Can I Have Rheumatoid Arthritis And Fibromyalgia
by Patient Advocate
Diseases are called comorbid when they exist at the same time and independently within the same patient.
With the increasing interest in the field of comorbidity and rheumatic diseases, it becomes even more important for us as patients to discuss our experiences in living with more than one disease as awareness leads to empowerment.
Treating Spinal Osteoarthritis May Take A Combination Of Therapies
Talk with your doctor about your neck and/or back pain to make sure your diagnosis is accurate and current. Remember that certain types of back problems are degenerative, meaning they may change, improve, or worsen with time. Management of your spinal arthritis pain may involve more than 1 medication or therapy. You have choices, and your doctor can work with you to find the right drug or combination of medications and therapies to ease your spinal osteoarthritis symptoms.
Electrical Nerve Stimulation for Arthritis Pain. Arthritis Foundation Web site. https://www.arthritis.org/living-with-arthritis/treatments/natural/other-therapies/electrical-stimulation-knee.php. Accessed October 29, 2018.
When To Seek Medical Advice
You should see your GP if you think you have symptoms of rheumatoid arthritis, so your GP can try to identify the underlying cause.
Diagnosing rheumatoid arthritis quickly is important because early treatment can help stop the condition getting worse and reduce the risk of further problems such as joint damage.
Read more about diagnosing rheumatoid arthritis.
How Is Ra Diagnosed
RA is diagnosed by reviewing symptoms, conducting a physical examination, and doing X-rays and lab tests. Its best to diagnose RA earlywithin 6 months of the onset of symptomsso that people with the disease can begin treatment to slow or stop disease progression . Diagnosis and effective treatments, particularly treatment to suppress or control inflammation, can help reduce the damaging effects of RA.
What Is The Safest Drug For Rheumatoid Arthritis
The safest drug for rheumatoid arthritis is one that gives you the most benefit with the least amount of negative side effects. This varies depending on your health history and the severity of your RA symptoms. Your healthcare provider will work with you to develop a treatment program. The drugs your healthcare provider prescribes will match the seriousness of your condition.
Its important to meet with your healthcare provider regularly. Theyll watch for any side effects and change your treatment, if necessary. Your healthcare provider may order tests to determine how effective your treatment is and if you have any side effects.
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How Is Rheumatoid Arthritis Diagnosed
Your healthcare provider may refer you to a physician who specializes in arthritis . Rheumatologists diagnose people with rheumatoid arthritis based on a combination of several factors. Theyll do a physical exam and ask you about your medical history and symptoms. Your rheumatologist will order blood tests and imaging tests.
The blood tests look for inflammation and blood proteins that are signs of rheumatoid arthritis. These may include:
- Erythrocyte sedimentation rate or sed rate confirms inflammation in your joints.
- C-reactive protein .
- About 80% of people with RA test positive for rheumatoid factor .
- About 60% to 70% of people living with rheumatoid arthritis have antibodies to cyclic citrullinated peptides .
Your rheumatologist may order imaging tests to look for signs that your joints are wearing away. Rheumatoid arthritis can cause the ends of the bones within your joints to wear down. The imaging tests may include:
In some cases, your provider may watch how you do over time before making a definitive diagnosis of rheumatoid arthritis.
What Makes Ra Get Worse
Different factors affect the pace and progression of individual patients RA. Some things you cant control, like whether you have a family history of the disease. In addition, although women are more likely to get RA, when men get rheumatoid arthritis, their prognosis is generally worse, Dr. Bhatt says.
But there are factors you can control and change. We know smoking makes RA more aggressive, so smoking cessation is key, Dr. Lally says. Also, people with heavy manual occupations might stress the joints further and might have quicker progression, Dr. Bhatt says. If your workplace can make accommodations for your disease, that will help. Read more about how to make working with arthritis easier.
Exercise and maintaining a healthy weight can also help reduce stress on the joints, Dr. Bhatt says. But talk to your doctor before starting a workout regimen. A physical therapist can advise patients on the right type of exercise, he says. If patients do exercises wrong it could stress the joints even further. In addition, getting enough sleep, starting an anti-inflammatory diet, eating less red meat, and possibly using herbal remedies like turmeric may help control RA, Dr. Bhatt says. Here are more healthy habits to adopt if you have RA.
