Managing your symptoms

Eat a good diet

Although diets and supplements won't cure your arthritis, eating a healthy, balanced and varied diet is good for your overall health and well-being.

Your body needs energy and nutrients from food to keep you going throughout the day, as well as to help your bones and muscles stay strong and develop

Eating should be pleasurable and can be an important way of spending time with friends and family.

Basing a healthy diet around whole (rather than processed) foods, which are low in fat, sugar and salt, would be good.

Eating plenty of fruit and vegetables is a smart move as well – you've probably heard of the ‘five-a-day’ recommendation. Eating fruits and vegetables can help prevent heart disease and strokes and possibly reduce the chance of some types of cancer.

Read more about diet.

Eat fibre

Foods with fibre are also good for you. As well as having a beneficial effect in preventing heart disease, people with diabetes tend to find increasing the fibre in their diet can help improve their blood sugar control.

Foods high in fibre include:

  • fruit and vegetables
  • beans
  • nuts
  • oatmeal and some cereals
  • wholemeal bread and wholewheat pasta.

It's recommended that people consume at least 20–35 g of fibre each day. You can check the amount of fibre in many foods by reading the product label.

Drinking plenty of water throughout the day is important as this helps carry nutrients around your body and get rid of waste. Having tea and coffee as part of a balanced diet is fine, but it's important that caffeinated drinks aren't your only source of water.

Exercise

Regular, careful and safe exercise is one of the best things you can do to manage your condition and improve your health.

There’s no evidence to suggest that exercise makes your arthritis worse. In fact, we know that gentle exercise can help with inflammation.

Why do I need to exercise?

Your body is supposed to move and it needs exercise. If you don’t exercise regularly and keep your joints moving, they'll become stiff and painful.

Exercise is great because it:

  • improves your self confidence and mood
  • increases your energy levels
  • improves your sleep patterns
  • produces endorphins, which help to reduce pain, stiffness and anxiety
  • increases fitness, strength and flexibility
  • can reduce the risk of complications caused by your arthritis, such as muscle weakness and stiffness
  • helps speed up your recovery from flare-ups.

Exercise can also help you to keep to a healthy weight. Being overweight can make your symptoms worse, put extra strain on your joints and make treatments less effective. A healthy weight can help you manage your condition and improve your self-confidence.

The more you get into an exercise routine, the more natural it'll be, and the more you'll enjoy it. Aim for at least one hour of moderate exercise a day. Try to include exercise in your daily life, for example by cycling to school or to see friends, instead of getting a lift.

Get a good night's sleep

Getting a good night’s sleep is important for your physical and emotional well-being.

If you have arthritis, symptoms such as pain may disrupt your sleep.

Poor or disturbed sleep night after night may make you feel more achy, tired and in a low mood. It can cause increased muscle tension and can be linked with muscle pain.

Healthcare professionals will usually suggest you think about ‘sleep hygiene’ – things that you can do to improve your sleep pattern.

Read more about sleep.

How can I improve my sleep pattern?

Get into a relaxing and familiar routine – try to get up and go to bed at roughly the same time every day. Ideally, go to bed when you’re sleepy.

Be active throughout the day so you're tired when you go to bed. Exercise regularly, but not within three hours of going to bed.

Eat sensibly so you don’t feel hungry during the night, but avoid eating and drinking large amounts just before bedtime.

Improve your bedroom

A tidy bedroom and clean, fresh-smelling sheets will make you feel more relaxed. Making your bed can be hard at times, but a made bed with no wrinkles will help add to the relaxed environment.

Your bed shouldn't be too hard or too soft. Use a suitable number of pillows – your neck and back should be in a straight line when you're lying on your side.

The darker the room, the better chance you have of getting to sleep, so it would help if you have thick, dark curtains.

Scented cushions or candles can also make your room smell nice.

Keep warm

Use a hot-water bottle or microwave wheat bags to warm your sheets. A warm bath before you go to bed can help ease stiff or painful joints.

Relax

Do any chores early in the evening if you can, so you have time to relax before going to bed. Pack your bag and get anything you'll need ready for the next day. A to-do list for the next day can be helpful.

Share any worries with someone you can trust and write them down. Don’t bottle them up. You might like to try some relaxation techniques, such as meditation.

If you do have nights when you can't get much sleep, don't be critical of yourself.

What can affect my sleep?

Some activities can overstimulate your brain and make getting to sleep difficult, including:

  • playing games
  • working and checking emails
  • using social media.

Watching TV, particularly scary or exciting programmes, can also be overstimulating. Try to avoid having a TV in your bedroom or turning it on if you can't sleep.

Try to not listen to loud music before going to bed. Maybe find some soft/relaxing/chilled music instead?

It's best not to eat just before you go to bed. Try to avoid caffeinated drinks (tea, coffee, cola, energy drinks) from late afternoon. If you're really struggling to get to sleep you might want to cut these drinks out earlier in the day.

You should also avoid smoking before bedtime or during the night. Of course, it’s strongly advisable not to smoke at all.

Try not to sleep during the day because this can make it difficult to sleep at night.

Manage your fatigue

It's important to get the right balance between work, socialising and resting; and having arthritis can make this challenging.

It's also important to find time to exercise regularly. Staying fit and healthy and keeping your joints moving is a big part of managing your condition. Exercise will help you feel more energetic and sleep better.

The key is to listen to your body – know your limitations and rest when you need to. Overdoing it can cause discomfort or pain the following day.

