Frequency of Rheumatoid arthritis in general population is about 1%. Rheumatoid arthritis (RA) is a chronic inflammation of joints. The deformation continues till the inflammation is adequately controlled. It’s rare for rheumatologists to come across a case where the RA disappears without any modern treatment. Modern anti-rheumatic medications play a crucial role in controlling the symptoms of this disease and in halting the damage done by Rheumatoid Arthritis. Treatment started soon after the diagnosis is most effective. There are about 100 types of Arthritis and RA can often be mistaken for other types of arthritis. Therefore, besides the right treatment for Rheumatoid Arthritis, the right diagnosis is of utmost importance. There is new research happening for RA and new treatments are being developed so the universal knowledge about RA is constantly changing and we still have a lot to learn about this arthritic disease. Yet, there are many misconceptions about this treatable and controllable disease. In this blog post, I’m going to help break these myths.
Myth: Rheumatoid arthritis is just like ‘regular arthritis.’
TRUTH: RA is not “regular arthritis.”, What is commonly known to the general population as “regular arthritis” is osteoarthritis which results by injury or as a result of normal wear-and-tear on aging joints. Osteoarthritis is the most common joint disease in the senior citizens. By contrast, RA occurs as a result of abnormality in immune system initiated by a so far unknown trigger, the body makes antibodies that attack its own joint tissue. It mostly affects the joints, although other body systems can also be affected. Once disease begins, it causes continuous joint inflammation. In some people it can result in intermittent episodes of painful and swollen joints. In some individuals otherwise doing well with the medications, sudden or acute episodes of joint inflammation results, these are called ‘Flares’.
Myth: Only old people suffer from rheumatoid arthritis.
TRUTH: RA generally starts between the ages 25 to 55, but even teenagers can develop it.
Myth: Rheumatoid Arthritis is not such a serious disease.
Truth: RA is very serious. It can rapidly damage and deform your joints, involve other organ systems and even shorten your life span by few years, if it’s inadequately treated. Many people downplay RA as just ‘Grandma’s rheumatism,’ and they miss the boat completely. They delay seeing a Rheumatologist, often for months or years and a lot of joint damage happens during that time. RA needs prompt diagnosis and regular treatment to protect joints from harm. RA also increases the risk for certain other conditions like cardiovascular diseases, infections and lung disease etc.
Myth: People with rheumatoid arthritis will end up in a wheelchair because nothing can be done other than consuming pain killers & undergoing physiotherapy.
TRUTH: RA takes a different course in different people, but most people will go on living independently without pain and joint damage if treated early with modern medicines under the supervision of a rheumatologist (Joint physician).
RA has been known to cause much disability in people and this information comes from 20 to 30-year-old studies done before we started treating early RA with methotrexate, before we had the new biologic and other DMARDs (Disease modifying anti Rheumatic drugs. Extra ordinary strides have been made in recent times towards the excellent treatment of this disease. Today, an overwhelming number of people under treatment for rheumatoid arthritis are doing excellent and they regain their independence and mobility. But these results are only true for patients treated by a Rheumatologist. A recent study suggests that 94% of people with rheumatoid arthritis continued to perform all their normal activities independently even after living 10 years with the disease.
Myth: Most people with RA will be unable to work.
TRUTH: This myth may have been true in an earlier era, prior to the current treatments. Some people may need allowances at work, or will have to limit some activities during disease flares but a large proportion of people suffering from RA will continue working. In fact, in one large study of people who had had rheumatoid arthritis for more than 10 years, their employment rates were no different than their counterparts without RA.
Myth: As RA treatment can be toxic, it’s best to wait until the disease progresses.
TRUTH: This can prove to be the most dangerous thing to do. In fact, treating rheumatoid arthritis early prevents joint damage and disability. Ideally, aggressive treatment should start as soon as a positive diagnosis. Delaying treatment can worsen the situation. Numerous studies suggest that early treatment could delay full-blown rheumatoid arthritis from developing in some people. Although medications used to treat RA can have side effects but these side effects can be efficiently detected and treated through close monitoring by the rheumatologist and is definitely not worse than untreated rheumatoid arthritis. Simple blood tests and doctor’s visits can detect many of the serious side effects of rheumatoid arthritis medications.
Myth: Most people with rheumatoid arthritis get cancer too.
TRUTH: RA itself increases the risk for developing lymphoma (blood cancer), but the risk is low overall. For blood cancer, the lifetime risk is about twice as high in people with RA. It’s not clear why; perhaps because of chronic persistent inflammation. But the fact is that only a small minority of people with RA get blood cancer. For example, in one study, after following over two thousand people with rheumatoid arthritis for about eight years, 11 of them developed blood cancer. Most people with RA do not get cancer. Methotrexate, the new biologics, or both may partially increase this risk. However, you have to weigh the risks and the benefits. Untreated rheumatoid arthritis is frequently devastating, while blood cancer is uncommon, often slowly progressing and treatable. On the bright side, the risk of one cancer, colorectal cancer is actually reduced by up to 40% in people with RA. One theory says that the use of anti-inflammatory medicines called NSAIDs in this condition helps to prevent cancer in the colon.
Myth: Painful, stiff joints from rheumatoid arthritis need to rest most of the day.
TRUTH: In contrast joints affected by RA need stretching and exercise. Immobility can be counterproductive. Joints become painful and stiff making the patient immobile. Immobility sets up a vicious cycle. Muscles around a joint contribute a large part of the joint’s strength and stability and these require regular activity to stay healthy. Everyone with rheumatoid arthritis can perform some kind of exercise. Stretching exercises require minimal exertion and help keep joints flexible. Low-impact aerobic exercise improves joint health. High-impact exercises are to be avoided.