and you can tick them off as you go along.
• Take time out if you are feeling stressed even if it’s only for a couple of minutes or a couple of hours.
• If you are travelling, work out in advance what you need to do and prepare for your trip.
• Meet up with family and friends and stay connected.
• Look at healthy ways to unwind and relax (music, exercise, dance, meditation, or yoga)
• Keep on moving, any activity no matter how small is good for our minds (and our joints).
• Make time for your hobbies and things that give you pleasure in life. Consider taking up a new hobby with a friend.
• Take break from technology, instead of checking your phone, email and texts use this time as a space for you. Practice some breathing techniques, sip a cup of tea, or just sit in silence for 10 minutes or listen to some music.
• Writing is great way of expressing ourselves and using our mind. You could start a journal that you can use to write about the positive things in your life, and on days when we are not feeling as well, we can look back on the good days and try to keep positive.
• Try focusing on the things that have gone well during the day rather than the things that might have been difficult or more of a struggle.
Remember there is no one-size fits all way to manage stress. Everyone is different, and it may take time to find something that works for you. If you have tried some of the ideas we suggested to manage your stress but you think that you need extra support, it may help to talk to someone. You may need the professional support of a counsellor, psychotherapist, GP or charity support groups.
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Feeling connected to other people promotes positive mental health, physical health and gives life meaning
Fostering good relationships and friendships is a crucial aspect of your overall arthritis management. Your emotional wellbeing and the support you receive from others can have a profound impact on how you cope with this condition.
Much evidence exists for the significant role connecting with people and having supportive relationships plays in our overall health and wellbeing, including:
• Emotional support
Building strong relationships and friendships can provide you with a valuable emotional support system. Living with arthritis can be challenging both physically and emotionally, and having a network of friends and loved ones who understand your struggles can make a world of difference. They can offer encouragement, lend a listening ear, and provide comfort during difficult times.
• Reduced stress
As we saw earlier, chronic stress can exacerbate arthritis symptoms. Positive relationships and social connections can help reduce stress by providing a sense of belonging and security. Engaging in enjoyable social activities can serve as a wonderful distraction from the pain and discomfort associated with arthritis.
• Motivation for self-care
Friends and loved ones can motivate you to prioritise self-care. This includes sticking to your treatment plan, engaging in regular exercise, and maintaining a healthy lifestyle. Having people who care about your well-being can encourage you to stay committed to these essential aspects of arthritis management.
• Improved mental health
Loneliness and isolation can contribute to mental health issues like depression and anxiety, which often coexist with chronic conditions like arthritis. Positive relationships can help in the management of the feelings associated with such mental health challenges and promote a more positive outlook on life.
• Practical support
Friends and family can offer practical assistance when needed. This can include help with daily tasks, transportation to medical appointments, or simply providing company when you’re not feeling your best.
Feeling connected to other people promotes positive mental health, physical health and gives life meaning. However, the ability to form and foster warm and trusting relationships and to display empathy and intimacy with others can be challenging to some of us. In this chapter, we’ll look at how you can develop and improve your relationships and connections.
Overall, connecting with others provides us with a sense of belonging and a sense that we’re not alone. It provides us with an opportunity to be heard, and to give and receive support. Also, connecting with others often provide a good distraction from ourselves! Sometimes when we are dealing with pain or worry, we become ‘self-absorbed’ and it’s hard to see beyond our own suffering. Connecting with others help us to ‘get out of our own heads’ so to speak and give us a well needed break from ourselves.
Relationships and connection with others also include the quality of the relationship we have with ourselves, which is an important part of how we connect with others. Before we explore how to develop and improve our relationships with others, it’s important to first look at ourselves, and the types of relationships that best suit us.
Are you an extrovert (a more ‘outgoing’ person) who needs lots of connection or are you more of an introvert (a more ‘introspective’ person) who needs lots of time alone in between connections? Notice how you feel if you have had a day of lots of connecting versus a day when you connected with few people.
Spending time alone and connecting with yourself is also important and it is often in this time we get to notice what our preferences are. It’s important to balance time alone with time with other people and find your optimal set point of what works best for you.
It’s not about connecting with and spending time with others for the sake of it, it’s about bringing awareness to and noticing those interactions you have that have a positive impact on your wellbeing and give you energy as opposed to other interactions where you come away feeling somewhat drained or depleted.
Our inner dialogue, our self-regard, and our acceptance of our strengths and weaknesses, can have a profound effect on our mental health and our ability to connect with others. When we pay attention to our thoughts, and emotions in a mindful way, it can help us look at ourselves in a more balanced, compassionate, and hopeful way. This in turn makes it more likely that we will want to connect with those who are important to us.
Be open about your condition with your friends and loved ones. Educate them about your arthritis, so they can better understand your needs and challenges.
Visit or invite
Try visiting friends, or invite friends to visit you.
