The Impact of Rheumatoid Arthritis on the Musculoskeletal System

In healthy people, the musculoskeletal system works harmoniously to provide support, stability, and movement to the body. The bones of the skeleton, muscles, cartilage, tendons, ligaments, joints, and connective tissue comprise the musculoskeletal system. Rheumatoid arthritis, as well as certain other rheumatic diseases, affect the musculoskeletal system — and sometimes other systems of the body. Most commonly, the joints are affected by rheumatoid arthritis. Joint damage and joint pain, which is characteristic of rheumatoid arthritis, can lead to physical limitations and functional limitations. The severity of the limitations is related to the severity of disease activity and disease progression.

Activities Hampered by Rheumatoid Arthritis Symptoms and Limitations

At some point, there is no denying that physical limitations, fatigue, and pain related to rheumatoid arthritis directly impact your abilities. You may find that, in time, your ability to perform or participate in certain activities changes. For example, it may become difficult or impossible to:

Roughhouse with your children or grandchildrenContinue working at your current jobSocialize, especially spontaneouslyWalk for a distanceDrive or be the passenger in a car on a long day tripDo yardworkDo houseworkMake plansBe everything to everyone

We learn what our individual limitations are — and they’re not the same for everyone. It is essential, though, that we admit to ourselves things have changed and accept what we can no longer do. There are consequences, some possibly dire, if we do not accept our new reality. If you overlook or ignore that you can no longer do something, you may be risking a flare of symptoms, injury, or worse. The structure and routine of your life before rheumatoid arthritis gives way to the need for you to be flexible and adaptable. You must overcome your desire to force things to remain the same, to resist change, or to push beyond your limits. Otherwise, you may make harmful or destructive choices.

Personal Stories From People With RA Suggest It Is Difficult to Accept Change

Paula Mair of Woodbury, Minnesota, has had RA for 21 years. “It took me a long time to admit to myself that because of RA, there were things I could no longer do,” she explains. “First, I had to convince myself that I wasn’t being lazy or simply not trying hard enough. I was often overdoing things and paying the price. Then, I’d admit I couldn’t and I grieved each and every thing. Types of things that I couldn’t do included opening jars, getting groceries, and various everyday tasks.”

Guilt and Other Emotional Barriers to Accepting RA Changes

“I feel guilty about the changes I’ve had to make that affect my family too,” Mair says. “I sometimes feel inadequate. I’m not contributing like I want to and like I should be. I constantly start projects around the house and then realize I can’t. Thank goodness I have a husband who will help when I get in that situation. I still struggle with this but I am getting better. I never know where that line is between being able to do something and not being able to. I believe, for me, it’s important to push myself as far as I can, but it is hard then to not cross that line. I’ve found things I can do by pushing a little. I have learned that I just have to say ’no’ sometimes.”

Unrealistic Attempts to Do Pre-RA Activities

Rebecca, who asked her last name not be used, of Little River, South Carolina was diagnosed with RA in 1998. Rebecca shared, “I was pretty good about facing reality at first, but then got tired of feeling my life as I knew it had ended, and I started doing some things that ultimately made things far worse. I bought a horse in 1999 that was entirely inappropriate for the skill level of ’the new me.’ I ended up with some severe injuries with consequences that are still haunting me.”

It’s Hard to Say No, Especially at Work, When You Have RA

“As for being able to say ’no,’ I was okay with saying no if someone, for example, asked me to help them with a physical project,” continues Rebecca. “But I worked a high stress job with long hours for 20 years after my first RA symptoms, and that definitely took a permanent toll.”

“I feel totally inadequate and guilty for the effect of my condition on my husband and daughter,” continued Rebecca. “Some days, I don’t know who I am and what I have to offer to anyone. My husband does 99 percent of the housework and what little outdoor work is required. That was okay when I was working long hours, but now, I feel I have become a useless liability. Most days, I can deal with it, but occasionally it gets overwhelming.”

Does the Temptation to Overdo Physical Activities Ever Go Away?

“My daughter and her friend were visiting recently, and we all went to Charleston,” Rebecca shared. “My husband was careful to plan the activities that he and I did around my lack of ability to walk. We sent the young women off to explore by themselves on foot. When we were doing things together, we went to look at a lighthouse. The original plan was for the young women to walk out to the lighthouse, and for my husband and me to stay behind. Well, I stupidly tried to walk out there, got halfway and realized I was in serious hurt. The only way back was to walk, so I did. It really messed me up for days and I am still paying the price. My husband tried to talk me out of attempting it, but I didn’t listen. He is amazing about structuring activities so that I can do them, and I need to listen to him, not be in denial.”

Major Lifestyle Changes May Be Inevitable When You Have RA

“I quit my job in 2016 after I realized that I had already done major damage to myself by continuing to work in system support,” Rebecca explained. “I pushed for too long, so now I don’t feel capable of doing any work at all. Maybe if I’d made a job change years ago to something less intense in terms of hours and stress, I might still be productive.”

Recognize Denial’s Power When You Live With Chronic Illness

Like Paula and Rebecca, I have had incidents, too, where I got myself into trouble because denial was more powerful than recognizing I likely couldn’t do something. Just because you want to doesn’t mean that you can. One of the incidents occurred in 2011 when I was attending a Bon Jovi concert with my cousin at the MGM in Las Vegas, Nevada. The MGM is an enormous property and the RA had been causing me difficulties around that time. I was in denial and said I could walk the distance we needed to cover. Not even close! My poor cousin had to find me somewhere to sit while she ran through the venue to find a wheelchair for me.

Learning the Hard Way to Respect Your Own Limitations

Another incident occurred in 2000 when my extended family and I went on a cruise. It was my first cruise, as a matter of fact, and I didn’t do my homework. Getting off the cruise ship into a dinghy to do a side excursion on Catalina Island almost landed me in the ocean. Who knew you had to do that — and who knew how hard it would be for me? Live and learn, they say? With RA, it should be “learn and then live.”

8 Tips to Help You Accept the Life Change That RA May Demand

By not accepting the changes in your life caused by having RA, you risk making things much worse for yourself. Here is what you need to do to accept change: