Behavioral aspects of arthritis and rheumatic disease self-management

Chronic diseases such as arthritis and related conditions have no 'cure', a nd thus require ongoing management. The long term nature of chronic disease gives the individual a crucial role, if not the most crucial role, in mana ging 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: (i) medical management; (ii) joint protection strateg ies; (iii) physical activity and exercise; (iv) topical applications; (v) c omplementary and alternative strategies; and (vi) stress and mind/body prac tices. Conceptualizing arthritis self-management in this manner enables a d iscussion of a range of practices that may be used to manage arthritis cond itions. The literature on several established arthritis self-management programs th at are designed to improve either self-care and/or exercise behaviors is al so reviewed. Despite evidence of cost containment and improved health outco mes, 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-man agement is approached from a broad perspective and, if established, self-ma nagement programs are integrated into clinical interventions.