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

Polyarthralgia 1983 & '90. RA diagnosed '91 after knee pain & general decrease in mobility. Side-effects from Gold injections & some NSAIDs; knee injections helped. Now Methotrexate10mg/wk (+folic acid) & Ibuprofen 1/day & pain killers. Sjogren's syndrome.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 23 >> Is frustrated when physiotherapy referrals specify one joint when the pain may be referred from nearby joints.

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 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 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.

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 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 16-20 years >> Interview 25 >> 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 >> 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.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 11-15 years >> Interview 33 >> 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 >> Rheumatoid Arthritis >> Disease duration 6-10 years >> Interview 32 >> She used disassociation to help control the pain.

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 >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 04 >> Swimming helps her physically and psychologically and she enjoys special sessions in a hydro pool two or three times a week.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 13 >> Pain can make him depressed and 'grumpy' at times, which can affect relationships with other people.

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 0-5 years >> Interview 24 >> She thinks that she couldn't have a sexual relationship and thinks that RA 'killed' that part of her.

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 >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 19 >> Staying positive and planning something nice to look forward to, such as a weekend away, helps take her mind off the pain.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 11-15 years >> Interview 10 >> He had flares every day.

RA diagnosed after wrist problems & then overall disability. Some joint injections. RA medication: Gold 20mg/month, Diclofenac & Solpadol daily, Movelat (NSAID gel), Zopiclone (Sleep). Other drugs for ulcer, blood pressure, Emphysema, stroke and migraine.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 11-15 years >> Interview 06 >> She has experienced severe flares which start quickly and are very disabling.

RA began with stiff neck and initial severe flare lasting months; 11 yrs - no further symptoms; then 2 acute flares in 2 years. Steroid injections helped. Currently on Methotrexate 10mg /week & daily hydroxychloroquine 400mg, Ranitidine 300mg & folic acid.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 11-15 years >> Interview 33 >> Health workers need to be gentle and to allow plenty of time for the consultation.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 05 >> Her flare ups often come on over night, are very painful, restrict mobility and she has to rest.

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.

Ongoing symptoms - pain, joint problems, fatigue, depression and weight changes

Bones & joints >> Rheumatoid Arthritis >> Disease duration 6-10 years >> Interview 30 >> He developed severe symptoms quite suddenly, with excruciating pain in one ankle.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 6-10 years >> Interview 26 >> It began suddenly with a swollen ankle, pain in his knees and wrists, and aching all over as though he had flu.

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 >> Rheumatoid Arthritis >> Disease duration 11-15 years >> Interview 29 >> Before RA was diagnosed she found it hard to walk down stairs as her feet hurt and she had stiff hands on waking.

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 >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Interview 12 >> The symptoms of RA developed quite suddenly, with excruciating pain in his left arm and right hand.

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 >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Interview 35 >> Thought his symptoms were rheumatism but did not visit a GP for 2 months which in hindsight was too long to put up with the pain.

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 >> Rheumatoid Arthritis >> Disease duration 26 years plus >> Interview 22 >> Aged two she had painful joints, developed a rash and high fever. Juvenile Chronic Arthritis was diagnosed.

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 15 >> Avoids taking painkillers if possible but needs them sometimes to help her sleep.

Diagnosed '85 after 2 hospital stays for groin pain; decreased mobility & sleep disruption. Side-effects on Gold injections & Methotrexate. Has steroid pulses/joint injections & daily Meloxicam 7.5mg & 2-4 co-codamol. Starts Anti-TNF in 2 wks. Operation on toes planned.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 25 >> An education course taught her to take painkillers at regular intervals.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 04 >> Describes intense pain - counted the hours between taking the pain killers.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 13 >> Has learnt to take painkillers before doing something strenuous to counteract the pain before it happens.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 6-10 years >> Interview 26 >> Uses painkillers together with exercise and distraction to overcome pain. Has come to terms with taking them.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 03 >> After being a bit concerned before her first anti-TNF alpha treatment she felt the effects immediately.

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 16-20 years >> Interview 25 >> She has lost the range of movement in her neck and regrets not keeping up her neck exercises.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 05 >> Thinks that some physiotherapists don't understand how much pain some of their exercises can cause.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Interview 39 >> Tries to go without painkillers to test if she needs them for a particular activity but takes more if necessary.

Diagnosed for 9 months but symptoms for 4/5 years. Current treatments Sulphasalazine,voltarol, thyroxine, ventolin, coproxamol. Diclofenac twice daily.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 11-15 years >> Interview 29 >> Mistakenly overdosed on painkillers on holiday by taking them too frequently.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 26 years plus >> Interview 17 >> Previously she had experienced joint flares but then a severe whole body flare 'crept' upon her which she didn't associate with RA.

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 6-10 years >> Interview 09 >> Finds that cold helps relieve the pain of hand and joint flares.

After several months of wrist/hand pains treated with NSAIDs and physiotherapy by GP, RA diagnosis made by private consultant. Mother had RA. Currently RA controlled on Sulfasalazine. Has returned to being active, playing golf, tennis, dog walking etc.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 15 >> Initially the 'pumping' pain she felt made it difficult to sleep for days on end.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 11-15 years >> Interview 02 >> Describes some of the pain she has experienced with her RA and how sometimes you need to go through the pain barrier.

