Hi

Patients with RA should be advised/educated most of all re. pain and the nature and course of RA illness. During flare ups RA patients should be advised to use ice to calm affected areas and to continue to move the affected joint.

RA ultimately causes distortion/deformities of the joint after the inflammation has subsided and gentle exercise (3xreps) even during flare up will not harm the joint, and will preserve ROM. I would not advise manual techniques. Gentle whole body ROM exercises (again 3 reps max during flare up) will not cause harm to the joint and should be encouraged! Hope this helps