What is fatigue?

Fatigue is a feeling of extreme physical or mental tiredness, or both. Common features of fatigue include:

  • your body and limbs feeling heavy and difficult to move
  • flu-like feelings of exhaustion
  • feeling that your energy has drained away.

If you have arthritis or a related condition, you may experience fatigue, especially during a flare-up. It shouldn't last and there are ways of managing fatigue.

Most of the time you'll have more or less the same amount of energy as your friends.

If you're feeling these symptoms, talk with a rheumatology nurse or consultant. 

It's important not to confuse lack of stamina, due to deconditioning (not being physically fit), with fatigue. If you're unfit you'll feel tired after exercise. With a gradual training programme your fitness, stamina and fatigue will improve.

Read more about fatigue.

What can help with fatigue?

Pacing means managing your time and working within your limits. It involves being organised and sensible with your jobs. It can help manage fatigue.

Pacing can help you to work out your most important work and chores. Thinking and planning ahead is key.

To begin with, forget about non-essential activities and concentrate on the most important ones. Once you've worked these out, organise your day so that you alternate heavy and lighter activities in order to ensure that you have enough energy left for activities you enjoy.

Prioritising tasks can help you get the most urgent ones done and, if necessary postpone less important tasks. Having achieved something makes you feel better about yourself.

Take regular rests, pace yourself and allow lots of time to do activities.

Fatigue may have stopped you doing things you really want to, so it's worth thinking what you could achieve that would make you feel good (for example socialising with friends or getting back into a hobby).

Setting small, weekly goals can help you build up to what you really want to do as you start managing your fatigue.

You're much more likely to meet small, specific goals than vague ones or ones that aim too high. Your occupational therapist or rheumatology nurse specialist may be able to help you set and review goals.

If you're working and find the days are too long, you might find it helps to discuss your condition with your employer and ask about flexitime. You may need a letter from your consultant, but many employers will be happy to accommodate you.

Some general advice:

  • When you can, sit rather than stand.
  • Don't put extra stress on yourself. Deal with your worries and talk to someone close to you.
  • Relax, breathe deeply and avoid holding your breath during difficult tasks.
  • Avoid postures which increase levels of fatigue, for example bending and reaching. Make sure your shoulders and neck stay relaxed.

Manage your pain

Pain is something you'll unfortunately know more about than most of your friends.

It's very personal and individual. The way your brain interprets pain and how you react to it depends on many factors, including:

  • how you're feeling, for example if you're worried or scared
  • previous experiences of pain
  • other people's reactions
  • how well you sleep.

Many people often find it difficult to explain exactly how they're feeling when they're in pain. There are things you can do to help you better explain how you're feeling. If you’d like to know more about this, talk to your rheumatology department.

Pain doesn’t have to dictate how you live. Even if you experience a significant amount of pain, you can lead a fulfilling life. There are steps you can take to reduce the impact of pain and to make yourself feel better.

How can I fight pain?

Keeping up with your medication routine is very important but if you're still experiencing pain, you can ask your doctor for extra or alternative forms of pain relief. 

It's really important to try to gain a sense of control and to not let pain rule your life. The tips below might be helpful.

Read the tips below, or find out more about managing your pain.

Keep doing things you enjoy

Even if you’re in pain, it’s important to try to keep doing the things you enjoy and need to do as much as possible. This might seem tough at times, but it will help.

Doing the things you enjoy, such as seeing friends, can help prevent you feeling sad and can distract you, which can prevent you focusing on pain as much.

Be as independent as you possibly can at all times. Ask your occupational therapist about handy gadgets.

Stay warm

Keeping warm can be a useful way to ease pain. Try having warm baths or doing some gentle stretches in warm water – ask your rheumatology team about this.

Warm your bed with a hot-water bottle, microwaveable wheat pack or electric blanket, and try putting your clothes on a radiator before you get dressed.

Exercise

Doing some exercises recommended by your physiotherapist will help. Try a hot pack over your joints before exercising; if this doesn’t work try a cold pack.

Exercise is important to keep you moving. If you become inactive and then unfit, stresses and strains of everyday life can become harder to deal with and you might find it harder to get to sleep.

Talk about it

Don’t bottle up your worries – talk to family or friends, or your rheumatology nurse/consultant. Sharing ideas about coping with pain with other people in the same situation can also help. 

Having a good posture is important. Try not to be in a position where you are bent over and try not to remain in one position for too long – keep mobile.

Below are some other steps you can take to help yourself feel better:

  • Ask the physiotherapists about splints to help relieve joint pain.
  • Ask your parents or friends to give you a gentle massage.
  • Try to get a good night's sleep.

Concentrate on your breathing

Pain may affect your breathing. It can make you take short and frequent breaths and this can make you feel a little dizzy.

It’s important to concentrate on how you're breathing. Try to take slow, deep breaths and get into a gentle rhythm.

You might find it helpful to put one hand on your chest and one hand on your stomach while you practice. As you breathe in, your stomach should rise a little and as you breathe out it should fall.

Try relaxation

Once you've controlled your breathing, listen to your favourite music and let your mind relax.

One relaxation tip is to visualise your favourite place. This could be a warm beach, or a beautiful lake by a mountain. It might be somewhere you know that makes you feel happy and safe, such as your grandparents’ living room or your favourite cafe.

Try to picture yourself there and think of the sights, sounds and smells.