Rheumatoid arthritis (RA) is an autoimmune disorder that causes joint pain and injury in the body. The joint injury generally develops on both sides of the body.

Read through the article to know about the various myths and facts regarding this painful condition:


Rheumatoid arthritis is age-related

Unlike osteoarthritis, RA is not due to aging. It’s due to an overactive immune system that causes inflammation and subsequent damage in the joints. It typically affects the younger individuals sometimes even teens in the form of juvenile rheumatoid arthritis. For unknown reasons, the disease is also more commonly seen in females.

RA is familial, can be transmitted to children

Not true. It’s a possibility that some types of arthritis run in the family. We now know that even if you have genes that are associated with RA, you may not develop it. The genes are necessary, but not sufficient, to developing the disorder. Something else has to happen - some kind of environmental trigger, like a virus, for example - for someone to develop RA.

There is no cure for RA. I just have to accept my fate & be a cripple

Absolutely not, especially in today’s era. We have brilliant therapies which work wonders. The new biologic agents have profoundly altered the personality of the illness. With patients seeking earlier treatment and better therapies we no longer see the kind of fulminant RA patients that we used to see before. With timely interventions, disease remission could be expected and irreparable joint damage could be avoided.

The pain in RA is just like OA pain. You just complain too much

RA is a life-changing illness. It can be an extremely frustrating problem to deal with for patients who often go through terrible episodes of pain which doesn’t seem to end unlike a viral illness, crippling joint stiffness and bouts of depression. A fulminant rheumatoid can be worse than cancer if appropriate timely treatment is not initiated. Fortunately, the percentage of severe rheumatoid illness is rare accounting for less than 10% of all RA patients.
Dr. Gavaskar

Patients often benefit from strong support from family and friends. It’s important to understand the problem and help these patients get treated at the earliest.

RA is just about joint

No. RA is a systemic disorder. It can affect the internal organs, although that’s not as common as it was in the past. One of those tissues, that can be inflamed is the eye, resulting in conditions such as scleritis. The inflammation in the joints can, for example, “spillover” to blood vessels (causing premature coronary artery disease or atherosclerosis), it can spread into the bones (causing osteoporosis), and it can even lead to an increased risk of lymphoma.

There are so many treatments for RA. But are they effective?

There are a lot of amazing medications for RA. The illness can be controlled, along with the spillover effect of the inflammation. Joint damage can be avoided and a joint replacement may not be required. Those who are diagnosed and treated early on can, in particular, do quite well.

The efficacy of new medications is outstanding compared to conventional drugs. Traditional anti-rheumatoid medications like antimalarial drugs and methotrexate can still be effective for many people with milder forms of RA. Newer medications like the anti-TNF biologic medications are much better and more effective for a wide range of people.

If I develop RA, I am destined for surgery

Absolutely not. Previously it was around 25% of people with RA who end up in joint replacement surgeries, which was still less than the incidence in OA patients. The incidence of joint replacement in RA is far less now, as low as 5%. This is as a direct result of early diagnosis of aggressive non-surgical treatment with these new medications and, not unimportantly, aiming at an outcome and achieving it.

It is vital to get your inflammation level down to, or close to, zero, and the patient and physician need to work together to make that happen in order to prevent or minimize joint damage. If, however, a joint is damaged to the point that you can’t stand the pain, the disability, or both, you may need to have surgery. But if it’s just inflammation, you may respond to one of these newer medicines, a local steroid, or other means of treatment. There is a lot we can do before you have to resort to surgery.

Physical therapy doesn’t help

Physical therapy has an important role in the treatment of RA. A well-qualified physiotherapist can help you in maintaining joint motion, muscle strength, overcome stiffness and thus maintain overall functionality.

Newer therapies are dangerous

Definitely not. The medicines that we’re now using are to control the immune process. They’re not a cure, because we don’t yet know the cause of RA. So we’re treating the underlying cause of the illness. Sometimes as we suppress the immune system we introduce some unwanted side effects, and there is no medicine that has no side effects. Risk-benefit assessment is the key.

Truths About RA

Rheumatoid arthritis is a systemic disease, and we have to hit it early on, on all fronts.

It also tends to be a chronic illness. However, those with early signs of arthritis who start on medication right away are more likely to go off the medication within a year and will be able to stay off it. There may very well be a “window of opportunity” when it comes to aggressively treat RA early enough. For successful results, there needs to be a close relationship between you, your doctor and the physical therapist. Autoimmunity means that a normal immune system, which is supposed to fight invaders to our system, is instead fighting our normal, healthy tissue, inflaming it as a result. We then have to reset that level of inflammation and immunity.

Inflammation can lead to joint problems and tendon damage. For this reason, RA should be considered a medical emergency. Collateral systemic damage from RA can occur in the form of premature atherosclerosis and osteoporosis. Luckily, we now have medications that work very well, and early, aggressive treatment can profoundly improve the outcome. Along with medical treatment, patients should ensure that their health is otherwise in control by quitting smoking and monitoring their lipid, cholesterol, blood pressure, and weight levels. For damaged joints in patients with RA, joint replacement surgeries offer a brilliant long-term solution.

- Ashok S.Gavaskar, (MBBS, Ms Orth, FACS, Fellow(AAOS, Ao, Sicot), Senior Consultant and Clinical Lead, Orthopaedics, Dr. Rela Institute & medical Center Chennai)