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Tumor Necrosis Factor Inhibitors
Tumor necrosis factor alpha is a pro-inflammatory cytokine produced by macrophages and lymphocytes. It is found in large quantities in the rheumatoid joint and is produced locally in the joint by synovial macrophages and lymphocytes infiltrating the joint synovium. TNF is one of the critical cytokines that mediate joint damage and destruction due to its activities on many cells in the joint as well as effects on other organs and body systems. TNF antagonists were the first of the biological DMARDS to be approved for the treatment of RA. These drugs began to enter the market for rheumatoid arthritis in 1999 and are now considered a part the ACR recommendations for treatment of RA. There are currently five TNF inhibitors FDA approved for the treatment of RA etanercept , infliximab , adalimumab , certolizumab pegol , and golimumab . Etanercept is a soluble TNF receptor-Fc immunoglobulin fusion construct infliximab, adalimumab, and golimumab are monoclonal antibodies and certolizumab pegol is an anti-TNF antigen binding domain-polyethylene glycol construct. While differing in structure, the efficacy and safety of the drugs is similar across the class in reducing the signs and symptoms of RA, as well as in slowing or halting radiographic damage, when used either as monotherapy or in combination with methotrexate.
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Tips For Rheumatoid Arthritis Pain Management
Other than the pain itself, rheumatoid arthritis can cause many other problems and disruptions in life. There are some things you can do to stay healthy and reduce your pain. These are in addition to your regular treatments.
Here are some tips to help you with your rheumatoid arthritis pain management and coping with the disease:
Dont smoke: Smoking can have serious health consequences on rheumatoid arthritis patients. Smoking causes inflammation, which can complicate these disease and cause more pain.
Be conscious of your use of joints: Try reducing the stress on your joints by being conscious of your daily activities. Picking up items and turning door handles can add pressure to your joints causing them to feel sore. Look for ways to adjust your daily habits and limit the aggressive use of your joints.
Talk to your doctor and rheumatologist: If you still feel pain despite treatment, or you notice new pain, be sure to communicate with your physician and your rheumatologist. There may be additional pain relieving options available.
Seek emotional support: Deal with any stress or trauma you may feel by joining a support group of other rheumatoid arthritis patients. Professional counseling may also help improve your mood and help you to remain positive.
If you continue to experience chronic pain, there are several options for you to try. Talk to your rheumatologist about rheumatoid arthritis pain management options that are right for your individual case.
Surgery For Rheumatoid Arthritis
If joint pain and inflammation become unbearable or joints are severely damaged, some people need joint replacement surgery. The hips and knees, and sometimes the shoulders, are the most common joints that get replaced. Surgery can dramatically improve pain and mobility. Most people wait until after age 50, because artificial joints tend to wear down after 15 to 20 years.
Some joints, such as the ankles, don’t respond well to artificial replacement and do better with an operation called joint fusion.
Talk about your options with your doctor. You may want to ask things like:
- What are the pros and cons?
- What are the possible complications?
- How long will it take to recover?
- Will I need physical therapy?
- How long will the joint last?
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How Your Ra Treatment Plan Prevents Disease Progression
Perhaps the biggest factor that affects how RA progresses is if youre in treatment with a specialist who can put you on medications to slow the disease. Being on a DMARD or biologic therapy for RA is the best way to prevent progression, Dr. Lally says.
Disease-modifying anti-rheumatic drugs are usually the first line in medication. Methotrexate is the anchor drug for rheumatoid arthritis, Dr. Bhatt says. Some patients are scared because methotrexate is also used for cancer chemotherapy so they dont want to take a chemo pill, but those we use for RA are a very small dose with lesser chance of side effects. Your doctor will reassess in a month or so and see if its necessary to add in other drugs.
If after three to six months they have still not responded then we progress to medications called biologics, Dr. Bhatt says. These genetically engineered drugs target the inflammation process specifically, and are usually self-injected or infused via IV in your doctors office or a medical center. There are sub-classes and different types, Dr. Bhatt says. Your doctor will try various medications to see which you respond best to.
Can Physical Therapy Help Arthritis In The Back
In short: YES!
Physical therapy is a very effective arthritis back pain treatment.
A licensed physical therapist, like the ones at In Motion O.C., can teach you physical therapy exercises for lower back arthritis that can relieve your symptoms and get you back on your feet.
Back pain is one of the most common reasons people seek professional help from a physical therapist.
Strengthening the muscles around the vertebrae allows the muscles not the joints to do the work. Stronger muscles will help you move with less pain and discomfort.
Physical therapy is crucial to reducing the symptoms of back arthritis.
- Sit in a firm chair with armrests to relieve pressure in your back and shoulders.
- Keep your upper back straight and shoulders relaxed. Keep stomach muscles pulled in, and maintain the proper curve in your lower back. You can do this by tightening your stomach and buttocks. Some people are more comfortable sitting with the back of the chair at a 15- to 20-degree angle. A small cushion behind the lower back to maintain the natural curve of the back also can be quite helpful.
- Keep your knees slightly higher than your hips.
- Use a footstool or book under your feet if necessary.
- Keep your feet flat on the floor or other surface.
- Donât sit for a long period of time. Stand up every now and then to stretch tight muscles and give them a chance to relax.
Lie on your side with your knees bent.
