Finding the best treatment for a chronic health condition is hardly ever a simple process—and rheumatoid arthritis is no different. After all, people’s symptoms can vary wildly in severity, so finding the right medication for you can take some time and a bit of experimentation.That’s because it can take several weeks for your rheumatoid arthritis medication to kick in, so you might not always know if it’s helping right away (if only!). Plus, some drugs may work for a while and then stop, prompting a relapse in symptoms. After a certain point, you may realize that your current treatment plan just isn’t doing it for you, and that’s pretty normal.But how can you tell when you’ve reached that point? The answer looks a little different for everyone, so we asked five people with rheumatoid arthritis when they knew it was time to switch things up. They’ve been there, done that, and their stories show that listening to your body, being honest with your doctor (and yourself), and being open to trying new approaches can literally be life-changing.1. Your symptoms start resurfacing gradually.Ashley Nicole, 38, was diagnosed with rheumatoid arthritis in 2010. “My hands were extremely painful due to inflammation, swelling, and stiffness,” she tells SELF. “I also had limited mobility in my wrists.”The personal trainer and founder of RA Warrior Fitness relies on her joints to support her during work, so she can demonstrate exercises to clients. Nicole’s rheumatologist originally started her on a biologic medication, which targets the part of the immune system involved with causing rheumatoid arthritis. It helped—but only for a while. “It gave me relief from joint pain, but it gradually stopped working after about a year,” she recalls.Eventually, Nicole once again started dealing with joint pain in her hands and wrists, which got worse over time. So she visited her rheumatologist to get to the bottom of it. “I’m blessed to have an amazing rheumatologist,” Nicole says. “I talked to her about how I was feeling and wanted to try something new and she agreed.”Nicole tried several different medications after that because nothing worked fully. Finally, she tried the different biologic that she’s currently using, which has helped reduce her pain for the past four years. “It works like a charm,” Nicole says. “I have occasional discomfort, especially when the weather changes, but I’d rate most days a 2.5 or 3 out of 10 on a pain scale, with 10 being a huge, painful flare,” Nicole says. “I have my RA under control now. It’s a wonderful feeling.”2. Or your symptoms come back really suddenly.Kelly Rouba-Boyd was just two years old when she was diagnosed with rheumatoid arthritis in 1982. “Normally, I was a really good toddler and my mom became concerned because I was rather fussy and had a fever. A little later on, I was limping,” the now-41-year-old tells SELF.Rouba-Boyd’s pediatrician immediately suspected she had arthritis due to these symptoms, and she received an official diagnosis not long after. Initially, Rouba-Boyd was treated with baby aspirin. “At that point in time, they didn’t have much to treat children with rheumatoid arthritis,” she explains. “But that did not do much to stop the progression of the disease.”
Answer From April Chang-Miller, M.D.Although rheumatoid arthritis primarily affects joints, it sometimes also causes lung disease. Occasionally, lung problems surface before the joint inflammation and pain of rheumatoid arthritis.Men in their 50s and 60s who have more-active rheumatoid arthritis and a history of smoking are more likely to develop rheumatoid arthritis-related lung disease.The lung problems most often linked to rheumatoid arthritis include:Scarring within the lungs. Scarring related to long-term inflammation (interstitial lung disease) may cause shortness of breath, a chronic dry cough, fatigue, weakness and loss of appetite.Lung nodules. Small lumps can form in the lungs (rheumatoid nodules), as well as in other parts of the body. Lung nodules usually cause no signs or symptoms, and they don’t pose a risk of lung cancer. In some cases, however, a nodule can rupture and cause a collapsed lung.Pleural disease. The tissue surrounding the lungs, known as the pleura (PLOOR-uh), can become inflamed. Pleural inflammation is often accompanied by a buildup of fluid between two layers of the pleura (pleural effusion). Sometimes the fluid resolves on its own. A large pleural effusion, however, can cause shortness of breath. Pleural disease may also cause a fever and pain on breathing.Small airway obstruction. The walls of the lungs’ small airways can become thickened because of chronic inflammation and infection (bronchiectasis) or inflamed or injured (bronchiolitis). This may cause mucus to build up in the lungs, as well as shortness of breath, a chronic dry cough, fatigue and weakness.Contact your doctor promptly if you have rheumatoid arthritis and experience any unexplained breathing problems. Sometimes treatment is aimed at the rheumatoid arthritis. In other cases, treatment involves medication to suppress the immune system or a procedure to remove fluid surrounding the lungs.Updated: 11/26/2020Publication Date: 2/7/2013
