Canes and other assistive devices can make living with RA inflammation and joint pain much easier.

If you have rheumatoid arthritis, sooner or later you may need to rely on a cane to help you stay active and independent. “I encourage it, especially if you have pain in your hips, knees, or ankles,” says Marie-Jose Benjamin, occupational therapist at Brigham and Women’s Hospital in Boston. Benjamin recommends that you get a cane as soon as standing up and walking is challenging.

A cane can help protect your joints, even before you notice serious problems. But many people put off using canes for as long as possible. “A cane signifies disability, and people don’t want to associate with it,” explains Benjamin, who notes that this reluctance can cause unnecessary wear and tear on the joints and do more damage in the long run.

While a cane can provide stability, its major use is to reduce pain. A cane with just one prong can support up to 25 percent of your body weight.

Rheumatoid Arthritis: What to Consider in a Cane

“It depends on the person and their needs,” Benjamin says, but there are some practical considerations to think about before you make your choice:

• Weight. It’s important to get something that is not too heavy. “Choose something that you can manage all day,” Benjamin says.
• Grip. “Your hands can change when you have rheumatoid arthritis,” Benjamin says. “A good cane has a grip that you can hold without awkwardness or pain.”
• Height. Benjamin explains that bad posture can be dangerous to a cane user: “A cane that is too short will make you have to reach down toward the floor. This is not safe. And one too tall will make you hike up your shoulders — again, not safe.” The right length: Your arm is slightly flexed, no more than 30 degrees, and the cane is on the ground. This should mean that the top of the cane reaches the level of the wrist.
• The weather. “You also want a tip that can change with weather, so you can be safe in different conditions. A tip with a spike can be used in ice, and a rubber tip is good in rain,” Benjamin says.

Rheumatoid Arthritis: Using Your New Cane

“Technique depends on where the pain is felt and what surface you are walking on,” Benjamin explains.

• Walking. “You hold the cane on opposite side of the pain,” Benjamin says. This gives support to your weaker joints as they advance.
• Stairs: Going up. “For going up the stairs, use the cane on your strong side,” says Benjamin. “You lead with the strong side and pull the weak side with you.”
• Stairs: Going down. “It’s the reverse to go down. You lead with the weak side. This puts less stress on the affected and painful joints.”

Rheumatoid Arthritis: Cane Modifications

Kelly Rouba, advisory board member of the Arthritis National Research Foundation and author of Juvenile Arthritis: The Ultimate Teen Guide, uses a walker to get around her home. “When I was younger, I mostly used the walker. We added a feature, a platform to lean on, so you can push it with your whole arm, not just your wrists.” Rouba explains that the modification saved her wrists from pain by making the stronger part of her arm do the work.

Other adaptations are for fun. “There are canes, crutches, and walkers that can be decorated or designed and personalized," Rouba says. "It makes it more unique, more bearable to use."

Rheumatoid Arthritis: See a Professional

“I always recommend a visit with a doctor who can refer the patient to an occupational therapist or physical therapist who can assess your needs and give advice about the right cane height and style,” Benjamin says. “Even if you only visit once or twice, it’s so important to go, just to get the right assistive device and to learn how to use it.”