6 Things I Wish My Patients Knew About Rheumatoid Arthritis
Pat Bass III, MD
RA is an inflammatory condition causing pain, swelling, and stiffness in the joints. While nearly 1.3 million Americans have RA according to the American College of Rheumatology, a number of misconceptions and myths remain around this complicated medical illness. Here are some facts for patients to separate from fiction.
Increase your IQ about RA. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2Fde%2Fc3%2Fbba68c624299a3b096dfb4b3f9af%2Fhumira-SS-myths-1.jpg
While all forms of arthritis cause some degree of pain, the similarities end there. There are more than 100 types of arthritis and it’s important to know which type you have, as each has its own symptoms and treatment. Your doctor will evaluate your symptoms to determine your type of arthritis. RA, for example, tends to impact small joints first (such as fingers, wrists, or foot joints) and usually occurs on both sides at the same time. Other types of arthritis may impact larger joints first (like hips or knees) and occur only on one side initially. RA is an autoimmune arthritis, meaning your immune system mistakenly attacks the lining of your joints. Osteoarthritis (OA), the “wear-and-tear” arthritis that affects nearly 27 million Americans, results from the breaking down and loss of cartilage, the tissue found between bones. While the treatments for RA and OA may be similar at the beginning (including nonsteroidals like ibuprofen), RA treatment quickly moves on to more aggressive therapies known as disease-modifying antirheumatic drugs.
1. All arthritis is not the same. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2Ffa%2Fe9%2F74470c8f421c9fbfbceefe9e886c%2Fimage-health-stories-bones-joints-and-muscles.jpg
The autoimmune nature of RA means other body systems can be impacted. Your RA doctor will monitor your skin, eyes, lungs, heart and other organs to see if RA has led to damage in areas beyond your joints. Additionally, RA patients appear to be at increased risk for heart disease, which can lead to heart attacks and heart failure. Pain and decreased mobility from your RA can trigger issues such as anxiety, depression, difficulties sleeping and decreased ability to work. As a result, RA can have a significant impact on your overall quality of life.
2. RA doesn’t just affect your joints. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F2f%2F1f%2Fc8989ecd4eee8bb70d98966a6685%2Fhow-lupus-affects-your-body-6.jpg
Many patients mistakenly think if they lose a little weight and use over-the-counter pain medications, RA will only be a minor inconvenience. While lifestyle changes such as weight loss, aerobic activity and eating better may help improve some RA symptoms--and are good for your general health--these healthy habits will not reverse the underlying autoimmune process of RA. Similarly, pain medication does not stop or slow the progression of joint damage, even if symptoms may decrease.
The fact is the exact cause of RA in unknown. While stress and poor eating are not good for your health overall, current evidence does not support them as definitive causes of RA. Obesity may increase your risk of developing RA, and small amounts of alcohol may decrease risk your risk. Smoking seems to increase risk and quitting decrease risk of developing RA, especially among patients with a certain gene. But for the most part, your chances of developing RA are out of your control.
4. Similarly, bad lifestyle habits do not cause RA. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F8f%2Ffd%2F0cf26ef6447f9271d2f7c6794612%2Fquit%20smoking.jpg
Many patients believe they need to decrease activity significantly after a diagnosis of RA. Quite the contrary, it is very important to stay as active as possible. Inactivity leads to weak muscles and stiffer joints. Talk with your doctor about seeing a physical therapist who can help you develop an exercise plan for your RA and an occupational therapist who can help you with strategies for adapting tasks of everyday living.
5. RA requires you to stay more active, not less. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F7b%2F01%2Fa1f5da5a43a1955ef1e22875e931%2Fstryker-SS-exercise.jpg
Because some medications used to treat RA are not safe for the baby developing inside of you, take time to plan and talk to your doctor before trying to conceive. Together, you can develop a strategy to treat your RA in a way that doesn’t put your fetus at risk.. As with any pregnancy, it’s also important to ask about prenatal vitamins and folic acid supplementation before getting pregnant. You will need to change medications if you’re being treated with methotrexate or leflunomide, and your doctor will try to avoid high-dose steroids in early pregnancy. Many women notice that symptoms of RA improve during pregnancy, but then worsen after delivery of the baby. By working with your doctor before, during and after your pregnancy, you can take steps to minimize the impact of RA and ensure the healthiest possible experience for you and your new family.
6. Women with RA can still have healthy pregnancies. https://d33ljpvc0tflz5.cloudfront.net/dims3/MMH/thumbnail/580x388/quality/75/?url=https%3A%2F%2Fd26ua9paks4zq.cloudfront.net%2F4f%2F7a%2Fd3a8d2754620b3ecd7c3569943d9%2Fimage-pregnant-women-holding-ultrasound-picture-over-stomach.jpg