Participate in social activities
Join social groups or activities that align with your interests. This can be a great way to meet new people who share your passions. This could be anything from sports and walking clubs to bingo and book clubs.
Remember that relationships are a two-way street. Be there for your friends and loved ones in their times of need as well.
Consider joining an arthritis support group. These groups can provide a unique opportunity to connect with others who are going through similar experiences.
Remember the bigger picture - you may not enjoy golf or bingo, but the social interaction you get from being part of it may outweigh your lack of interest. Also, be prepared to move outside of your comfort zone and experiment with new ways of connecting.
Ask yourself ‘how am I doing with this part of my life? What score would I give myself out of 10 on how satisfied I am with the relationships and amount of connection I have in my life? What’s the areas that are working well? Are there areas you’d like to improve?
We all have relationships in our life that take more energy out of us (drains), whereas other relationships seem to provide us with energy (radiators) and we tend to be in better form after an interaction with the ‘radiators’ in our life. Can you identify some of the relationships in your life where you feel a drain of energy and those where you feel more energised?
Of course, it’s not always possible or desirable to disconnect from those you identify as drainers, particularly if they are close family members; however, bringing awareness to the impact of these types of relationships in your life is useful. It can give you options on perhaps limiting time spent in their company and balancing it with spending time with some radiators before or after encounters with those where you feel drained.
It may also be useful to develop skills around establishing and maintaining boundaries around relationships where you notice a drain on your energy reserves. Setting healthy boundaries is important for maintaining balance and preserving individual wellbeing within relationships.
Some people find it useful to set a target level of connection for themselves daily (for example, at a minimum I will speak to at least two people by phone each day). What goal or target could you set for yourself around making and maintaining connections on a daily or weekly basis?
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Don’t underestimate the power of a good night’s sleep in improving your arthritis symptoms and your overall quality of life.
Sleep is a necessary and vital biological function. It is essential to a person’s physical and emotional well-being. Studies have shown that without enough sleep, a person’s ability to perform even simple tasks declines dramatically.
Here’s why prioritising quality sleep is essential:
Lack of sleep can increase your sensitivity to pain, making arthritis symptoms such as joint pain and stiffness feel more intense. Adequate sleep is essential for managing pain effectively.
Sleep is a critical time for your body to repair and regenerate tissues, including those affected by inflammation in your joints. Insufficient sleep may lead to increased inflammation, which can worsen arthritis symptoms.
Restful sleep is essential for maintaining your energy levels and mobility during the day. When you sleep well, you are more likely to have the physical and mental stamina needed to engage in activities and exercises that can help manage your arthritis.
Arthritis can take a toll on your mental health, leading to feelings of stress, anxiety, and even depression. Quality sleep is vital for emotional well-being, as it helps regulate mood and reduce the risk of mental health issues.
Sleep plays a vital role in helping you cope with the challenges of arthritis and promoting better overall health. However, arthritis can often disrupt your sleep patterns and make it challenging to get the restorative sleep your body needs. However, studies show that as many as 80% of people with arthritis have difficulty sleeping. Sleep deprivation can make pain worse and have impact on overall health.
People might assume that when pain persists sleeping problem will also continue. Fortunately, this does not have to be the case, and it is possible to sleep well despite ongoing pain.
Sleep hygiene is used to describe good sleeping habits. Many of us don’t pay attention to our sleeping habits but they are essential; a good night’s sleep can improve a person’s mood, memory and health.
Helpful tips to improve your sleep include:
• Establish a routine
Try to maintain a consistent sleep schedule, going to bed and waking up at the same times every day, even on weekends. Avoid napping during the day, or at least limit the length of time you nap to no longer than 15 to 20 minutes.
• Establish good habits
Don’t go to bed hungry, try a little snack before bed such as warm drink. Foods like bananas and kiwis may help you to sleep. Develop a relaxing routine before bedtime and calm your senses. You could try warm bath, listen to music, and read a book, or the smell of lavender.
• Create a comfortable sleep environment
Ensure that your sleep environment is conducive to rest. This includes a comfortable mattress, pillows, a dark and quiet room, and a comfortable room temperature.
• Manage your pain
Take your arthritis medications as prescribed and consider talking to your healthcare provider about pain management strategies that may help to improve your sleep.
• Relaxation techniques
Practice relaxation techniques such as deep breathing exercises, meditation, or gentle stretching before bedtime to calm your mind and body.
• Limit stimulants
Avoid caffeine, alcohol and sugary drinks close to bedtime, as they can interfere with sleep quality. Turn off electronic screens and devices at least one hour before bed. Minimise external noise, close the window or move into a quitter room.
• Stay active
Engaging in regular, gentle physical activity as discussed earlier can also promote better sleep. However, avoid strenuous exercise close to bedtime.
