Frequently Asked Questions to rheumatologist

What is rheumatology?

Rheumatology is an area of medicine dedicated to treating joint pain diseases. This includes disorders of the bone, joint, muscles and the immune system. Examples include osteoarthritis, rheumatoid arthritis, osteoporosis, lupus and gout. Additionally, rheumatology encompasses individual areas of pain including bursitis and tendonitis.

What services are offered in our clinic?

Diseases that we treat in our clinic are Rheumatoid Arthritis, Polymyalgia Rheumatica, Sjögren’s Syndrome, Inflammatory Muscle Diseases, Recurrent Blood Clots, Psoriatic Arthritis, Vasculitis, Fibromyalgia, Osteoporosis, Lupus (SLE), Antiphospholipid Antibody Syndrome, Osteoarthritis, Raynaud’s, Paget’s disease, Scleroderma, Positive ANA, Ankylosing Spondylitis, Gout/Pseudogout, Back Pain, and cases of recurrent Uveitis.

What is the difference between osteoporosis and osteoarthritis (OA)?

Osteoporosis is a condition in which the bones lose mass and become more porous, resulting in brittle bones that are more prone to fracture. We all reach our peak bone mass around age 35. From that time, our bones start getting thinner. Since estrogen helps to maintain bone thickness, the drop in estrogen level during menopause causes the bone loss to increase. Calcium, Vitamin D, exercise, hormone replacement therapy and certain medications can help slow bone loss.

 

Osteoarthritis is the wearing down of cartilage in the joint. The body responds by creating new bone but not necessarily in the correct position. This new growth may make some joints appear larger and misshapen and can make the space between the bones smaller. The bones may then rub against one another, interfering with the joint’s normal function.

What is Rheumatoid Arthritis (RA)?

Rheumatoid Arthritis is an autoimmune disease where your immune system causes inflammation in your joints.

Is there something I could have done to prevent RA?

Because we do not fully understand why RA happens, we do not know if anything could prevent it.  We do know there is a genetic predisposition for some patients for RA, meaning it may be 
inherited. We also know smoking increases your risk of developing 
RA, particularly if you have the right genetic makeup.  It’s never too 
late to stop smoking though; even quitting now may decrease the severity of RA and make it easier to treat effectively.

What is the difference between RA and OA?

While RA is an autoimmune disease, osteoarthritis, or OA is often described as a disease of “wear and tear.” In other words, for most people with osteoarthritis, the cartilage in the joints can wear out because of mechanical damage from years of use.  OA is very common; 10% of people will develop OA in their lifetime and that number increases with age.  Common joints in OA are weight bearing joints and the spine.

Is there a cure for RA?

No, there is currently no cure for rheumatoid arthritis.  However, there are a growing number of medications, which have been shown to be very 
effective in treating RA, reducing patient symptoms and slowing bone 
changes.

I recently started some new medication but it isn’t helping yet – how long will it take to start working?

Most disease-modifying medicationstake 8-12 weeks to be effective, particularly if they require a gradual dose increase. Some people do notice an improvement earlier than this, however. Providing you experience no side effects, it is usually worth persevering for at least 3 months before stopping DMARD treatment.

I have an infection and am taking antibiotics – should I stop taking my other medications?

Ordinarily you would not need to stop your disease-modifying treatment whilst taking antibiotics. If you were taking methotrexate, however, we would usually advise you to omit this if you develop an infection, since its immunosuppressive effects may hinder your recovery. You should not take your biologic agent if you are unwell and should notify the rheumatology team if your illness persists for more than a week and/or requires antibiotic treatment.

Should I stop any of my medications before going into hospital for surgery?

Depending upon the reason for your hospital admission, it may be advisable for you to temporarily stop some or all of your treatment. However you should continue to take all prescribed medication unless specifically advised to do otherwise.

What is lupus?

Lupus is a chronic, autoimmune disease that can damage any part of the body (skin, joints, and/or organs inside the body). Chronic means that the signs and symptoms tend to last longer than six weeks and often for many years. In lupus, something goes wrong with your immune system, which is the part of the body that fights off viruses, bacteria, and other germs. Normally our immune system produces proteins called antibodies that protect the body from these invaders. Autoimmune means your immune system cannot tell the difference between these foreign invaders and your body’s healthy tissues. In lupus, your immune system creates autoantibodies, which attack and destroy healthy tissue. These autoantibodies cause inflammation, pain, and damage in various parts of the body.

How can a doctor tell if I have lupus?

Many people have lupus for long time before they find out they have it. If you have symptoms, tell your doctor right away. No single test can tell if a person has lupus. But your doctor can find out if you have lupus in other ways, including:

  • Telling your doctor about your symptoms and other problems you have had can help him or her understand your situation.
  • Tell your doctor if lupus or other autoimmune diseases run in your family.
  • Your doctor will look for rashes and other signs that something is wrong.
  • The antinuclear antibody (ANA) test can show if your immune system is more likely to produce the autoantibodies of lupus. Most people with lupus test positive for ANA. But, a positive ANA does not mean you have lupus.
  • With a biopsy, doctors perform a minor surgery to remove a sample of tissue. The tissue is then looked at under a microscope. Skin and kidney tissue looked at in this way can show signs of an autoimmune disease.

 

What causes fibromyalgia?

The etiology of fibromyalgia is, as yet, not fully understood. In fact, it may turn out to be the case that fibromyalgia has not one, but many different causes. Currently, the suspect causes for the onset of fibromyalgia (unfortunately, none of which are proven) include: sleep disturbances, physical injury, stress, viral infection, allergies, hormonal changes, changes in neurotransmitter levels, dietary deficiencies, bacterial infection, and contamination by environmental pollutants.

What is fibromyalgia sometimes mistaken for?

Fibromyalgia is initially mistaken for several other conditions, including lupus, depression and rheumatoid arthritis to name just a few illnesses. Other conditions for which fibromyalgia is occasionally mistaken include digestive disorders, sleep disorders and thyroid problems. Often, it is because the various symptoms of fibromyalgia are so similar to the symptoms of other disorders that many patients do not receive a proper diagnosis for many years.

Will my arthritis medication(s) interact with other medications?

There can sometimes be dangerous interactions between medications. Speak to your doctor or pharmacist about potential problems. Using your medical history and medication plan, they can quickly determine any potentially harmful interactions.

 

Homeopathy is good for arthritis and there are no side effects, is that true?

Even if you were treated with some herbals, chances are you will feel a little better. This is called the placebo effect. Studies have not shown homeopathy to be better than placebo. Homeopathy cannot prevent a person from getting crippled or disabled.

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