Pain and discomfort from rheumatoid arthritis (RA) can make the most basic tasks cumbersome. And while the disease can affect the hands and joints, it often causes fatigue as well. All of this can make taking a shower not only a significant hurdle, but also a safety concern. Luckily, there are simple fixes to help—from using a shower bench to installing grab bars or investing in a long-handled sponge—so you can move on to spend time and energy doing what you want.
Why Does RA Make It Hard to Shower?
When you have RA, your immune system attacks the lining of the joints. This can cause pain, stiffness, and swelling, and leave lasting damage, often beginning in the hands and wrists. When it comes to taking a shower, it might be difficult to step over the edge of a tub, manipulate a bar of soap, squeeze a washcloth, wash your hair, use a razor, and simply bend down to wash your legs and feet.
Sitting Down Can Beat Fatigue
In response to active inflammation, your body produces certain substances that cause fatigue, explains Alejandra Rodriguez-Paez, M.D., a rheumatologist at Illinois Bone & Joint Institute. While many other symptoms of RA can be mitigated with treatment, “fatigue continues to be a significant problem,” Dr. Rodriguez-Paez says. When this gets bad, even standing for a few minutes in the shower can take its toll. An easy way to conserve energy is to use a chair or bench.
Why Falling Is a Big Concern
Getting in and out of a shower is one of the biggest risks for people with RA, says Trish Siegel, an occupational therapist and assistant professor at the University of New Mexico in Albuquerque. “For most people if you fall, you’re going to hurt yourself. If you’re already frail and you have rheumatoid arthritis, it’s a whole new ball game,” she says. One reason falling is such a big deal is that people with RA are at greater risk of osteoporosis, a condition where your bones weaken and fracture more easily.
How to Play It Safe
To prevent falls you’ll want a bath mat, Siegel recommends. And if you don’t have a walk-in shower, you can get a shower bench that rests over the edge of your tub, so you can sit down and scoot over without stepping over a ledge. Grab bars around the shower can also help. “A lot of accidents happen in the bathroom,” says Beth Ekelman, Ph.D., director of the occupational therapy program at Cleveland State University. But if you think ahead, you can reduce these hazards.
Simple Modifications Can Help
Once you’re in the shower, the tasks of cleaning your body can stress inflamed joints. Fortunately, there are ways to modify your routine: A long-handled sponge or brush can ease strain on shoulders to reach your legs and back. You can replace a bar of soap with a liquid container or use pump shampoo instead of a bottle. A bath mitt can also be a big help. To shave, consider using an electric razor outside the shower, which can be easier to manipulate.
Hot and Cold Therapy
If you wake up feeling stiff, a warm shower can help ease joint pain and set you up to feel better for the rest of the day. Others with RA prefer using ice packs or cool showers, so let your own body be your guide. In general, it’s best to avoid really hot showers, particularly during a flare. “Adding heat to an already inflamed joint may cause it to become more inflamed,” cautions Ekelman.
What to Do When Your RA Flares
A flare is often when you’re most fatigued, and a shower bench can be a great option to just sit and let the water wash over you. If it feels better to skip a shower for a day or two, that’s OK. Using dry shampoo or taking a sponge bath might help you feel more like yourself if you don't have the stamina for a full-on shower.
Other Tips and Tricks
Anything that helps your arthritis will help you shower. In general, clinicians recommend staying active and using physical therapy to strengthen the muscles around your joints. “If you have toned muscles that can improve their function,” Dr. Rodriguez-Paez says. And if you’re having a problem, consult your doctor or occupational therapist and they can work with you to come up with an individualized solution. “It doesn’t have to cost a lot to make showering an easier task,” Ekelman says.
If you’re looking to outfit your shower to accommodate arthritis, consider these options. Bathroom chairs and benches: You can pick one up at a pharmacy or home-goods store for under $50 or splurge on a fancier product . Grab bars: These can range from $20 at a hardware store to a few hundred dollars . Long handled brushes and scrubbers : Low-cost and widely available, typically for $15 or less. Dry shampoo: Many of the most popular brands sell a form of spray or powder for under $20. A nonslip bath mat : You can pick one up for less than $30.