• Consult your healthcare team
If sleep problems persist, discuss them with a member of your healthcare team. They can offer further guidance.
If you wake up and cannot get back to sleep after 20 minutes, get out of bed and do something calming until you feel drowsy again (but resist the urge to grab your phone while you try to get back to sleep!) If there’s something on your mind, putting your thoughts on the paper before bed can help to put a pause on the day.
Don’t underestimate the power of a good night’s sleep in improving your arthritis symptoms and your overall quality of life. Sleep is an important part of maintaining health and well-being. Sleep enables the body and mind to rejuvenate, re-energise, and restore.
Getting a good night sleep can often be more difficult for individuals experiencing pain due to arthritis. Reviewing and practising good sleep hygiene can help with these difficulties, and to find different techniques that work for you.
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It’s essential for you to understand why avoiding these risky habits is crucial for your overall health and arthritis management.
Certain lifestyle habits, such as smoking and excessive alcohol consumption, can have a significant impact on your arthritis. It’s essential for you to understand why avoiding these risky habits is crucial for your overall health and arthritis management.
Smoking is known to have detrimental effects on various aspects of your health, and it can be particularly harmful when you are living with arthritis. Here’s why:
• Increased inflammation
Smoking is linked to increased inflammation throughout the body, which can exacerbate the symptoms of arthritis. Inflammation is a key contributor to joint pain and swelling, which are common in arthritis. Heavy smoking can increase the risk of developing rheumatoid arthritis by up to 100%.
• Reduced blood flow
Smoking narrows your blood vessels, leading to decreased blood flow to your joints. This can impede the delivery of essential nutrients and oxygen to your joints, making it more challenging for your body to repair damaged cartilage.
• Weakening of bones
Smoking has been associated with a higher risk of osteoporosis, a condition characterised by weakened bones. For arthritis patients, fragile bones can result in fractures and additional complications.
• Interference with medications
Smoking can interfere with the effectiveness of arthritis medications, making it harder to manage your symptoms and potentially leading to increased pain and discomfort. If you smoke and have inflammatory arthritis, higher doses of medication are often needed in comparison to patients who don’t smoke.
If you smoke, quitting is one of the best things that you can do for your health. It will improve your overall health, reduce the severity of your arthritis, and allow your treatment to work as effectively as possible.
Quitting smoking is difficult, however there is a lot of support out there to help you. If you are vaping to help you quit smoking, you can work with a stop smoking advisor. They can give you free advice and support to quit smoking for good.
Call the National Smokers’ Quitline on 1800 201 203 and speak with a stop-smoking adviser who will talk you through all your options.
While moderate alcohol consumption may be considered acceptable for some individuals, it’s essential to be aware of its potential impact on arthritis:
Alcohol can contribute to inflammation, similar to smoking, which can worsen arthritis symptoms.
Alcohol can interact negatively with certain arthritis medications, leading to reduced effectiveness or even adverse reactions.
Alcohol is a diuretic, meaning it can lead to dehydration. Adequate hydration is crucial for maintaining joint health and cushioning the joints.
Excessive alcohol consumption can contribute to weight gain, which can put additional stress on your joints and worsen arthritis symptoms.
The good news is that there is little evidence to show that drinking alcohol worsens inflammatory arthritis. However, remember to stay within the recommended limits.
There are certain medications to treat inflammatory arthritis that can interact with alcohol. It is important to discuss this with your nurse or doctor. Make sure to take a list of all your medications that you are taking to your appointments. This includes over the counter medication and any herbal remedies or supplements that you are taking.
There are some easy tips to help you cut down your drinking, whether you are going out or staying at home. If you are going out:
• Go out later
• Pick lower strength drinks
• Alternate between alcoholic and non-alcoholic drinks
• Drink slowly – sip drinks
• Avoid rounds
If you are having a drink at home:
• Limit the number of drinks you keep at home
• Buy low-alcohol or alcohol free drinks (zero-alcohol beers)
• Use a measure rather than pouring free hand
• Start drinking later – try some activities in the evening instead
• Don’t make alcohol part of your weekly shop
• Try not to use alcohol to deal with stress
Humans have been drinking alcohol for 10,000 years and the debate of ‘tonic versus poison’ still goes on, but moderating your consumption will significantly reduce the risk of having alcohol-related health problems.
Many drugs are prescribed to help people sleep, manage anxiety, relieve pain, and treat depression; however, many of these drugs can also be abused. Make sure you stick to your prescription and talk to your prescriber if you think you are developing any problems .
There are also many illicit or ‘street’ drugs that are sold illegally. The most common of these are cocaine, cannabis, ecstasy, and opiates (morphine, codeine and heroin). There are also a newer group of illicit drugs called ‘New Psychoactive Substances’ which is an umbrella term used to describe drugs that are synthetically made to mimic some of the drugs named above.
