- Types of Arthritis
- Tips for Living Well
- Programs and Services
- Publications and Resources
- Research in Action
- Open Forum Community
- Donate
Browse Questions & Answers
 |
Eighteen years ago, I was diagnosed with lupus erythematosus. My symptoms recently disappeared, but I was just diagnosed with fibromyalgia, which may explain the constant pain I feel in the back of my neck and in my knees, ankles and spine. I have trouble sleeping, even when I take sleeping pills. I want to train to complete a marathon this year. Last year, I only managed to cover half the distance. I tried to relieve my pain with Tylenol, Advil, Motrin, Naprosyn, Toradol and Celebrex, but it didn’t work. Are there other analgesics for fibromyalgia? |
 |
Fibromyalgia does sometimes occur in association with lupus and rheumatoid
arthritis. Treatment requires both drug and non drug therapies. Recommendations include stress and sleep management as well as progressive physical fitness retraining leading to aerobics. Lyrica and Cymbalta are the medications approved by Health Canada, but experience has shown that good results can be obtained with tricyclic agents such as Elavil and other antidepressant drugs as well as muscle relaxants. You should discuss these options with your doctor. |
| Answered on: September 01, 2010 | |
 | |
|
I have rheumatoid arthritis and came across an article on the success of COMET method of treatment. What is this? |
|
Data from the COMET study (COmbination of Methotrexate and ETanercept (Enbrel) in Active Early Rheumatoid Arthritis), has demonstrated the impact of early intervention on a rheumatoid arthritis patient's quality of life, including reducing disability to normal rates in more than half of patients. This first major rheumatoid arthritis trial to use clinical remission as a primary endpoint has highlighted the importance of early intervention to achieve clinical remission. |
| Answered on: August 16, 2010 | |
| |
|
I was diagnosed with psoriatic arthritis in 2008 and have been on Methotrexate and Humira which controlled the inflammation. I got off Methotrexate 6 months prior to getting pregnant and Humira 6 weeks after getting pregnant. I have now been off Humira for 2 months and the inflammation has returned and is near unberable. I have previously received many corticoid injections into the inflamed joints which help for a short time. My arthritis doctor wants me to take prednisone to control the inflammation during my pregnancy but from what I can find of the limited studies that is not recommended. Can you suggest anything that is safe during pregnancy and tell me more about prednisone and the risks. |
|
Most pharmacological agents should be avoided during pregnancy. However, if truly necessary, corticosteroids such as prednisone may be used. Taking into account duration and dosage, monitoring of the mother must be done for the possible occurrence of pre-eclampsia, hypertension and diabetes and of the newborn for possible adrenal insufficiency. Your physician is aware of your condition, he will , of course, evaluate the risk/ benefit ratio in your case and carefully monitor your evolution and that of your child. |
| Answered on: August 09, 2010 | |
| |
|
I am a 31 year-old woman and I have had problems with my left knee for 10 years. The first time my knee swelled up, I had a puncture and it was over. The situation repeated itself three times over the next years. The punctures relieved me completely, and each time I could get back to my normal activities. Four years ago, however, the situation started getting worse, and I am very worried because no one seems to be able to explain my symptoms and condition. Here is what happens: my knee swells up suddenly, and the swelling lasts approximately 7 days. (These flare-ups are debilitating: I can no longer flex my knees, so I need crutches to get around, and I am in constant pain.) After that, the swelling goes down for about 7 days. Then my knee swells up again, and so on. I take NSAIDS, avoid walking too much or doing anything stressful for my knee, but nothing seems to help. Last year, my succession of flare-ups and remissions lasted approximately 4 months, even though I had a puncture and took NSAIDS. What put an end to this flare-up period was taking oral cortisone. During all these flare-ups, I saw orthopaedists and doctors. They performed X-rays, MRIs and punctures (which were analysed and did not reveal any infection). My blood work is negative. I took NSAIDS and had a cortisone injection. I saw a rheumatologist who said that perhaps I have intermittent hydrarthrosis, but didn’t suggest any treatment or explain the long term effects of this condition. I started a new series of flare-ups at the end of March, and I am in my 4th period of swelling. This episode really started without my putting any unusual stress on my knee. I have been taking NSAIDS since the end of March. I am completely discouraged. I had to stop most of my activities, because as soon as I put too much stress on my knee, it flares up again. I am hoping that with your expertise, you can provide me with answers and solutions to recover my quality of life. |
|
I sympathise with you and understand your pain and frustration. However, it is always difficult to answer a patient’s questions via the Internet without having seen the clinical picture, the sero-immunological picture, the synovial fluid test or the X-rays. Obviously, yours is not a simple case since all these people weren’t able to solve it. I suggest you see your rheumatologist again. Given the period of progression
of your condition, perhaps a new blood work and synovial fluid test will provide
an answer. I sincerely hope it does. |
| Answered on: July 30, 2010 | |
| |
|
I have had costo-chondritis for seven weeks and it has not settled down yet. I have been off work the past three weeks due to it. The pain is so bad it is making me feel sick to my stomach. When is cortisone injection used for costo-chondritis? |
