Dr. M.J. Bazos, MD
Patient Handout
ARTHRITIS,
RHEUMATOID
About Your
Diagnosis
Rheumatoid arthritis (RA) causes inflammation
leading to pain, stiffness, and swelling in joints. The joints most frequently
affected are the hands, wrists, feet, and knees. Fatigue can also be severe in
RA. Less commonly, RA can cause inflammation in other parts of the body
including the lungs, eyes, heart, blood vessels, skin, and nerves. Rheumatoid
arthritis used to be called “crippling” arthritis because of the
potential joint damage. Now, because of better treatment, less joint damage may
occur. Although certain hereditary and environmental factors may increase an
individual’s risk of developing RA, the exact cause of RA is unknown.
Rheumatoid arthritis is not an infectious illness. In other words, you cannot
“catch” it from another individual. Rheumatoid arthritis affects 1%
to 5% of the adult population throughout the world. It occurs two to three times
more frequently in women than in men, and occurs more commonly during a
women’s childbearing years. To diagnose RA, a physician obtains a medical
history, performs an examination of the joints, and orders laboratory tests and
possibly x-rays of the joints. Laboratory tests may include an erythrocyte
sedimentation rate (ESR), which measures inflammation in the body, a complete
blood cell count (CBC), and a test called a rheumatoid factor (RF). Because only
75% of individuals with RA have a “positive” RF and other
individuals without RA may also have a positive test, this blood test does not
confirm a diagnosis of RA with 100%
accuracy.
Living With Your
Diagnosis
Rheumatoid arthritis causes
joint pain and stiffness that can affect your ability to do daily activities.
Rheumatoid arthritis of the hands, wrists, or shoulders can decrease your
ability to write, open jars, dress, and carry items. Arthritis affecting hips,
knees, or feet can decrease your ability to walk, bend, or stand. If arthritis
affects your neck, it may limit your ability to look around. There is no cure
for RA. However, with earlier detection, improved medications, and comprehensive
treatment, individuals with RA can lead a full
life.
Treatment
The
best way to manage RA is with a combination of medications, therapies, exercise,
education, and “pacing” of activities to prevent fatigue.
Medications help decrease the inflammation that causes pain and swelling.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are often the first line of
therapy. If these medications do not adequately control the pain and swelling, a
physician may prescribe “disease modifying” medications that may
slow down the RA disease process. These medicines include hydroxychloroquine,
methotrexate, and gold shots. Because these medications may take up to a few
months to be effective, the doctor may prescribe prednisone. Prednisone is a
strong anti-inflammatory medication that works quickly. All medications can
cause side effects. The NSAIDs may cause stomach upset, diarrhea, constipation,
ulcers, headache, dizziness, difficulty hearing, or a rash. Hydroxychloroquine
may cause nausea, diarrhea, and a rash, and rarely it may affect the eyes.
Methotrexate and gold shots may affect your blood, liver, or kidneys and may
cause a rash. Prednisone may cause skin bruising, high blood sugar, increased
blood pressure, difficulty sleeping, cataracts, weight gain, and thinning of the
bones. Learning about your arthritis is essential because you may have RA for a
long time, maybe for the rest of your life. Exercise is important to maintain
joint movement and muscle strength. Alternating periods of rest and activity
helps to manage fatigue.
The
DOs
• Take your medication as
prescribed.
• Call your doctor if you
are experiencing side effects from
medications.
• Ask your doctor which
over-the-counter pain medications you may take with your prescription
medications.
• Exercise to maintain
joint range of motion and muscle
strength.
The
DON’Ts
• Wait to see
whether a possible medication side effect will go away
itself.
• Give up. If one medication
doesn’t work, discuss with your physician other medicines that might help
decrease your pain and stiffness.
•
Go on a special diet without the consent of your
physician.
• Continue an exercise
program that causes pain. If pain after exercise continues, it usually means the
exercise program needs to be modified.
When to Call Your
Doctor
• You experience side
effects that you believe are caused by your
meds.
• The meds and treatments are
not helping the pain, swelling, or
fatigue.
• You believe you may need a
referral to a physical or occupational therapist for exercise or joint
protection.