How does a 35-year-old manage RA while doing demanding work?

Question

Hey doctor,

I work construction, and I literally cannot afford to slow down; my whole crew depends on me to show up and pull my weight. But my hands have been so stiff and swollen lately, especially in the mornings; sometimes it takes like an hour before I can even properly grip anything. My rheumatoid factor came back at 78 last month, and my doctor confirmed it is RA.

How does a 35-year-old manage RA while doing physically demanding work without losing their livelihood?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com

I have read your query and am sorry for such discomfort.

Rheumatoid arthritis can be an annoying disease to manage, but with proper medications and physical therapy, you will feel much better than you do now.

The first step is to control your current disease activity. Starting with low-dose Prednisolone at 15 mg (milligrams) daily for two weeks before gradual withdrawal, combined with Methotrexate 25 mg weekly, should be enough to start showing improvement in joint pain and stiffness. No improvement might require adding biological therapy.

You should add a comprehensive program of physical therapy, including fine hand movement training, training on activities of daily living, exercises, and splinting, in addition to physical modalities, as superficial heat therapy can do wonders for your joints and help not just relieve the remaining pain but also improve your stiffness, joint mobility, and flexibility, thus improving your quality of life.

The key in rheumatoid arthritis is to be regular with your medications and follow up with new investigations and checkups at the rheumatology clinic.

Please do get the following investigations done:

CBC (complete blood count).
ESR (erythrocyte sedimentation rate).
CRP (C-reactive protein).
ALT (Alanine Aminotransferase).
AST (Aspartate Aminotransferase).
Sr Creatinine (Serum Creatinine).
HCV AB (Hepatitis C Virus Antibody).
HBsAg (Hepatitis B surface antigen).

Follow up after three months of treatment and physical therapy to evaluate response in terms of joint pain, stiffness, and ability to perform activities of daily living.

Please try to follow up if you find this answer helpful.

And I hope you will feel better soon.

Thank you.