|
Steroid injection may be done if an adequate treatment with NDAIDs fails to help the patient. It is a simple procedure. |
| Answered on: July 19, 2010 | |
| |
|
I was diagnosed at the age of 18 with Seronegative asymmetrical Polyarthritis. I was told it was a reaction to a viral pneumonia I came down with at the time. I had a cough one day, and the next day was in hospital with problems breathing, massive fever, and swollen and painful joints. Since then I have been treated with anti-inflammatories by some doctors, and treated like a faker from others...until one doctor finally did an MRI to find bone deterioration and put me on methotrexate. So, then I find out my brother was just diagnosed with the same thing. If it is brought on by a virus, why did we both get it? |
|
I cannot truly answer your question because I do not have enough information on the extent of the laboratory work-up in your case and even more so, in that of your brother. Viral arthritis does exist. It tends to regress however, after six to eight weeks whereas rheumatoid arthritis, for instance, goes on and progresses. Has your brother seen a rheumatologist? Have you? I would suggest it. A proper differential diagnosis must be made. |
| Answered on: July 12, 2010 | |
| |
|
I am a 22 years old and recently have undergone an OATS procedure in my knee, which is a cartilage transfer from a non weight bearing surface to the affected weight bearing surface. I also had a lot of meniscal repair and a meniscectomy performed. The surgeon had also discovered other chondral defects which the surgeon claims will affect me in the future. My question is about preserving the cartilage that I currently have and what would be the best way to go about doing that and to prevent osteoarthritis in that knee? |
|
Osteoarthritis is a degenerative condition of the joints. There is no known cure at this point. The treatment is symptomatic and based on pain-relieving agents such as analgesics and NSAIDs. The joints can also be injected with visco-supplements or corticoids in certain cases. Surgery can be performed as you have described and joint replacement can be done when the damage is severe. Non-drug treatments include exercise to preserve motion and strengthen the muscles. Low-impact is recommended to avoid trauma to the spine or weight-bearing joints. A healthy diet to control weight is recommended because, for example, one pound of excess weight when projected to the knee, is equivalent to four pounds. Canes and walking aids may relieve pressure on affected joints. Braces may also be indicated in some patients. |
| Answered on: July 05, 2010 | |
| |
|
I was diagnosed with Sjogrens syndrome. I have lost three teeth in the past month experiencing pain and fatigue as well as weight loss. Is this normal? |
|
Sjrogren’s Syndrome is an auto-immune condition characterized by ocular and oral dryness. There may also be vaginal dryness and dry skin. There may be constitutional symptoms such as prominent fatigue glandular enlargement and polyarthritis. Loss of saliva may make dental hygiene more difficult and lead to tooth decay. |
| Answered on: June 28, 2010 | |
| |
|
If Diffuse Idiopathic Skeletal Hyperostosis (DISH) is the second most common form of arthritis, why is there so little information to be found about it, and why don't any of my doctors seem to have heard of it? |
|
DISH also called Forestier’s disease, affects 3-4% of the general population and 7-10% of people over 70. It is characterized by flowing calcification along the sides of the vertebrae and it may also cause inflammation of the tendons. It is slowly progressive. Unfortunately, there may be a lack of good patient information compared to osteoarthritis, rheumatoid arthritis and gout, as you state. |
| Answered on: June 21, 2010 | |
| |
|
I am 43 years old and have had osteoarthritis for 20 years. I just met with the surgeon and he says that the cartilage is almost gone and that the only solution now is a total ankle replacement or fusion. What is life going to look like after ankle replacement at my age due to arthritis having set into this joint? |
|
Of course there is hope! As Winston Churchill used to say: “Never give up!” Your surgeon has offered solutions to relieve the pain in your ankle and allow you to walk. This is a good sign. Do discuss it again with him if you are afraid but many, many people have had joint replacements and consider it a blessing compared to what they had to endure before the surgery. |
| Answered on: June 14, 2010 | |
| |
|
Can rheumatoid arthritis cause incontinence in certain cases? |
|
Urinary incontinence is not a usual symptom of rheumatoid arthritis. Another cause must be searched for. |
| Answered on: June 07, 2010 | |
| |
|
I am 26 years old and have been living with rheumatoid arthritis for 7 years. My treatment has remained unchanged since I was diagnosed: Cortancyl (5 mg/day), Apranax 550 (1 tablet/day), Novatrex (3 tablets/week) as well as supplements to counter the side effects of these three main medications. My blood picture seems to be improving, but my hands, feet and wrists (I have a subluxation of the left wrist) are getting worse. On top of it all, I have osteopenia. I am losing patience and starting to have doubts about the efficiency of this treatment. I know that disease severity can vary, but how much time does it take on average to go into remission? Are bone deformations irreversible? Shouldn’t I stop cortisone? Can it be replaced by another medication? |
|
The treatment algorithm recommended by the American College of Rheumatology calls for early aggressive treatment with a remission agent to prevent bone erosion and deformation. If the agent used is not efficient and fails to stop disease progression, it can be changed or combined with other remission agents. If this is still inefficient, a biologic agent can be used to bring the disease under control. Biologics are exceptional medications whose reimbursement conditions vary from one province to the other. If your disease is not controlled, talk to your rheumatologist about the possible use of biologics. |
