Can my daily habits worsen my rheumatoid arthritis flares?

Question

Hello doctor,

I am 25 years old and was diagnosed with rheumatoid arthritis last year after months of hand stiffness and swollen joints.

Although I am on regular medications, I experience pain and weakness in my fingers on some days. My doctor recently spoke to me about using stronger injections. But I am concerned about the adverse effects of it.

Does this imply that I am going through faster progression of arthritis?
Can uncontrolled inflammation permanently damage joints even when symptoms seem mild some days?
Also, are there foods or daily habits that actually make flare-ups worse or better in younger patients?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

If you have ongoing joint pains, stiffness, and swelling despite adherence to your medication regimen, then now might be the right time to think about stepping up your treatment.

The problem is that if rheumatoid arthritis is not controlled over a long period of time, then it will result in the development of erosions in the joints and their destruction. As it is impossible to reverse this damage, it is crucial to address this issue immediately without postponing treatment. So, we always change the treatment strategy if it does not work effectively.

First of all, if you are on Methotrexate and do not take its maximum dose, you might need to increase the dosage to 25 mg per week. In case the maximum dose of the drug is being used but it fails to relieve your symptoms, you might need to start biologic agents such as anti-TNF drugs.

What concerns your eating habits, you should avoid fats and fizzy drinks since they contribute to the exacerbation of inflammation. Besides, keeping the proper body weight is important as well.

For the determination of current disease activity and to make sure that the treatment is safe for you, your doctor may suggest a few blood tests which include complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), liver function test (ALT and AST), serum creatinine, HCV antibody, HBV surface antigen, HIV antibody, tuberculin skin test, chest x-ray, and x-ray of the hands.

The recommended treatment would be Methotrexate 25 mg once weekly together with Folic acid 10 mg once weekly. A short course of steroids at 20 mg daily for two weeks may be used initially, followed by a gradual taper.

However, if there is no satisfactory progress through this treatment option, then biologic therapy should be taken into account.

A follow-up appointment is suggested within three months of initiation of treatment in order to assess the patient’s reaction and see if any other changes should be made in the treatment regimen. In the meantime, it is important to get enough sleep and do exercises in the physical therapy program.

I hope that this information will be helpful.

Take care.