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Rheumatoid Arthritis
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Discovery :
What is Rheumatoid Arthritis?
Original symptoms and visiting a GP
Referral to a rheumatologist, tests & diagnosis
Impact of the diagnosis
Ideas about causes
Impact of diagnosis on family & others
Tests and treatments :
Choosing treatments & taking part in trials
Painkillers
Anti-inflammatory drugs
Disease modifying anti-rheumatic drugs (DMARDs)
Steroid tablets, injections & intravenous pulses
Biologic treatments: anti-TNF and B-cell therapy
Long term use of drugs
Regular monitoring and other diagnostic tests
Physiotherapy & hydrotherapy
Occupational therapy
Other hospital specialists
Surgery - introduction
Surgery - upper limb and neck
Surgery - lower limb
Outpatient clinics
Complementary and alternative approaches
Living with rheumatoid arthritis :
Diet & food supplements
Exercise
Personal life and changes to the home
Social life & relationships
Mobility, driving & transport
Work
Financial implications & financial support
Sources of support
Body image
Attitude to RA & facing the future
Self-management
Ongoing symptoms- flares, stiffness & sleep disturbance
Ongoing symptoms- pain, fatigue, depression, weight change
Pregnancy & breastfeeding
Parenting & childcare
Messages to others with RA
Messages to health care professionals
Finding information about RA
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Rheumatoid Arthritis
Subject index
Topic
Bones & joints
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Rheumatoid Arthritis
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Exercise
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Exercise
Exercise
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Bones & joints
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Rheumatoid Arthritis
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Disease duration 16-20 years
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Interview 23
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Successfully chose to do strengthening exercises instead of having joint surgery.
Psoriasis age 17. Rapid onset RA diagnosed seronegative '86. Various DMARDS tried and complementary therapies/diet helped. Stroke '00, blood disorder & Sjogrens. Currently Steroids, Dihydrocodeine, Vioxx. 2 new knees/1 hip/2 shoulders & right thumb fusion.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 6-10 years
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Interview 26
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Uses painkillers together with exercise and distraction to overcome pain. Has come to terms with taking them.
Diagnosed '94 after flu like symptoms & joint problems for 6 weeks. Gold injections 50mg/week, slow release Voltarol 75mg/day, pain killers, Prozac 20mg/day (depression). Steroid injections when required. 3 bone removal operations from toes and ankle.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 6-10 years
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Interview 32
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She used to take anti-inflammatories especially before exercising but after a time found she didn't need them.
Diagnosed seronegative RA '97 but symptoms since '77 after flu-like virus. Took Opren but side-effects so chose homeopathy. Mid '90s significant disease progression & began DMARDS, but side-effects. Now 6 weekly Depomedrone injections (120mg), physio & hydrotherapy.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 16-20 years
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Interview 25
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Recovered quickly from her bilateral knee replacement surgery by exercising regularly and feels she now has more energy.
Juvenile chronic arthritis diagnosed '85, on steroids since. Hip replacements age 23 & 32, 2 knees together at 36 & wrist/hand ops. Currently Methotrexate, Prednisolone, Rofecoxib & Tramadol. Cinnarizine & Stemetil for side effects - balance loss & nausea.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 11-15 years
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Interview 33
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She wishes that she had done more exercises because she has lost some movement in her shoulder.
Juvenile chronic arthritis diagnosed 1990. Initially NSAIDs, then methotrexate but nausea & then oral steroids from age 15. Finger tendon repair & hip replacement (01) Currently Anti-TNF Humira injected 2/month, indometacin, co-codamol & Lansoprazole.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 16-20 years
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Interview 25
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Finds that swimming helps control her weight.
Juvenile chronic arthritis diagnosed '85, on steroids since. Hip replacements age 23 & 32, 2 knees together at 36 & wrist/hand ops. Currently Methotrexate, Prednisolone, Rofecoxib & Tramadol. Cinnarizine & Stemetil for side effects - balance loss & nausea.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 13
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He tries to keep mobile by moving around the office and by gardening.
