Frequently Asked Questions (FAQs)

 

Will I always have arthritis?

The simple answer is Yes but the outlook is improving all the time as treatments become more effective.

What is the difference between Rheumatoid factor negative and positive?

Rheumatoid factor is an antibody produced by a reaction in the immune system.  Only about half of all people with rheumatoid arthritis have a positive test for rheumatoid arthritis when first diagnosed and some people never develop a positive rheumatoid factor.  People who test positive for both RF and anti-CCP may have more severe rheumatoid arthritis.

What is a DAS 28?

We use a DAS 28 to measure your disease activity.  We count how many tender and swollen joints you  have in your shoulders, elbows and hands (28 joints) and ask questions relating to how you are feeling, we will also do a CRP and all these results will give us a disease activity score. A low DAS can indicate that your disease is well controlled but a high DAS suggests otherwise and we may need to review your treatment plan.

What is a CRP?

C-reactive protein is found in blood plasma and can rise in response to inflammation i.e. when your arthritis is active / bad. A high CRP does not always indicate that you disease is active as there can be other reasons for it to be elevated but it will help us with our assessments.

Why can't I just take steroids (prednisolone)?

Prednisolone is very good at managing the symptoms of arthritis and can also provide some protection to your joints in early diagnosis however it also comes with its own  long term side-effects so disease modifying treatments  are the best long-term treatments as they alter the disease processes and prevent the disease from becoming active and causing long term damage to your joints.

Why do I need to take disease modifying treatments (DMARD's)?

They alter the underlying disease rather than just  treating the symptoms. They slow down the disease and how it affects the joints and cause less inflammation.

Why do some people need to take more than one DMARD?

Research suggests that a combination of disease modifying drugs work better particularly for those with more severe forms of Rheumatoid arthritis, or if your disease is still active when using one disease modifying treatment we sometimes will add another to gain better control.

Will I always need to take medication?

Most people will need to take these medications for many years or possibly life but if your disease is well controlled we may trial a dose reduction or stop altogether.

What do I do if I get side-effects?

Side-effects will often settle down on their own but if they don't you should call the helpline to discuss this further as we may be able to adjust some of your medications to lessen the side-effects.

What if I miss a dose of my medication?

If it is a weekly medication such as methotrexate you should take it when you remember but you will then need to change the day that you take it so there is still 7 days  between doses i.e.  re-set the day you take the medication from then on.  If it is another DMARD you should just take the next dose as planned. You must never stop taking Prednisolone without discussing with us first as it needs to be reduced very slowly. You should always carry the blue steroid card that you will be given when you first start prednisolone.

Can I take other medications?

In general, methotrexate, sulfasalazine and prednisolone can be used in combination with almost any other drug. We will tell your general practitioner (GP) what drugs you use. If you see your dentist, you should let them know what medication you are taking.

Your drug information leaflet for methotrexate may say it cannot be taken with anti-inflammatories, but because the dose of methotrexate you are taking is low, this is not generally a problem.

Certain antibiotics should not be taken when you are also taking methotrexate, so if you are prescribed any antibiotics, always check with your GP or pharmacist. Trimethoprim is an antibiotic commonly prescribed which should never be taken with methotrexate. If you want to take any other medications, such as complementary or herbal medicines, please check with a pharmacist also.

 

What is a flare?

At times your disease can suddenly become more active and you will experience pain, swelling and stiffness. The timing of the flares will vary and it may be over in a few days but can also last a few weeks.

What do I do when I have a flare-up?

You could try taking regular pain killers such as paracetamol or you can take anti-inflammatories such as Ibuprofen (if you are allowed). Heat or cold therapy can help to sooth a swollen joint and resting it in a neutral position can also help but do a little gentle exercise to ease stiffness.  If it doesn't  settle you can see your GP or call our helpline.

Using regular pain killers, heat and ice can sometimes help and sometimes a flare will settle on its own if you rest, but if it doesn't you can see your GP or call our helpline. It will help to do a little gentle exercise to ease stiffness.

How do I manage pain?

Take regular paracetamol and anti-inflammatories if you are allowed, or see your GP for further pain killers. Please the "Staying well" part of our website for more information about alternative methods of pain relief that may help.

Where do I get test results?

Test results that are performed in clinic here will usually be attached to the end of your clinic letter so please wait until it arrives, if there is anything that needs to be actioned urgently we will contact you. Routine blood monitoring is usually done at your GP surgery so you should contact them for any results for tests you have had there.

What happens if my bloods are abnormal?

The GP should follow the instructions on the back of your yellow card which relates to the shared care guidance that we use. Sometimes you will need to temporarily stop your disease modifying treatment until the bloods are within an acceptable range. The GP can call us for further guidance or you can use the helpline for further advice.

What is a DXA?

Both rheumatoid arthritis and steroids can sometimes weaken your bones, so your rheumatologist may decide to check this by sending you for a DXA scan. This scan will show your rheumatologist if they need to prescribe extra medication to limit further bone loss. This scan is a simple, quick, and does not involve any injections.Please see the osteoporosis section within the "Conditions we treat" part of our website for more information.

Why do I feel so tired all the time?

High levels of fatigue (tiredness) are common in people with arthritis and many things can contribute to this such as inflammation, anaemia (often found with inflammation), stress, anxiety, pain, low-mood, sleep disturbance, poor diet and weak muscles. Some drugs can cause drowsiness or loss of concentration and other long term conditions can also cause fatigue. It is important not to overdo things.Please see the "Staying well" section of our website for more advice and helpful links.

When should I call the helpline?

In general, you can call the helpline if you have non-emergency concerns regarding your arthritis, for example:

• Your joints are flaring and you feel unwell
• You have concerns regarding your arthritis medication or are experiencing side-effects
• You have been advised by your GP to call us or have had abnormal blood results in your most recent test