Addressing Arthritis Successfully in Rural Communities
Joan S. Grant, PhD, RN
Arthritis affects more than one-third of rural Americans, with greater than 100 conditions which affect tissues, joints and connective tissues. More than half of these individuals live with joint stiffness and pain that affect activities in carrying out daily responsibilities (CDC, 2024). In one of the few studies examining the relationship between geographic location and the use of health services for people with rheumatoid arthritis (RA) and osteoarthritis (OA), urban individuals living with RA were more likely than rural individuals to report specialized rheumatology visits. This finding may suggest primary health professionals are being used for arthritis care by rural individuals because of inadequate specialists. There also were fewer urban-rural disparities in OA care but this may be because of the lack of biologic disease-modifying anti-rheumatic drugs (bDMARDs) used in RA that require close monitoring. This study emphasizes the need to provide innovative health care delivery strategies to offer rheumatologic care in rural communities (Desilet et al., 2025).
In addressing both the lack of specialists in rural areas and rural patients who are less likely to use patient portals (Sun et al., 2022), rheumatology fellows and attending physicians from an urban rheumatology clinic provided a value intervention by working with rural primary care providers to offer valuable care. The clinic provided information to rural providers for evaluating and managing patients with rheumatic diseases, which enhanced specialized care to rural individuals with transportation and financial issues (Jain et al., 2023) This study highlights how telemedicine allows rural patients to access specialized arthritis rural care without leaving their home.
Other innovative solutions suggested for enhancing arthritis care for rural patients include:
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Community-based initiatives such as mobile health clinics that access underserved areas and provide screenings, education, and tailored treatments that address both healthcare access and cultural perceptions;
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Collaborative partnerships with healthcare organizations, government agencies, and non-profit groups to obtain funding for local clinics, healthcare worker training, and community campaigns that raise awareness about arthritis (Zocto News, 2026); and
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Nurse-led:
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disease monitoring and medical and psychological support;
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structured education and hands-on training;
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participation in health promotion and bDMARD treatment;
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pain-coping sessions for those with arthritis pain;
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specialists who emphasize how to adapt assistive equipment in carrying out daily rural activities;
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use of video tutorials with feedback that focuses on slowly increasing at-home exercises (Auyezkhankyzy et al., 2024); and
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assistance for uninsured/underinsured rural patients to access patient-assistance programs for expensive bDMARDS.
Together, rural nurses can provide effective arthritis care for rural patients that will enhance their lives and enable them to carry out meaningful activities in their rural setting.
References
Auyezkhankyzy, D., Khojakulova, U., Yessirkepov, M., Qumar, A. B., Zimba, O., Kocyigit, B. F., & Akaltun, M. S. (2024). Nurses’ roles, interventions, and implications for management of rheumatic diseases. Rheumatology International, 44(6), 975–983. https://doi.org/10.1007/s00296-024-05603-7
Centers for Disease Control and Prevention. (2024, May 16). Arthritis in rural America. https://www.cdc.gov/rural-health/php/public-health-strategy/arthritis-in-rural-america.html
Desilet, L. W., Pedro, S., Katz, P., & Michaud, K. (2025). Urban and rural patterns of health care utilization among people with rheumatoid arthritis and osteoarthritis in a large US Patient Registry. Arthritis Care & Research, 77(3), 412–418. https://doi.org/10.1002/acr.25192
Jain, P.,Tiller, E., Doughton, J., Ishizawar, R., & Rivadeneira, A. (2023, November 13). Optimizing rural rheumatology access: Collaborative tele-health clinic between University of North Carolina and Piedmont Health 1 Year extension and opportunities for improvement [Poster presentation]. ACR23 Covergence: Where rheumatology meets. San Diego, CA. https://acr23.eventscribe.net/fsPopup.asp?PresentationID=1324177&mode=presInfo
Sun, E. Y., Alvarez, C., Callahan, L. F., & Sheikh, S. Z. (2022). The disparities in patient portal use among patients with rheumatic and musculoskeletal diseases: Retrospective cross-sectional study. Journal of Medical Internet Research, 24(8), e38802. https://doi.org/10.2196/38802
Zoco News. (2026). Rural access to arthritis treatment.
https://zocto.in/rural-access-to-arthritis-treatment/
