Q: I was recently diagnosed with arthritis by my family doctor, who prescribed an NSAID for me. I have heard that there are all kinds of new arthritis treatments, including something called biologics. Do you think NSAIDs are enough to help me?
A: I wonder if your doctor told you which form of arthritis you have. Although we casually use the term arthritis to refer to one of many different conditions, arthritis (literally meaning "joint inflammation") is really more a symptom than a disease itself.
Joint involvement can occur in more than 100 different diseases, including osteoarthritis (OA), rheumatoid arthritis (RA), lupus, ankylosing spondylitis and gout, just to name a few. Treatment depends on the form of arthritis or related disease, and the sooner you discover which form you have and begin appropriate treatment, the better you will do in the long run.
The drug your doctor prescribed is just one of many of a class called nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs work by limiting the body's production of hormone-like substances called prostaglandins, which are involved in causing inflammation (which, over time, can lead to joint destruction) and pain.
For many arthritis-related diseases NSAIDs provide some symptomatic relief and therefore can be an important part of a treatment plan. But for many types of arthritis, NSAIDs should not be the sole medical treatment. Some doctors, unfortunately, don't realize this.
If you have RA, for example, you will benefit from more powerful drugs early on. Not too many years ago, most doctors – even those highly experienced in treating arthritis – used NSAIDs as the first line of treatment against RA. They might have used a number of different NSAIDs over several years. When it became obvious that the disease was progressing and causing joint damage, the doctor would then start a disease-modifying drug such as gold.
Now we know that most of the joint damage of RA occurs within the first two to three years. So it's important to control the inflammation affecting the joints before they are damaged. NSAIDs won't do that.
Has anyone else experienced these symptoms?
The main thing with the RA and OA that I am dealing with is trying to have a positive attitude. We cannot let this bring us down. When I look beyond my own situation I see so many people in worse situations so we all need to be bigger than the problem. I was diagnosed about 4 years ago at the Mayo with both RA and OA. My local Doctors couldn't determine what was wrong with me because the sed rate test always came back neg for RA.
After much pain, not being able to walk, 2 trips to the ER I was sent to the Mayo and finally diagnosed with both RA and OA. I am currently on 8 methotrexiates per week, 400 plaquinal per day, and cymbalta. I was on prednizone as well until about a month ago when I finally got off it. I live in Minnesota so unfortunately the cold weather seems to be a bother for me so I think I need to go south for the winters.
God bless all of you and keep a positive attitude!
Annette
RA is my problem,I decided that if I would not recommend my Doctor to family or friends, then I am going to the wrong Doctor.
It was too late for me for any surgeries, did the physical therapy, did the tens unit blah blah. Finally I was referred to a pain management/spine specialist. He tried me on a few things (tens unit, celebrex etc). But like Maureen, he is very compassionate. He prescribed Kadian. I've been on it for a year now and boy has my life never been better. I also have Fiborymaglia and with Kadian and the Lyrica, they both work hand in hand and really help me with all of my pain. If I miss one or the other or both I feel it and pay the price. So yes, like Maureen said, talk to your doctor and hopefully you all will find a compassionate doctor that actually cares. Mine wants me off all drugs if possible. I am looking into doing that spinal stimulator, I did the trial period and it worked out great, but what is holding me back now is the possibility of having MS. So ask your doctor about Kadian. It really helps me.
Hip replacement is out of the question at this point, as well as I am uninsured and am "uninsurable" due to the RA. Thank goodness for the drug study which gives me a doctor and the Orencia. For those with the same issue, you might want to look into these studies.
At the time of diagnoses I was 30 years old and the doctors felt I was too young for a hip replacement. It appears as though it is moving throughout my body. Do you think that it's time for me to try to fix the hip before everything else gets worse?
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