Arthritis is a leading cause of pain and disability worldwide. You can find plenty of advice about easing the pain of arthritis and other conditions with exercise, medication and stress reduction. How do you know what will work for you?Here are some do’s and don’ts to help you figure it out.BasicsWhatever your condition, it will be easier to stay ahead of your pain if you:Learn all you can about your condition, including what type of arthritis you have and whether any of your joints are already damagedEnlist your doctor, friends, and family in managing your painTell your doctor if your pain changesEveryday routinesPay attention to your joints, whether sitting, standing or engaging in activity.Keep your joints moving. Do daily, gentle stretches that move your joints through their full range of motion.Use good posture. A physical therapist can show you how to sit, stand, and move correctly.Know your limits. Balance activity and rest, and don’t overdo.In addition, lifestyle changes are important for easing pain.Manage weight. Being overweight can increase complications of arthritis and contribute to arthritis pain. Making incremental, permanent lifestyle changes resulting in gradual weight loss is often the most effective method of weight management.Quit smoking. Smoking causes stress on connective tissues, which can increase arthritis pain.ExerciseWhen you have arthritis, movement can decrease your pain and stiffness, improve your range of motion, strengthen your muscles, and increase your endurance.What to doChoose the right kinds of activities—those that build the muscles around your joints but don’t damage the joints themselves. A physical or occupational therapist can help you develop an exercise program that’s right for you.Focus on stretching, range-of-motion exercises and gradual progressive strength training. Include low-impact aerobic exercise, such as walking, cycling, or water exercises, to improve your mood and help control your weight.What to avoidAvoid activities that involve high-impact and repetitive motion, such as:RunningJumpingTennisHigh-impact aerobicsRepeating the same movement, such as a tennis serve, again and againMedicationsMany types of medications are available for arthritis pain relief. Most are relatively safe, but no medication is completely free of side effects. Talk with your doctor to formulate a medication plan for your specific pain symptoms.What to doOver-the-counter pain medications, such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) can help relieve occasional pain triggered by activity your muscles and joints aren’t used to—such as gardening after a winter indoors.
One of the most frustrating parts of being diagnosed with rheumatoid arthritis is realizing that there isn’t one medication that can instantly relieve your symptoms. Instead, you may need to try different medications for a few months at a time until you find one that makes a big difference for you. Sometimes, a certain medication may work for a while and then fail—so the process of finding a treatment that works starts all over again.This trial-and-error is mentally and physically exhausting, especially because you’re already dealing with a chronic condition that can cause debilitating symptoms like joint swelling, stiffness, and pain. But you shouldn’t give up trying. There are so many medications available to treat rheumatoid arthritis, which means if one doesn’t work for you, you still have options.Many people have success with biologics, a class of different medications that attack various elements of your immune system involved in rheumatoid arthritis. When you find a type of biologic that works, it can really change how you feel in your body. (Keep in mind that your treatment options may change over time based on new research and newly available therapies. Make sure you have ongoing conversations with your doctor about which treatment options may be best for you.) To help you understand how this journey looks different for everyone, SELF spoke to five people with rheumatoid arthritis who had a winding road to the best treatment for them—and how it gave them their lives back.1. “I had this feeling like there was hope.”Lisa Copen, 53, was diagnosed with rheumatoid arthritis in 1993. Over a period of three weeks, her feet, ankles, knees, and wrists became so sore and stiff that she could barely open a door and could no longer work the stick shift in her car.By 2000, Copen had tried nonsteroidal anti-inflammatory drugs (NSAIDs)1 in addition to disease modifying anti-rheumatic drugs (DMARDs), which target the immune system to control the inflammation. But nothing helped. As a result, she had significant joint damage and needed multiple surgeries to regain her mobility. Later that year, Copen talked to her rheumatologist about trying biologics to treat her condition—and that’s when her life significantly improved. After she made the switch, she no longer felt limited by chronic pain.In 2003, Copen and her husband adopted their son, and just being able to throw a ball with him has been so rewarding. “It’s significant when you do something that’s very normal, and you realize five minutes into it that you’re able to do it,” Copen tells SELF. It was while walking around a mall with her husband, just before adopting their son, that this really sunk in. “I was walking along, and not really thinking about my pain. I had this feeling like there was hope.”Although she still struggles to do certain things—like walk for long periods of time—Copen is happy with how far she’s come since her diagnosis. “We can celebrate our little wins, whatever they are,” she says.2. “I’m no longer the mom who cries all the time.”Stacy Courtnay, 43, has been in remission for the last 10 years, but finding the right medication took some time. Courtnay was diagnosed with rheumatoid arthritis in 2003 when she was almost 25. By then, the stiffness and pain she started noticing in her feet about a year earlier had spread to her shoulders and wrists. “I couldn’t even squeeze the toothpaste,” Courtnay tells SELF.