Full list of topics

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

Michelle is currently on anti-TNF treatment: Humira. She has taken Methotrexate for a number of years but has had breaks in between following a biopsy that revealed liver scarring. Michelle was diagnosed with osteopenia (a milder form of osteoporosis) in her spine and needs to take calcium tablets regularly.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 23 >> Explains feelings towards her joint operation, not wanting to know details and seeing it as a positive step.

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 >> Rheumatoid Arthritis >> Disease duration 26 years plus >> Interview 16 >> 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 >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 14 >> Had her ankle operation under spinal block because she doesn't like general anaesthetics nor too much sympathy.

Diagnosed '84 as sore fingers; main symptoms age 30+ & began DMARDs. Now Methotrexate 15mg/wk & daily folic acid, Meloxicam 15mg, Prednisolone 2.5mg, 6 Co-codamol & Lansoprazole. Operations; toe '90; wrist & finger fusions; 2 ankle replacements '01/03.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 25 >> Synovectomy of the fingers was painful and did not improve her grip.

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 >> Rheumatoid Arthritis >> Disease duration 26 years plus >> Interview 22 >> Describes the improvement immediately after her knee replacement operation.

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 >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 23 >> Successfully chose to do strengthening exercises instead of having joint surgery.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Pat - Interview 59 >> Pat was diagnosed in 1982 at the age of 25 and talks about the many operations she has had since then.

Pat was diagnosed with rheumatoid arthritis aged 25 but it took almost three years and a progressive deterioration of her symptoms for her to get an appropriate treatment. Her disease has remained active and to date she has had ten operations and four implants. Pat participated in a clinical trial for a newer drug called Golimumab (Simponi) but the therapy failed to improve or control her rheumatoid arthritis. She is due to start another biological therapy; Rituximab.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 23 >> Explains feelings towards her joint operation, not wanting to know details and seeing it as a positive step.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 19 >> Feels surgeons could explain more and patients should ask questions about the planned operation.

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 >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 05 >> Was very glad to have moved from a private room to an NHS ward after her hip operation.

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 >> Rheumatoid Arthritis >> Disease duration 26 years plus >> Interview 17 >> Was shocked at how many operations the surgeon thought she needed and wished the wait were shorter.

Diagnosed 1970. After early years, had 15 yrs when relatively well on NSAIDs. Flared up 99/00. Methotrexate 25mg/wk, daily Rofecoxib 25mg, Tramadol 200mg, anti-depressants & HRT. Awaiting 1 hip & 2 elbow replacements, wrist & finger straightening surgery.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 26 years plus >> Interview 22 >> Didn't like her scars and ate lots of Vitamin C rich fruit to heal them.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 25 >> Has used silicone gel on her scars to reduce the redness and swelling.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 03 >> Describes her shoulder problems, how she had them replaced with a 'wonderful' result.

RA diagnosed '86. For 10 years chose NSAIDs/pain killers and complementary therapies. DMARD treatments started 1996 (various). 2 replacement shoulders 2000. Started Infliximab 9/02. Less pain/tiredness but pre-existing damage means hip replacement '04.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 6-10 years >> Interview 31 >> 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 >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 11 >> Had two carpal tunnel operations and a wrist bone removed to reduce tingling and pain and increase finger flexibility.

RA diagnosed after months of knee and elbow pain and reduced mobility. Many joint injections. Took steroids & Penacillamine for 10 years but chose to stop. Now Co-odamol 4/day and blood pressure drugs. 2 Carpal tunnel operations & wrist bone removal.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 26 years plus >> Interview 16 >> Had both partial wrist replacements together and although it was very restricting for 3 months she felt it was worth it.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 23 >> Decided against having her wrist fused as she wants to keep the residual movement she now has despite the pain.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 13 >> The fusion of his thumb gave him a stable and stronger grip.

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 >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 03 >> Recovery after hand surgery took longer than she expected.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 05 >> Describes her neck problems, how the thought of a neck operation was frightening but that it was very successful.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 19 >> Describes her two neck operations and having anti-TNF treatment to assist the bone graft.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 36 >> Waited several years for hip and knee replacements. Waiting led to increasing disability and her life went on hold.

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 >> Rheumatoid Arthritis >> Disease duration 26 years plus >> Interview 22 >> Was given good advice before her hip replacement that she should not compare her recovery time to patients with osteoarthritis.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 11-15 years >> Interview 33 >> Returning home after her hip operation was challenging and she had to get used to being independent again.

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 >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 25 >> Recovered quickly from her bilateral knee replacement surgery by exercising regularly and feels she now has more energy.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 36 >> Her fourth joint replacement was complicated by a broken femur, so recovery took much longer.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 14 >> Dislocated her ankle and consequently had pinning and replacement surgery in that and her other ankle.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 05 >> Would have liked the surgeon to tell her how her ankle would feel after the plaster was removed.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 6-10 years >> Interview 30 >> Describes a toe and ankle fusion operation and how the pain is now more like mild toothache than a raging fever.

Diagnosed '95 after severe ankle pain (maybe virus triggered). Subject in Anti-TNF trial. Pneumonia due to RA. Regular steroid injections prior to ankle fusion. Methotrexate/folic acid, Celebrex, Tramadol, Diazapan, Tomazapan, Prozac, Atenolol, Dothiepin.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 04 >> After several operations on her feet, which she was inadequately informed about, she still has pain and needs further surgery.

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.