ALL of these drugs can cause severe problems and should be avoided. They may also interact with any prescribed medication you are on.
Remember that your healthcare team is there to support you on your journey to better health. If you have any questions or concerns or need assistance with quitting smoking or reducing alcohol intake, don’t hesitate to reach out to a member of your healthcare team. They are there to help you make the best choices for your arthritis management.
Online supports and tips can be accessed at Ask About Alcohol on the HSE website www.hse.ie or on the A Quick Question leaflet at www.drugsandalcohol.ie/18438/.
Support is also available by calling the HSE Drugs and Alcohol Helpline on 1800 459 459 or by emailing helpline@hse.ie.
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There are many areas of everyday life that can affect your health and arthritis and that you are able to change
We hope you have found the information and resources in this booklet useful. Arthritis brings its own challenges, both physical and emotional; however, as this booklet has shown, there are many areas of everyday life that can affect your health and arthritis and that you are able to change.
The aim of this booklet was to help you live your best life with arthritis, to help you look at the things in life that matter to you, to support you in making changes to your health and wellbeing, and to build on your own capabilities and confidence.
Remember, you can use this booklet at any stage of your arthritis, and you can bring it to clinic appointments to help guide your conversations with members of your healthcare team. It may help you to talk to your healthcare team about some of the changes that you are working on, and to get advice on some of the issues on which you may need more support.
It’s also important to celebrate and share the success you have had in making these changes.
For further support you in setting and achieving your goals the following websites may be of interest to you:
Arthritis Ireland The national patient organisation for supporting people living with arthritis in Ireland (a health and research charity).
www.arthritisireland.ie
Exercise & Movement
Get Ireland Active
HSE
Irish Society of Chartered Physiotherapists
Irish based website to promote physical activity, a one stop shop for physical activity information. It also contains information on physical activity, how to get started, tips to stay motivated.
www.getirelandactive.ie | www.getirelandwalking.ie
Read tips on how to fit physical activity into your day. Guides on active living to suit your lifestyle.
www2.hse.ie/living-well/exercise/
National professional body recognised as the voice of physiotherapy in Ireland.
www.iscp.ie
Irish Nutrition & Dietetic Institute
Professional body for registered dieticians in the Republic of Ireland.
www.indi.ie
HSE Read tips on how to eat well.
www2.hse.ie/living-well/healthy-eating/how-toeat-well/
Safefood
Irish Heart Foundation
Our role is to promote awareness and knowledge of food safety and nutrition on the island of Ireland.
www.safefood.eu
A national charity fighting heart disease and stroke, promotion of positive health strategies.
www.irishheart.ie
HSE Information and advice about your mental health and wellbeing.
www.yourmentalhealth.ie | Freephone 1800 111 888
HSE HSE Stress Control course can help you learn stress management skills.
www.stresscontrol.ie
HSE HSE online mental health and wellbeing programme (five video sessions covering self care, understanding thoughts, exploring emotions, building positive relationships, and improving resilience).
www.2.hse.mindyourwellbeing.ie
Samaritans Samaritans listening service for anyone that needs it.
Freephone 16123
Arthritis Ireland Arthritis Ireland national helpline and online support.
0818 252846 | helpline@arthritisireland.ie
www.arthritisireland.ie
Social Prescribing Network
The All Ireland Social Prescribing Network is a network of people connected by a shared belief in the potential of Social Prescribing as a force for good.
www.allirelandsocialprescribing.ie Sleep
HSE
Information and advice about sleep.
www2.hse.ie/mental-health/issues/sleep-problems/
National Smokers’ Quitline
If you want to quit smoking, you can get lots of help. Call the National Smokers’ Quitline and speak with a stop-smoking adviser who will talk you through all your options.
1800 201 203
HSE Information and advice about quitting smoking.
www2.hse.ie/living-well/quit-smoking/supportservices/
HSE
Information and advice about alcohol.
www.askaboutalcohol.ie
HSE
Self-management Support for Long-term Health Conditions. This is a free self-management programme supported by the HSE for people living with a long-term condition.
www.hse.ie/eng/health/hl/selfmanagement/
Arthritis Ireland Living well with arthritis self-management course.
www.arthritisireland.ie
This booklet was developed by a team of health professionals. We would like to acknowledge the contribution of the content creators of this booklet: Una Martin, Nicole O’Keeffe, Bindu Irudayaraj, Dr. Patsy Mc Sharry, Paul Goff, and Louise Reynolds
The content of this booklet and resources are for general information purposes only and should act as an information source. You should not rely upon the material or information as a basis for making any other decisions.
This guide was developed by the rheumatology department at University Hospital Waterford with the support of the Royal College of Surgeons in Ireland Faculty of Nursing and Midwifery, Arthritis Ireland & The Irish Rheumatology Nursing Forum.