According to Arthritis Ireland, “self-management is about being aware of and putting into practice the little things that make a big difference to your quality of life when you have arthritis”.
“Taking medication does not represent the full spectrum of arthritis treatment, but is rather just one (albeit essential) part of keeping your arthritis under control. Self-management is about recognising this and understanding that you and how you live is the key to taking back control of your life.”
Arthritis Ireland states that there are three sets of self-management tasks:
1. The first is for the patient to take care of their health problems, such as taking medicine, exercising, going to their healthcare providers, changing diet. The patient should also stay informed by asking questions, reading and when necessary carrying information from one provider to another. The patient is also advised to take part in planning their treatment programme by monitoring and reporting on their condition and sharing their preferences and goals with the doctor and all other members of their healthcare team.
2. Patients are also advised to continue to carry out their normal activities, such as employment and social life. Arthritis Ireland states that it is important for patients to keep doing the things in life that are important to them. However, there should be a recognition that this may mean changing the manner in which tasks are performed, doing the things in life that are important to patients. This may mean changing the way they do things. For example, this may mean the patient uses a garden tool on wheels or having prepared dinners in the freezer for times they are not feeling up to cooking.
3. Patients should also be aware of the need to manage the emotional changes that are brought about by their illness. These include anger, uncertainty about the future, changed expectations and goals, and sometimes depression. Changes can also happen in relationships with family and friends. An awareness that such emotional upheavals are natural and puts the patient in a better position to deal with these upheavals should they occur, according to the organisation.
<h3><strong>Pain/fatigue cycle</strong></h3>
Many patients assume that the symptoms they are experiencing are due to only one cause: their arthritis. While it can certainly cause pain and fatigue, it is not the only cause. Each of these symptoms can by themselves contribute to the other symptoms, and all can make pain and fatigue worse.
Even worse, they can feed on each other. For example, inflammation from the arthritis can cause pain, which causes stress and anxiety, that can cause poor sleep; poor sleep can cause depression, depression can sometimes make it hard to take medications correctly, and these can lead to more pain or fatigue, and so on. The interactions of these symptoms, in turn, make arthritis seem worse. It becomes a vicious cycle that only gets worse unless a way is found to break the cycle.
By understanding the pain/fatigue cycle and how each symptom contributes to increasing others, patients can learn techniques that help break the cycle at these various points.
Arthritis Ireland states there are a few key principles for pain management. One is that treating pain earlier is more effective than if a patient waits until it gets worse.
Small changes in pain can make a huge difference. Patients should be told that they do not have to be pain-free to do what they want and like. Sometimes, slightly reducing the pain can make a great difference.
Self-management activities such as exercise are not usually pain-free. However, the patient can use pain as a way to judge when they have done too much or should be doing more.
<h3><strong>Self-management toolbox</strong></h3>
There are many things a patient can do to break the pain/fatigue cycle using a self-management toolbox. This toolbox includes a variety of tools, such as physical activity (or exercise), healthy eating, problem-solving, modifying activities, planning, medications, communicating, and thinking activities. Arthritis Ireland states these tools can be used at different times, as needed, to break this cycle and manage pain and fatigue.
<h3><strong>Living Well with Arthritis course</strong></h3>
Arthritis patients can reduce their pain and reclaim their life from arthritis by signing up for Arthritis Ireland’s six-week Living Well with Arthritis course.
Developed by Stanford University, this award-winning course covers every area of arthritis self-management. Patients will be equipped with a variety of tools and techniques to help them better manage their condition.
The course is taught over a six-week period in weekly two-hour sessions. Each course usually has 18 people and is led by trained leaders, many of whom have arthritis themselves or are healthcare professionals. The next round of courses will start in September and the schedule and more information are available at www.arthritisireland.ie/go/programmes_events/living_well_with_arthritis.
Arthritis Ireland also runs a three-hour workshop called Breaking the Pain Cycle, which is designed to help patients understand their pain and identify ways to better manage it by developing a personal pain management plan.
