Behavioral Aspects of Arthritis and Rheumatic Disease Self-Management

Chronic diseases such as arthritis and related conditions have no `cure', and thus require ongoing management. The long term nature of chronic disease gives the individual a crucial role, if not the most crucial role, in managing their condition. Day-to-day self-management is extremely important in achieving optimal health outcomes, and indeed, people with arthritis use a variety of strategies to relieve symptoms or manage disease consequences. This review identifies and discusses 6 different domains of arthritis self-management behaviors: 1. medical management; 2. joint protection strategies; 3. physical activity and exercise; 4. topical applications; 5. complementary and alternative strategies; and 6. stress and mind/body practices. Conceptualizing arthritis self-management in this manner enables a discussion of a range of practices that may be used to manage arthritis conditions. The literature on several established arthritis self-management programs that are designed to improve either self-care and/or exercise behaviors is also reviewed. Despite evidence of cost containment and improved health outcomes, these programs reach only a small percentage of people with arthritis who may benefit from them. Clinical intervention for people with arthritis may be enhanced if self-management is approached from a broad perspective and, if established, self-management programs are integrated into clinical interventions.