| Answered on: May 31, 2010 | |
| |
|
I am 41 and was just diagnosed with Inflammatory Arthritis, most likely psoriatic arthritis. I was prescribed Methotrexate but now I am in remission again. Can I wait until it flares up to start this strong medication? |
|
Methotrexate is a very effective treatment for active inflammatory arthritis. If there is no active disease, there is no indication for treatment. I suggest that you consult your physician however to be sure. |
| Answered on: May 25, 2010 | |
| |
|
I have heard that there have been strides in using botox to treat osteoarthritis. My mom is affected by this condition in her knee. Is this type of treatment available in Canada? |
|
In a research study, Botox has been shown to be effective in the treatment of
painful localized contractures that do not respond to standard treatment after
orthopedic surgery but the authors suggested further investigations to better
identify appropriate dosages and the best inoculation schedule. Botox is not an approved treatment of osteoarthritis in Canada. |
| Answered on: May 17, 2010 | |
| |
|
I was diagnosed with juvenile rheumatoid arthritis at the age of 9 I went into remission at the age of 17. After 24 years I have been experiencing a lot of joint pain and stiffness and it is getting worse, does this mean I am coming out of remission and what are the implications. |
|
You should consult your physician. Arthritis can relapse but there are many causes of joint pain. A physical examination with a proper laboratory work-up, if needed, would answer your question. |
| Answered on: May 10, 2010 | |
| |
|
I have less movement in my shoulders because of my RA. Can physical therapy help me regain some of my range of motion or is my motion now limited forever? |
|
It is difficult to answer this question without knowing the cause of the limitation and the degree of damage that RA has done to your joint. As a rule, physiotherapy can increase muscle strength and joint mobility. It can also help in pain relief. Your physician can advise you after a clinical examination and possibly a joint X-ray. |
| Answered on: May 03, 2010 | |
| |
|
For the past few months, my six-year-old son has been complaining of very sore knees to the point that it sometimes brings him to tears. I can see no apparent redness or swelling in my son's knees when these episodes occur. I've been able to provide some relief with leg massages and children's Tylenol. These episodes occur maybe once a week or every two weeks. I am a 37-year-old female who has had ankylosing spondylitis since the age of 19. Along with a family history of arthritis on my mother's side (both of her parents) and my husband's side (his mother), my tests confirmed the HLA B27 gene. Could my son's sore knees/legs be just"growing pains” or should I be concerned that he may have inherited my arthritis gene? |
|
Many young children wake up at night with severe leg pains (normally in
their thighs, knees, shins or ankles) often there is no swelling or redness to
see and pain is relieved by rubbing the legs and taking simple pain killers like
Tylenol. In many cases the pains are completely gone by the next morning. These
pains are often referred to as 'growing pains' even they are not related to
growth. These pains eventually disappear on their own. With HLA B27 associated types of arthritis, the symptoms would tend to be more constant with worse pain and stiffness on awakening in the morning. If it were associated with the gene, you would feel warmth around the knees and notice swelling. If you do start to notice these signs, discuss these concerns with your health-care provider. |
| Answered on: April 26, 2010 | |
| |
|
I'm 18, female and have noticed some symptoms of arthritis in my knees and hips - swelling, aching, etc. I’ve started taking Vitamin C and the symptoms have almost disappeared. Could I win this battle by taking more vitamins? |
|
Your condition may or may not be arthritis. It should be assessed and diagnosed by a physician. The Vitamin C probably did not have a role in the symptoms disappearing. Some arthritis symptoms are self-limited and disappear no matter what is done and some may come and go randomly. Moderate doses of vitamins such as Vitamin C up to 500 mg per day should do no harm but I would not pursue mega doses of vitamins until there is definite scientific evidence that they are of value for arthritis. |
| Answered on: April 19, 2010 | |
| |
|
My husband was diagnosed with polymyalgia rheumatica and he's always in pain. Is there no cure? What works best? |
|
Polymyalgia rheumatica tends to occur in people over 40 and causes pain and stiffness mainly in the shoulder and pelvic girdles but it can affect other muscles. Doctors use a blood test to determine the erythrocyte sedimentation rate, or ESR. If the ESR is elevated, you will be diagnosed with polymyalgia rheumatica. The condition usually disappears after 2 to 3 years. Prednisone (a type of steroid or cortisone) works best and very quickly
(within 1 to 2 days) to cause the symptoms (pain and swelling) to disappear.
This rapid, marked improvement with prednisone is a diagnostic feature of the
condition. Within 2 weeks your ESR levels will be reduced. If there is no
response or an incomplete response to prednisone then another or an additional
diagnosis should be sought. |
| Answered on: April 12, 2010 | |
| |
|
Can the onset of rheumatoid arthritis be linked to significant trauma and fractures throughout the body? |
|
Trauma and fractures can alter the biomechanics of adjacent joints eventually leading to osteoarthritis in those joints. Rheumatoid arthritis is not caused by trauma; it is a systemic disease mediated by the body's immune and inflammatory systems. |
| Answered on: April 05, 2010 | |
| |