Mobility, driving & transport issues for people with rheumatoid arthritis

Mobility can be a problem for those with rheumatoid arthritis (RA), especially when there is active inflammation. Because of the nature of RA some people have difficulty walking even short distances one week but can walk much further the next week.

Those with bad rheumatoid arthritis find it particularly hard to get up in the morning, stand for any length of time, get out of chairs, kneel on the floor and find it difficult to get in and out of the bath. Many people found that their range of movement improved once treatment had started, and some found that steroid injections helped during a flare up (see Steroids tablets, injections and intravenous pulses and Biologic treatments anti-TNF therapy and B-cell therapy rituximab).

She had difficulty with mobility before she started treatment but now it is much improved.

Age at interview 27

Gender Female

Age at diagnosis 27

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When he first got ill it took him four minutes to get off the toilet seat.

Age at interview 76

Gender Male

Age at diagnosis 74

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Some of the people we interviewed found stairs or steps difficult too. One woman said that she could manage stairs on good days, but on other days she had to go up on all fours. Another woman found it particularly hard to walk down stairs. Her consultant advised her to walk down stairs step by step, standing sideways. She tended to look for places with lifts or escalators that went down as well as up.

Her specialist advised her to come down stairs sideways.

Age at interview 52

Gender Female

Age at diagnosis 47

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Sometimes people have difficulty using particular joints so use other parts of the body instead. One man said that when he was in a lot of discomfort he used his elbows instead of his hands to pick things up.

Surgery may also have a positive effect on peoples daily lives. One woman explained how surgery to her elbows had made it much easier for her to reach things. Other people who had recuperated from hip, knee and ankle surgery found their walking improved (see Surgery – Lower limb).

Surgery for her elbows changed her life and made movement much easier.

Age at interview 37

Gender Female

Age at diagnosis 27

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Some people spoke about their fear of falling, particularly if they couldnt put their hands out to save themselves from a nasty bump. Some people used walking sticks and watched carefully where they were walking.

People who needed to use wheelchairs, or other mobility aids, described how this helped them to be more independent. Many people found a wheelchair useful for longer distances outdoors, sight seeing, shopping, exhibitions, and conferences. Mobility aids sometimes could be hired or borrowed. One woman said other people tended to ignore her, talking instead to the person pushing the chair. Someone else said that when she was in her wheelchair others would speak to her loudly and clearly. They seemed to think she might be mentally as well as physically disabled.

She found it hard to accept using a wheelchair.

Age at interview 53

Gender Female

Age at diagnosis 30

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One woman pointed out that others expected her to stay firmly in her wheelchair, and stared in surprise when she got out of the chair to walk over the bridges in Venice.

Some people managed public transport. One woman said that she got a freedom pass from the local council because of her disability. Others found buses and trains difficult because they found it problematic to get to bus stops or around stations, hard to climb on and off and seats werent always available. However, those who used air travel said that this was fairly easy, because airline staff provided wheelchairs to help transport them around the airport and they often received preferential treatment.

People had various solutions for their transport difficulties including relying on family and friends for lifts. Some used taxis from time to time, but one person noted that it could be hard to get in and out of taxis. One woman, who couldnt walk far, used an electric four wheel trolley to get to and from the local village, and a man used a motorised scooter at work (see Work).

She uses an electric ‘four wheel trolley’ to get to the village and back.

Age at interview 78

Gender Female

Age at diagnosis 32

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One woman was still using her bicycle for short journeys, but another person had had to give up cycling.

Although some people had had to give up driving most could still manage it and valued the independence it gave them. People bought their cars with care, making sure they could open the doors and windows, easily get in and out, turn the ignition key and controls and adjust the seat to a suitable level. Having RA also meant they could not sit for long periods without becoming stiff, so planned breaks in long journeys.

Changed to an automatic car and describes what she looks for when choosing a new car to make sure…

Age at interview 43

Gender Female

Age at diagnosis 24

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Power steering, an automatic transmission, central locking and electric windows made driving much easier. However, some people said that they were loath to get power steering or an automatic because they didnt want to admit that something was wrong.

One woman had her car especially adapted so that she could drive, but eventually had to give it up, because she found it hard to get in and out of the car, and because steering became too difficult.

Adaptations made to a car enabled her to drive although after her arms became too painful she had…

Age at interview 51

Gender Female

Age at diagnosis 27

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Motor insurers need to know if disability is likely to affect driving. One man told his insurers that he sometimes had to wear wrist splints, but he said that this was not a problem.

Motability is an independent not-for-profit organisation, which can help people gain access to a car. Some people found this organisation useful (see Financial implications and financial support). Others found the Blue badge scheme, which allows them to park in otherwise restricted roads, a Godsend. Some people had difficulty applying for the badge whilst others found it another psychological barrier.

Work and rheumatoid arthritis

Although some people prefer to stay at home, most people work, not only for money, but because working gives a sense of achievement, a structure...