To best manage rheumatoid arthritis, take a care team approach.

Rheumatoid arthritis is more than a disease of the joints; it is a chronic systemic illness potentially affecting your entire physical, mental, emotional, and even spiritual well-being. Medical treatment for the disease is your first concern, but you may also need physical, rehabilitation, or occupational therapy, as well as help coping mentally with what can be a disabling condition.

The health care, mental health, and other professionals you will need on your care team will vary depending on the severity and stage of your condition, as well as your own particular impairments and needs. Your RA care team may include:

• Your primary care physician
• A rheumatologist
• An orthopedic surgeon
• A podiatrist
• A physical or occupational therapist
• A massage therapist
• A pharmacist
• An acupuncturist
• An ophthalmologist or optometrist
• A psychiatrist or psychologist
• A social worker

Primary Care Physician or Specialist If you experience sudden, unexplained joint swelling and pain or stiffness that doesn't clear up, gets worse, or is recurrent, you can start by seeing your primary care physician, who is well-qualified to determine if the joint problems are due to rheumatoid or osteoarthritis, or some other condition or injury. Whether a family doctor, an internist, a physician assistant, or a nurse practitioner, a primary care professional is trained to recognize the symptoms of RA and can refer you to a rheumatologist, who specializes in treating RA and related conditions. Your health plan may even require that you see a primary care physician for evaluation and to obtain a referral to a rheumatologist.

After your diagnosis is established and a treatment regimen is determined, you may continue to see the rheumatologist or work with your primary care physician, who can write the necessary prescriptions and routinely monitor minor, uncomplicated RA. But you'll also want to keep your rheumatologist involved in your treatment, especially if your condition is severe or gets worse, or if you experience other RA-related health conditions.

The Rheumatologist as Head of Your Care Team According to research, RA patients who see a rheumatologist several times a year do better than those who don't see a rheumatologist or see one only occasionally. This is because rheumatologists are highly trained and experienced in detecting changes to your disease early. They know how to adjust your treatment and tailor your RA management plan, including recommendations and referrals for other healthcare and support professionals.

Other Health Care Professionals You May Need Based on your rheumatologist's ongoing evaluation of your disease, other health care professionals may be added to your treatment team, such as:

• A physical therapist, to design an exercise program to control pain and preserve joint strength and range of motion.
• An occupational therapist, to determine when splinting or assistive devices may be needed.
• A podiatrist, to treat conditions specific to the foot or ankle joint. The podiatrist can prescribe medication to control inflammation and preserve joint function and may perform surgery.
• An orthopedic surgeon, to evaluate and treat bone, joint, tendon, and ligament damage arising from your RA. Interventions can range from minor arthroscopic procedures to major surgeries, such as joint replacement.
• An ophthalmologist or optometrist, to evaluate and treat visual defects or complications caused by RA or the medications you take and to prescribe glasses, contact lenses, or medications to correct your vision.

Alternative Care and Rheumatoid Arthritis Many RA patients say they are able to reduce pain and live more comfortably with alternative or complementary treatments. Alternative care practitioners who may help people with RA can include:

• A chiropractor, to manipulate RA-affected joints and improve range of motion and relieve pain.
• An acupuncturist, to insert small needles into certain areas of the body and lessen pain by triggering the release of endorphins.
• A massage therapist, to relieve muscle tension and improve range of joint motion.