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What Causes Rheumatoid Arthritis
The exact cause of rheumatoid arthritis is unknown. Researchers think its caused by a combination of genetics, hormones and environmental factors.
Normally, your immune system protects your body from disease. With rheumatoid arthritis, something triggers your immune system to attack your joints. An infection, smoking or physical or emotional stress may be triggering.
Is rheumatoid arthritis genetic?
Scientists have studied many genes as potential risk factors for RA. Certain genetic variations and non-genetic factors contribute to your risk of developing rheumatoid arthritis. Non-genetic factors include sex and exposure to irritants and pollutants.
People born with variations in the human leukocyte antigen genes are more likely to develop rheumatoid arthritis. HLA genes help your immune system tell the difference between proteins your body makes and proteins from invaders like viruses and bacteria.
Stage : Symptoms Are Visible
In this latter, more severe stage, blood tests and imaging are less relevant for diagnosis because you can actually see the effects of the disease. The joints start becoming bent and deformed, the fingers become crooked, Dr. Bhatt says. These misshapen joints can press on the nerves and can cause nerve pain as well, he says. In the older days we used to see more deformed joints when we did not have much treatment, but now we are seeing less and less, Dr. Bhatt says.
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Heat/cold Therapy For Temporary Pain Relief Of Spinal Arthritis
People with osteoarthritis often find that warmth, through warm towels or hot packs applied to the joint, or a warm bath or shower, can relieve pain and stiffness. Heat is known to help reduce inflammation and swelling in the joints and can help improve circulation. Water therapy in a heated pool or whirlpool may also help.
In some cases, cold, through cold packs or a bag of ice or frozen vegetables wrapped in a towel, can relieve pain or numb the sore area.
Often, applying heat for 20 minutes before doing an exercise routine or activity, and following up with applying cold to the affected area afterwards, will help alleviate activity and exercise related pain in the joints.
A doctor or physical therapist should be consulted to determine if heat, cold, or a combination of the two is the best treatment.
Ra Treatment: What Is The Safest Treatment For Rheumatoid Arthritis
Rheumatoid arthritis has no cure, but doctors recommend that patients adhere to suggested treatments early in diagnosis to decrease the severity of symptoms. There are a variety of treatment methods used to control symptoms and stop joint damage, including medications, surgery, and daily routine and lifestyle changes. Communication with a doctor or rheumatologist is necessary for choosing the most effective treatments. Your physician will ensure that treatments are safe and the medications are prescribed correctly based on each unique situation.
Treating RA will not cure the disease, but certain treatments can significantly reduce the pain and prevent permanent damage to the body. Depending on the severity of your symptoms, the goals of treatment will be to gain tight control of RA, meaning the diseases activity is kept steadily at a low level. Keeping RA in tight control can prevent long-term joint damage.
These goals primarily focus on:
- Reducing inflammation
- Preventing further or permanent damage
- Improving the quality of life
- Reducing daily and long-term side effects
Following a strict treatment regimen could bring RA into remission. Remission means that the level of disease activity has decreased in the body. It is never an indication that symptoms will not return, but following remission, many patients can go for long periods of time without experiencing symptoms.
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Rheumatoid Arthritis And Your Circulatory System: Ra Can Trigger Anemia And Fatigue
A large percentage of people living with RA experience anemia, a shortage of red blood cells or the iron-rich hemoglobin in the red blood cells. Red blood cells carry oxygen from your lungs to all the cells in the body and organs, so when your organs arent getting enough O2, you can experience weakness, fatigue, headaches, shortness of breath, dizziness, and more.
There are different types of anemia, and the most common type in RA patients is called anemia of inflammation and chronic disease , explains rheumatologist Robert W. Lightfoot, MD, a professor of medicine in the division of rheumatology at the University of Kentucky College of Medicine in Lexington.
No one knows exactly why anemia is more common with RA, but it may be that RAs inflammatory molecules interfere with the bodys ability to use iron, which in turn leads to anemia. Iron supplementation can help, but the best treatment is keeping the inflammation of RA under control with DMARD medication.
Another cause of fatigue: Inflammation can trigger the release of cytokines, molecules that are associated with fatigue. In addition, the depression and pain that can come along with RA can readily sap energy.
Causes Of Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune condition, which means it is caused by the bodys immune system attacking itself. However, it is not yet known what triggers this.
Normally, your immune system makes antibodies that attack bacteria and viruses, helping fight infection. But if you have rheumatoid arthritis, your immune system mistakenly sends antibodies to the lining of your joints, where they attack the tissue surrounding the joint.
This causes the thin layer of cells covering your joints to become sore and inflamed.
This inflammation in turn causes chemicals to be released that thicken the synovium and damage nearby:
- National Rheumatoid Arthritis Society : Possible causes and risk factors
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