Polymyalgia/palindromic arthritis episodes '88-92, RA diagnosed '94 & OA. Daily Voltarol 75mg, Defalzacort 6mg, pain killers & Methotrexate 25mg/wk (folic acid 5/7 days). Some steroid pulses. 2 hips, 2 knees replaced due to OA & shoulder operation proposed.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 11-15 years >> Interview 33 >> Her energy level has increased since taking anti-TNF alpha medication.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Interview 12 >> Being in pain and generally feeling unwell with the RA made him feel depressed but taking a short term anti-depressant helped.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 26 years plus >> Interview 27 >> Breastfed both her children for a time before needing to take medication again for her RA symptoms.

RA diagnosed 1975 after stiff fingers. Elbow replacement '91 and 2 toe operations. Currently Methotrexate 10mg/week & folic acid 6/7 days, daily Cyclosporin 150mg, Diclofenac 100mg suppository, co-codamol as required and Losarlyn 100mg (blood pressure).

Bones & joints >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Interview 48 >> His partner's pain had interrupted their sex life, which was frustrating for both of them.

Partner was diagnosed with RA at 25 has had the disease 5 years.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 11-15 years >> Interview 46 >> Gives practical and emotional support but finds it distressing to see his wife in pain.

Partner was diagnosed with RA at 58 has had the disease for 11 years.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 25 >> Has tried to reduce the strength of painkillers.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 6-10 years >> Tara - Interview 53 >> Talks about medication before and during her second pregnancy and managing pain without drugs.

Following her diagnosis Tara was put on Methotrexate and this controlled her illness very well. She came off Methotrexate after deciding to have a second child. She describes her antenatal care as 'excellent' and felt safe and reassured. She is currently on anti-TNF treatment: Humira.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 6-10 years >> Tara - Interview 53 >> Weeks after her first child was born Tara began to experience severe pain and joint inflammation and, initially her GP gave her Ibuprofen. She says th

Bones & joints >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Janet - Interview 56 >> Janet was diagnosed in late 2006 and her illness has affected the type of work she can do. Sometimes feels depress by the limitations impose by RA on

Diagnosed in 2006. Janet takes Methotrexate 15 mg but experiences severe sickness and nausea. She will start taking Methotrexate in injection form and hopes this will reduce its side effects. She also takes: Tramadol with paracetamol; folic acid and amitriptyline at night when needed.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Charlotte - Interview 55 >> After her diagnosis her employers and family have each helped her in different ways to manage her working life.

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 >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Charlotte - Interview 55 >> Her previous school allowed her to arrive late on those days when she had free periods in the morning. Her new school has asked if there is anything t

Bones & joints >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Emma - Interview 61 >> Emma finds it too painful to inject herself so a colleague at the hospital does the Cimzia injection for her.

In 2008, aged 21 Emma was diagnosed with rheumatoid arthritis (RA). Currently, she is on a combination therapy that includes Sulfasalazine, Methotrexate and Naproxen as a painkiller and a new biological drug called Cimzia (certolizumab pegol). The plan is to eventually reduce her RA medication to Methotraxate and Cimzia only.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Interview 01 >> Describes the tiredness, pain and swelling of a long term flare.

Psoriatic arthritis diagnosed at 15 then RA at 25 ('99) but delayed as negative blood tests. Initial treatments DMARDs and steroid pulses. Currently steroid tablets, NSAIDs, Methotrexate injected weekly & Anti-TNF Infliximab infusions began 2 months ago.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 05 >> Her flare ups often come on over night, are very painful, restrict mobility and she has to rest.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 6-10 years >> Interview 26 >> Uses painkillers together with exercise and distraction to overcome pain. Has come to terms with taking them.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 13 >> Has learnt to take painkillers before doing something strenuous to counteract the pain before it happens.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 21-25 years >> Interview 04 >> Describes intense pain - counted the hours between taking the pain killers.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 25 >> An education course taught her to take painkillers at regular intervals.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 15 >> Avoids taking painkillers if possible but needs them sometimes to help her sleep.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Interview 01 >> Describes the tiredness, pain and swelling of a long term flare.

Bones & joints >> Rheumatoid Arthritis >> Painkillers >> Painkillers

Painkillers

Bones & joints >> Rheumatoid Arthritis >> Disease duration 16-20 years >> Interview 25 >> Has tried to reduce the strength of painkillers.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 6-10 years >> Interview 31 >> Talks about medication in pregnancy and the worry of conceiving whilst taking penicillamine.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 11-15 years >> Interview 29 >> Mistakenly overdosed on painkillers on holiday by taking them too frequently.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Interview 39 >> Tries to go without painkillers to test if she needs them for a particular activity but takes more if necessary.

Diagnosed for 9 months but symptoms for 4/5 years. Current treatments Sulphasalazine,voltarol, thyroxine, ventolin, coproxamol. Diclofenac twice daily.

Bones & joints >> Rheumatoid Arthritis >> Disease duration 0-5 years >> Interview 01 >> Infliximab enabled her to reduce the other medication.

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