People with rheumatoid arthritis (RA) usually have their first encounter with a mobility aid as they recover from joint replacement surgery — or as they try to buy time and postpone it. As one’s RA progresses, the need for a mobility aid may become more obvious. RELATED: Rheumatoid Arthritis Changes You
Basic Facts About Mobility Aids and Rheumatoid Arthritis
We know a few things about mobility aids. We know that a cane is often used first, but as more support is needed, a walker or wheelchair may be the more appropriate option. We know that there is a right way and a wrong way to use a cane. We also know that no one wants to use one. Even when a cane is clearly indicated, some people will go to great lengths to avoid using it.
No One Wants to Need — or to Use — a Cane
Without question, we all would like to be pain-free and disease-free. We all would like to be physically strong, self-sufficient, and fully independent. That said, let’s be real. If you have rheumatoid arthritis, there may come a time when you need to use a cane. It may be temporary, transitional, or you may need it consistently. Do yourself an enormous favor and don’t fight it. Instead, embrace your cane. Embrace what a cane can do for you. Learn how to use it properly. Create a positive self-image that includes your cane. While at first the need for a cane seems to put a dent in your self-esteem and your body image, work hard at correcting that perception. What your cane can do for you is what ultimately counts. Your cane can provide safe mobility, stability, balance, an improved gait, less pain, and fall prevention. It can help you remain more active and independent. RELATED: Top Assistive Devices for Rheumatoid Arthritis
Stability, Mobility, Independence: Factors People With RA Can’t Ignore
The progression of joint damage, cartilage loss, inflammation, joint pain, and muscle weakness associated with RA can affect your gait, making it increasingly difficult to walk. The level of impact is related to disease severity. RA may impact the distance you can walk as well as your balance. A cane can compensate for some of the lost stability, steadiness, and strength. By snubbing the cane, you risk becoming increasingly sedentary, less active, and more dependent on others. RELATED: Physical Activity Is Essential for Managing RA
Assistive Devices Are About Safety and Reducing Your Fall Risk
With an impaired gait, there is an increased risk of falling. Falls can have serious and dreadful consequences, including worse disability, permanent disability, and even death. According to the Centers for Disease Control and Prevention (CDC), falls are the leading cause of injury and injury death in older Americans. The CDC states that 36 million falls are reported each year among older Americans (65 years old and older) causing more than 32,000 deaths. Each year, about $50 billion is spent on medical costs related to nonfatal fall injuries, and $754 million is spent on care related to fatal falls. RELATED: Tai Chi Beats Stretching and Conventional Exercise in Reducing Fall Risk for the Elderly Even the healthiest people are at risk of accidental falls. With diseases, such as RA, that affect musculoskeletal strength and body mechanics, the risk is magnified, and you must accept your own personal responsibility for reducing that risk. That includes accepting when you need a cane, and learning how to use it properly. Improper use of the cane can itself contribute to a fall. A study published in Gerontologist in April 2017 found that 75 percent of survey respondents who fell at home did not have their mobility aid or assistive device with them at the time. Reasons given included that the mobility aid was not needed, the person forgot to use it, using it made them feel old, or it was inaccessible.
Proper Use of a Cane and Difficulty Using a Cane
Your cane should be the proper height for you. As your arm hangs down loosely, the top of the cane should be at wrist height.If you have one side or leg that is stronger than the other, hold your cane on the side of your stronger leg.When climbing stairs with a cane, move your good leg first and follow with the weaker leg and cane together.When going down stairs, start with the cane first, then the weaker leg, followed by your good leg. (up with the good, down with the bad)
It’s best to be properly fit for a cane by a physical therapist or a knowledgeable person in a medical supply store — especially if it is your first cane. Be sure to wear your preferred walking shoes during the fitting. A physical therapist can also evaluate your physical condition, making sure you have sufficient upper body strength, balance, and dexterity to use a cane safely. If not, a walker, which provides a larger base of support, may be needed. A physical therapist can coach you about proper use and offer tips while observing your technique.
Some People With RA Have Legitimate Reasons to Forgo a Cane
People with RA of the hands, wrists, elbows, or shoulders may not be physically able to use a cane. As RA patient Becky Stofel Seibert of Lima, Ohio, wrote in a closed online discussion group, “I used a cane for many years until I was no longer able to hold it correctly due to the condition of my hands.” Another woman living with RA, Rebecca L. of South Carolina, wrote, “I’ve been thinking about getting a cane. The only reason I hesitate is because both hands, both shoulders, and one elbow hurt so much. I’m not sure I could actually use it. I don’t mind the image issue as I think it might help keep me from getting jostled in a crowd.” These physical reasons can be significant and, in those cases, a three-point cane or quad cane might be a better option than the commonly used single-point cane. Individual needs should be assessed.
Self-Image Versus Safety: Make the Right Choice
Self-image concerns should not override safety concerns. Fear that a cane will make you look old or feeble is not a legitimate reason to forsake safety. Another woman who has lived with RA for a long time, Karen Palmer of Mason, Ohio, wrote, “I used a cane before I had my knee replacements. Deciding to use it was tough. It was a visible sign of illness and disease, which really stinks when you are in your thirties. It was also painful to admit I needed it, since it was another sign the disease was progressing way too fast and way too aggressively.”
Focus on What a Cane Can Do for You
Work on developing a positive self-image. Feel positive about all that you are — all aspects of yourself — including that you use a cane. Focus on what the cane does to enhance your mobility and your safety. Don’t view it as the enemy or as something that detracts from who you are. Embrace the fact that your cane is allowing you to participate and be more active. With your increased activity level, you may be inclined to purchase a FitBit or other similar step counter. These have become popular items in recent years for people who set fitness goals or who simply enjoy tracking how many steps they have taken in a day. A study published in Orthopedic Research and Reviews in January 2021 evaluated if mobility aids interfere with the accuracy of step counters. Researchers concluded that gait aids do interfere with the reliability of step counters, especially walkers.
Make Your Cane Your Own
Acquire a cane that accentuates your self-image. There are many stylish canes to choose from, of different colors and designs. Look at FashionableCanes.com for possibilities. Incorporate it into your wardrobe as an accessory. I occasionally use a purple wooden cane that has drawn more smiles and positive reaction than you would ever expect. There’s a message in carrying a “different” cane. It lets people know that you are not hiding it or your need for it. They respond positively to your openness. Along with finding a cane that screams out your personality, work on controlling negative thoughts you may have about body image or self-image. Focus on acceptance and self-love. Become comfortable with who you are — and what you need.
