“RA can be emotionally and psychologically crippling in the worst cases,” says Katherine Upchurch, MD, the clinical chief of the division of rheumatology at UMass Memorial Medical Center in Worcester. “Even for those with early disease, if milestones can be set and achieved, that can boost morale, confer control to the patient, and also provide tangible physical benefit.” But not all goals are created equal. A goal that is vague, such as “Move more,” won’t help you as much as a more targeted goal, like “Walk 10 minutes each morning.” To make meaningful change, be sure to make your goals SMART:
SpecificMeasurableAchievableRealisticTimely
Giving yourself specific direction can help make achieving your goals is easier. Also, make sure your goals are measurable so you can keep record of your progress. For example, if you aim to walk for 10 minutes but only manage 5, you can note that and then try to walk a little more each day, until 10 minutes a day becomes routine. “A good goal is one that’s not impossible to achieve but may be a bit of a stretch,” says Dr. Upchurch. Other aspects of SMART goals are that they’re realistic and can be achieved in the time frame desired. If your goals are too demanding, you could overextend yourself and lose steam too quickly — worse, you could cause further damage to your joints. “With RA, it’s important to stop when there’s pain,” says Jyo Supnekar, OTR/L, an occupational therapist and a clinical specialist at Physical Medicine and Rehabilitation at Johns Hopkins Medicine in Baltimore. If you create unrealistic goals, you could set yourself up for failure. Worse, you might try to work through pain and do long-term damage to your joints. To help reduce morning stiffness Get up a half hour early each day to warm up your joints and ease into the morning. “Stretches can be helpful,” says Supnekar. Try starting your day with 10 minutes of stretching and a warm shower to get you going. “Additionally,” says Upchurch, “if you need extra time to get dressed because of joint deformity, pain, or weakness, waking up earlier could help reduce the stress of getting ready and improve the success of this daily task.” To keep your joints moving Activity helps you boost your overall health and maintain a healthy weight, which is especially important for those with RA, since fat contributes to the onset and progression of autoimmune conditions like RA. And exercise can help relieve everyday RA symptoms, according to the Arthritis Foundation. Choose an activity that you can do with your RA, and add it to your calendar to hold yourself accountable. “Swimming is an excellent choice; however, free weights are not,” says Supnekar. She recommends that you avoid any jarring activity, which means you might be better off taking a walk rather than running. Good RA-friendly exercise goals are to strive to swim three times a week for a half hour, or to go to a yoga or tai chi class twice a week. To help reduce fatigue When it comes to reducing fatigue, it’s important to pace yourself and plan your day ahead of time, advises Supnekar. Start by determining what activity is the most important for you to get to. This may change weekly or daily, depending on what your schedule is like. If family play time is your priority, make sure you don’t expend your energy on an errand that can wait, or on a task that you can ask someone else to do for you, says Supnekar. Make it a goal to decide your priority at the beginning of each day or week. Adds Upchurch, “You may also try to go to sleep earlier or nap during the day, given that fatigue is so common in RA.” To prevent unnecessary joint pain While some RA pain may seem as though it’s out of your control, make sure you’re not unnecessarily inflicting pain on yourself. Understand that having RA might mean doing things differently. A goal to reduce pain could be to bring and use a backpack when you go grocery shopping instead of using your hands to carry groceries. Or you might use adaptive equipment, like larger key holders, so you don’t strain your fingers and wrists too much, says Supnekar, who is also a certified hand therapist. Strategies like these, she says, help you avoid putting too much stress on the wrists and hands, which are often significantly affected by RA. What’s more, if you’re experiencing a flare, be cautious about the activities you engage in. When you have RA, says Supnekar, avoiding pain is an essential part of self-care. To avoid long-term deformity Over time, RA can cause joint deformity, particularly in your hands, says Supnekar, making fine movements difficult to perform. If you work at a desk, one goal may be to make sure that you’re set up ergonomically to minimize stress on your joints. You may also want to talk to your doctor or physical therapist about using splints to help reduce stress on your joints. According to Supnekar, setting daily or weekly goals to wear orthopedic splints on your hands for set amounts of time can help lessen the effects of RA on your joints. Supnekar also advises that you pay careful attention to pain and stop an activity if it causes pain. RA pain, especially accompanied by warmth near a joint, indicates harm to that joint. Over time, activities that cause pain can cause deformity in your joints.
Sticking With Your Goals
Once you’ve established SMART goals, set up milestones for each of them and reward yourself when you hit them. For example, if your goal is to take a 10-minute walk each morning, reward yourself with something small — like a warm bubble bath — once you’ve maintained that goal for a week straight. Then the following week, aim to take a 15-minute walk each morning, and reward yourself again once you’ve hit that milestone. It’s important as well to remind yourself that working toward your goals may fall to the wayside from time to time — during holidays and vacations, for example, or during transitional times in your life, such as getting married or starting a new job. When you fall off track, don’t be too hard on yourself. Tell yourself that the best thing you can do is to get back to the pursuit of your goals as soon as possible.