Diagnosed '78 after various joint pains. Knee synovectomy age 18; then 8 years quite symptom free; since RA in many joints. Some steroid pulses/joint injections. Now Gold injected 50mg/month, Meloxicam 15mg/day & Coproxamol if required. Thumb fusion operation.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 11-15 years
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Interview 33
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Talks about the benifits of Tai Chi.
Juvenile chronic arthritis diagnosed 1990. Initially NSAIDs, then methotrexate but nausea & then oral steroids from age 15. Finger tendon repair & hip replacement (01) Currently Anti-TNF Humira injected 2/month, indometacin, co-codamol & Lansoprazole.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 11-15 years
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Interview 29
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She enjoys exercising in a gym and uses a treadmill when she can't walk outside.
RA diagnosed '90 & Juvenile RA age 8-11. Significant DMARD side-effects. Had breast cancer '98 & drugs also relieved RA. Methotrexate 15mg/week, folic acid 5mg 6/7 days, daily Diclofenac, Tamoxifen 20mg & Nibedipine 20mg. Paracetemol & Zantac as required.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Interview 28
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Her daily routine includes stretching and gentle exercises morning and evening.
RA Diagnosed June 2002. Also has osteoporosis, OA & thyroid problem. Methotrexate 12.5mg/week & folic acid 5mg/week, Prednisolone 7.5mg/daily, paracetemol daily, Ranitidine 150mg/day (indigestion), lactulose & Thyroxine 150mg/day, Fossamax 70mg/week.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Interview 07
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Swimming has helped her physically and she enjoys the social side too.
RA diagnosed 1998 after months of wrist pain and early morning stiffness. Initial steroid injections. Currently: Methotrexate 7.5mg /week & folic acid 5mg/day, Hydroxychloroquine 400mg/day and Ibuprofen as necessary. Exercise helps so swims 5 days a week.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 04
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Swimming helps her physically and psychologically and she enjoys special sessions in a hydro pool two or three times a week.
Diagnosed '79 with rapid onset after glandular fever. Various foot surgery undergone and hand surgery planned. Symptom relief from physio/ hydrotherapy & some complementary therapies/diets. Currently Coproxamol, Methotrexate, folic acid & occasional NSAID.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 26 years plus
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Interview 22
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She used to enjoy going to the gym but had to stop because her joints were suffering.
Diagnosed 1964 Juvenile Chronic Arthritis. 11 years of steroids limited growth. NSAIDs 'til age 37. Now Methotrexate 10mg/wk + folic acid, daily Prednisolone 5mg, Naproxin 100mg, Niozadadine (anti-ulcer) & iron. 2 hips replaced age 26 & 2 knees, age 30.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 19
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She can't play sport, dance or go for walks, all activities she misses.
Diagnosed 1980. Early treatment NSAID, pain killer and steroids. 9 operations e.g. joint replacement, neck fusion. Various DMARDS. Currently on Anti-TNF Infliximab/7 weeks. Methotrexate weekly, Prednisolone, Rofecoxib, hydroxychloriquine daily.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Interview 35
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He belongs to the Ramblers' Association and his doctor says he can still walk as long as he doesn't 'overdo it'.
Polymyalgia Rheumatica diagnosed 2000 and various doses of oral steroids taken for 2 years. Swollen hand prompted visit to Rheumatologist Dec 2003 when RA diagnosis made. Depomedrone injection given and once since. Currently only on Fossamax (calcium).
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Interview 12
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He sets himself goals each day because he doesn't want to become a 'lifeless lump'.
Diagnosed mid-2000 after rapid onset. Side-effects from sulphasalazine with hydroxychloriquine. Currently Methotrexate, NSAID, Losec, Celeximab and Paracetemol. Some steroid pulses and planned knee replacement.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Charlotte - Interview 55
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She was diagnosed a few months ago and would welcome clear advice about diet and lifestyle.
