Management of Muscle Cramps in Rheumatoid Arthritis

Non-Pharmacological Approaches

• The American College of Rheumatology recommends applying thermal modalities, such as heat or cold, to affected muscles for pain relief and improved physical function in rheumatoid arthritis patients 1, 2
• Massage therapy can provide immediate relief of muscle cramps in rheumatoid arthritis patients, preferably delivered by a provider with experience treating RA patients 1
• Joint protection techniques can reduce stress on affected joints and prevent muscle cramps triggered by joint strain in rheumatoid arthritis patients 2, 3
• Activity pacing, energy conservation, and fatigue management strategies can prevent overexertion that may trigger muscle cramps in rheumatoid arthritis patients 3

Physical Activity and Exercise

• Regular exercise programs that include both aerobic and resistance training can improve muscle strength and reduce cramping in rheumatoid arthritis patients 4, 5
• Hand therapy exercises can maintain strength and reduce cramping in hand muscles for patients with hand involvement 3

Supportive Devices

• The American College of Rheumatology recommends using appropriate splinting, orthoses, or bracing for affected joints to maintain proper alignment and reduce muscle strain in rheumatoid arthritis patients 2, 3
• Assistive devices can reduce strain on muscles during daily activities in rheumatoid arthritis patients 3

Important Considerations and Cautions

• Electrotherapy modalities, such as TENS, are conditionally recommended against for RA management due to lack of evidence for improvement in pain and physical function 1
• Chiropractic therapy is conditionally recommended against due to potential cervical spine complications in people with rheumatoid arthritis 1

Treatment Algorithm

• Thermal modalities, such as heat or cold, and massage therapy can provide immediate relief of muscle cramps in rheumatoid arthritis patients 1, 2
• Activity pacing, joint protection techniques, and appropriate exercise programs can prevent muscle cramps in rheumatoid arthritis patients 2, 3
• Appropriate splinting, orthoses, or assistive devices can reduce muscle strain in rheumatoid arthritis patients 2, 3