Arthritis Self-Management

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How to Be a Good Self-Manager

by Kate Lorig, RN, DrPH

"There is nothing I can do about my arthritis. Why bother trying?"

Over the years I have heard people say this many times. Nothing could be further from the truth. There is certainly something you can do about arthritis. You can learn to be a proactive self-manager.

What is self-management?

To understand self-management, you have to know a little about acute and chronic conditions. An acute condition is something like an infection, a broken leg, or the flu. These conditions usually come on suddenly, are pretty easy to diagnose, and typically go away with the proper treatment.

Arthritis is not an acute condition. It is a chronic condition: It typically comes on slowly, is sometimes difficult to diagnose, and seldom has a cure. It does not go away. To deal with it, you and your doctor must form a partnership. This means that your doctor becomes your consultant, as it were, but carrying out the day-to-day business of living is up to you. You have to learn to live with your arthritis, and how you go about this is key.

Have you ever wondered why it is that some individuals with bad arthritis are able to lead full and happy lives? They work, take part in civic activities, raise families, play with grandchildren, and still have the time and energy for hobbies. Then there are other individuals with arthritis, maybe not even bad arthritis, who are constantly focused on the pain and how they are not able to do things.

The difference between these two groups is not their arthritis. It is how they manage it.

If you have arthritis, or any other chronic condition, you must self-manage. You do not have a choice. The individuals described above who have bad arthritis but lead full lives decided to proactively manage arthritis. The others chose to passively manage arthritis. That is, they chose to do nothing.

What can I do to be proactive?

There are many things you can do about arthritis. An important first step is to visit the doctor. Unfortunately, many individuals who think that nothing can be done never seek medical attention. These people are not taking advantage of their best resource: their physician. Depending on the type of arthritis, there may be very effective medicines the doctor can prescribe. This is especially true for inflammatory types of arthritis such as rheumatoid arthritis (RA), ankylosing spondylitis, and gout. In these cases, early treatment can often prevent the devastating damage that was once common with these conditions. And for both RA and the more common osteoarthritis (OA), surgery, especially joint replacement surgery, often allows people to return to activities that they never thought possible.

Once you have gotten the best medical consultation, the next step in proactive self-management of your arthritis is “learning to live with it.” This means learning to manage tasks in three categories.

• Medical management. This includes taking medicines as prescribed, exercising, and using your mind to manage pain.
• Life management. This includes figuring out how to do the things you want and need to do.
• Emotional management. This includes dealing with the anxiety, fear, and depression that sometimes accompany arthritis.

Medical management

People are often prescribed medicines for their arthritis. Unfortunately, many people do not take their medicines as prescribed. There are many reasons why you might choose not to take your medicines. You might not be able to afford them, you might not believe that they will help, you might not want to take more medicines, or you might decide to take them only if your arthritis gets really bad.

Unfortunately, not taking your medicines is not a good management style. Medicines can do several things. They can make you better, they can keep you from becoming worse, or they can slow the progress of your arthritis. Thus, if you stop taking a medicine because you think it is not helping, it might mean that you will get worse. Ask your doctor before stopping a medicine. If the problem is that you can’t afford the prescribed medicines, it’s better to tell your doctor than just not take them. The doctor might be able to prescribe something different or direct you to agencies or organizations that can help with the cost. If it’s a question of simply not wanting to take more medicines, you might consider whether it’s really worth giving up what your arthritis medicines can do for you — slowing of disease, prevention of deformity and disability, lessening of pain. The decision is yours. If you really will not take medicines, tell your doctor/consultant. Good managers don’t keep secrets from their consultants.

One last point about arthritis medicines is that they do not work like aspirin. That is, a little bit now and then when you feel you need it will not help your arthritis. Most arthritis medicines have to be in your body all the time to be effective. That is why you take them on a regular schedule.

Last Reviewed on June 1, 2011

Kate Lorig is Director of Patient Education at Stanford Arthritis Center and a Professor (Research) in the Department of Medicine at Stanford University School of Medicine. She developed the Arthritis Self-Help Course sponsored by the Arthritis Foundation and is coauthor of The Arthritis Helpbook.

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