7 Common Myths and Facts About Rheumatoid Arthritis

From everydayhealth.com

By Matt McMillen

Rheumatoid arthritis (RA) causes pain, stiffness, and swelling in your joints. While those are the most common and obvious symptoms, did you know the impact of RA on your body is much broader?

“RA is a systemic disease that not only affects the joints, but can also affect several other organs, such as the lungs, the eyes, the nerves, the heart, and the skin,” says Nilasha Ghosh, MD, a rheumatologist at the Hospital for Special Surgery in New York City.

RA is the most common type of autoimmune inflammatory arthritis, and it affects about 1.5 million people in the United States. RA is a chronic disease, and though there’s no cure, treatments can quell its inflammation and limit the damage it does.

To help you better understand the disease and how serious it is, our experts dispel some of the most common myths and misconceptions you may have heard about RA.

1. Myth: RA Is the Same as Osteoarthritis (OA)

While both cause joint pain, they’re not the same. “Rheumatoid arthritis is a disorder of the immune system affecting the joints, whereas most cases of osteoarthritis are the result of degenerative disease at the joint,” says Dr. Ghosh.

OA typically develops from wear and tear on your joints as you age. This causes the breakdown of cartilage at the ends of your bones where they attach to your joints. The result: Your bones begin to rub together, causing pain, stiffness, and swelling. Some research shows that people with RA are at a higher risk for OA. But because the diseases are different, their treatments differ as well, says Ghosh. RA treatments suppress or modify the immune system. These are not effective for OA.

2. Myth: RA Only Affects Older People

RA most often starts between ages 30 to 60, though it can occur at any age. Ghosh says the incidence of RA in young adults has been rising, though that increase, she adds, might be because doctors are better able to recognize and diagnose it.

Your age can make a difference in how RA presents. “In young and middle-aged people, let’s say 30 to 50 years old, RA most often develops insidiously and gradually, whereas in older people its onset is acute and sudden most of the time,” says Kezia Daniel, MD, a rheumatologist at Northwell Health’s Phelps Hospital in Sleepy Hollow, New York. Another difference she points to: In young people, RA typically affects small joints, like those in your fingers and toes. Older adults, on the other hand, frequently have pain and swelling in large joints like the shoulders, hips, knees, and neck.

3. Myth: RA Is Just Minor Joint Pain in the Hands or Knees

When you have RA, your immune system mistakenly attacks healthy tissue. These attacks lead to ongoing, damaging inflammation. This can result in much more than joint pain. “Chronic inflammation will erode the cartilage and bone, which can lead to joint damage and deformity,” says Dr. Daniel. And RA inflammation does not only affect your joints. It can harm your skin, eyes, and lungs, says Ghosh. RA, she adds, also contributes to heart disease and, without treatment, boosts the risk of cancer.

Daniel points out that RA also increases your risk of the following:

• Heart attack
• Stroke
• Interstitial lung disease
• Osteoporosis
• Blindness
• Vasculitis
• Infections
• Carpal tunnel syndrome

4. Myth: If You Have RA, You Should Avoid Exercise to Protect Your Joints

Actually, the opposite is true. “Exercise does not make joints affected by rheumatoid arthritis worse,” says Ghosh. “In fact, it is recommended.” Why? Ghosh says that inflammation in your joints can weaken the muscles and tendons that surround it. Exercise, she points out, may help prevent this weakening. Exercise also reduces RA disease activity and lowers inflammation. In other words, you’ll feel better if you exercise. “Many [RA patients] feel less stiff and sometimes have less pain after exercise given that mobility tends to help inflammatory joint pain and swelling,” says Ghosh.

Daniel recommends 15 to 30 minutes of exercise a day at least five days a week. “It will lessen pain and stiffness in your joints and will help keep them lubricated,” she says. She recommends asking your rheumatologist to refer you to a physical therapist who can design a safe and effective exercise routine that meets your specific needs.

If any exercise does cause significant joint pain, says Ghosh, don’t ignore it. “Discuss it with your rheumatologist or a sports medicine doctor to assess if the joint has excess inflammation and what can be done to mitigate that,” she says.

5. Myth: Joint Damage From RA Is Inevitable

“Joint damage can be prevented if caught early enough and if treatment regimens can be adhered to,” says Ghosh. That’s because the medications your doctor prescribes will keep RA’s joint-damaging inflammation under control. Daniel stresses the importance of regular follow-up appointments. Your rheumatologist will assess whether your current treatment is adequately managing your RA and preventing its complications. If it’s not, don’t worry. A change in dosage or a switch to another of the many available treatment options should get your disease in check. Your rheumatologist will determine your follow-up schedule, but Daniel says to expect appointments at least every three months.

6. Myth: You Don’t Need Medication Until Your RA Becomes Severe

If you have been diagnosed with RA and have begun to develop symptoms like joint pain, “early treatment is definitely recommended to help prevent joint damage and subsequent worsening of joint damage as time goes on,” says Ghosh. “It may also help prevent systemic complications that can accompany RA, such as cardiovascular disease and cancer risk.” In fact, with treatment, your RA may never become severe, she says.

7. Myth: Medication Is Not Necessary if You No Longer Have RA Symptoms

Right now, RA has no cure. The best that your doctor can do, says Daniel, is get your disease into remission, in which you have little or no active inflammation. “Remission means your medication is successfully doing its job right to suppress the disease,” says Daniel.

Once in remission, your symptoms should ease up significantly. But you likely won’t remain in remission if you stop following your treatment plan. “The majority of patients with rheumatoid arthritis will have a flare or relapse of disease if their medications are stopped, even if they were in clinical remission beforehand,” says Ghosh.

Most of Daniel’s RA patients ask her if they can at least reduce the amount of medication they take when they feel better. Her answer is no. Here’s what she tells them: Many of the medications used for RA require steady, consistent levels in your body to keep your immune system from attacking your joints. “If you take it randomly, the drug levels in your body drop rapidly between doses,” says Daniel. “That puts you at a higher risk for flares.”

The Takeaway

• Misconceptions about rheumatoid arthritis can delay diagnosis and treatment as well as discourage you from making helpful lifestyle changes, such as increasing how much you exercise.
• Following your treatment plan even when you feel better will increase the likelihood that your RA remains under control or in remission. Skipping doses of medications or stopping altogether puts you at risk of a flare, in which your symptoms return.
• RA can develop at any age. If you have symptoms, see a doctor. While the disease can’t be cured, treatments can prevent it from causing serious harm to your joints and other parts of your body.

https://www.everydayhealth.com/rheumatoid-arthritis/common-myths-and-facts-about-ra/