Charlotte was diagnosed with rheumatoid arthritis in July 2007. The first time she saw her consultant was as a private patient because on the NHS there was a waiting period of three months. She is on Methotrexate. She feels more tired than before her diagnosis.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 05
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Thinks that some physiotherapists don't understand how much pain some of their exercises can cause.
RA diagnosed as significant symptoms after birth of 2nd child. Complementary treatments used. Takes Diclofenac 15mg & 2 Coproxamol daily. 10 operations: hips, knees & shoulder replacement/revision; neck, ankle & toe fusions, and removal of bone in 1 elbow.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 04
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Has learnt that physiotherapy and hydrotherapy help greatly to keep joints moving.
Diagnosed '79 with rapid onset after glandular fever. Various foot surgery undergone and hand surgery planned. Symptom relief from physio/ hydrotherapy & some complementary therapies/diets. Currently Coproxamol, Methotrexate, folic acid & occasional NSAID.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Interview 12
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Continues to do the physiotherapist's exercises and finds playing the organ also helps keep his fingers flexible.
Diagnosed mid-2000 after rapid onset. Side-effects from sulphasalazine with hydroxychloriquine. Currently Methotrexate, NSAID, Losec, Celeximab and Paracetemol. Some steroid pulses and planned knee replacement.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Interview 24
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Does gentle exercises in a session specifically for people with disabilities.
Diagnosed April 1997 after sudden onset of symptoms and admission to hospital. RA widespread leading to initial depression. Side-effects from Methotrexate so now taking Leflunomide 20mg/day, Rofecoxib 12.5mg/ alternate days and pain killers as required.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 6-10 years
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Interview 31
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Recovered well with physio after two elbow replacements and is very happy with the movement she now has.
Diagnosed '93 after quick onset. Side-effects from various DMARDs. Currently on Enbrel (anti TNFa) twice a week, Brufen retard 2400mg/day, Prednisolone 7.5mg/day and Paracetemol as required. Both elbows replaced (2002) and knee washout operation.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 0-5 years
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Interview 39
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Describes the hydrotherapy exercises she did.
Diagnosed for 9 months but symptoms for 4/5 years. Current treatments Sulphasalazine,voltarol, thyroxine, ventolin, coproxamol. Diclofenac twice daily.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 26 years plus
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Interview 16
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Intensive physiotherapy on her hand after surgery really helped.
Diagnosed 1977 after shoulder pains. Diclofenac retard 100mg/day, Methotrexate 15mg/week & 5mg/day folic acid. Partial wrist & 2 finger joints replaced, thumb tendon repairs, 6 toe joint operations, ankle fusion & a back operation (not due to RA).
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 36
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Loved hydrotherapy - it kept her mobile and warm water relaxes stiff joints.
Diagnosed 1979 as a young child. Currently on Methotrexate 10mg & folic acid, tramadol 100mg 2/day, solpadol 7/day. 2 hips and 2 knees replaced under spinal anaesthetic in succession over 2 years. Broken femur complication of last knee operation.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 16-20 years
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Interview 25
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She has lost the range of movement in her neck and regrets not keeping up her neck exercises.
Juvenile chronic arthritis diagnosed '85, on steroids since. Hip replacements age 23 & 32, 2 knees together at 36 & wrist/hand ops. Currently Methotrexate, Prednisolone, Rofecoxib & Tramadol. Cinnarizine & Stemetil for side effects - balance loss & nausea.
Bones & joints
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Rheumatoid Arthritis
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Disease duration 21-25 years
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Interview 36
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She established exercise routines after hip and knee surgery.
Diagnosed 1979 as a young child. Currently on Methotrexate 10mg & folic acid, tramadol 100mg 2/day, solpadol 7/day. 2 hips and 2 knees replaced under spinal anaesthetic in succession over 2 years. Broken femur complication of last knee operation.
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