What is considered "early" when being treated for RA?
Hi there;
I read so much about how important "early aggressive treatment" of RA is, in order to minimize joint deformities.
What is considered "early"? I have been diagnosed with RA 6 months ago by my GP, and am finally seeing the Rheumatologist next week. The GP is reluctant to give me anything to treat the RA until I am seen by the rheumy. I notice my knuckles on one hand are considerably bigger than the other (with the exception of my pinky; knuckles are larger on the "good" hand). My elbows burn when I do something like pour some milk or pick up anything heavier than a loaf of bread. Knees hate me, esp walking down stairs; my toes have little bumps on them and give me stabbing pains if I walk for any length of time.
That's during the day. In the mornings, its all that, plus shoulders, hips, neck, are stiff; my fingers are curled like a claw, and forget about opening them for an hour at least.
Is it too late? Is this just pain (just!!) or indicative of joint damage?
Thanks in advance for taking the time to answer...
I was diagnosed almost 5 Years ago and have only one finger with deformity. I was not treated for the first year. During flares my toe will swell so much that I can't wear any shoes or even bend my toes. Once it calms down the swelling goes away. I also have it in both knees. hops , elbows and some fingers. I will get lumps behind my knees and elbows and when the inflammation stops the swelling will go away. So likely once you receive meds the inflammation and swelling should go down. Good luck to you and I hope that this has helped.
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GPs usually refer to rheumatologists for treatment. Once you get to your rheumatologist, you'll likely be prescribed one of the DMARDs (disease modifying antirheumatic drug), such as methotrexate, Arava, Paquinil or one of the Biologics. You're fairly early on in your career with RA and it is unlikely that you have major damage to your joints (of course, keep in mind that I am not a rheumatologist or even a doctor). Likely, your pain is due to inflammation and once your medications start suppressing the RA, you should feel much better. I'd recommend that you bring a list of questions to see the rheumatologist - it's easy to forget the things you want to ask when you're in the moment. For more information on, tips on how to cope, etc., you can check out our section for the newly diagnosed.
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Good Question!
When I was diagnosed, my rheumy talked to me about the importance in the literature of getting started on DMARDS ASAP because if we needed to add one of the biologics (and we did, Humira), the best success occurs when biologics are started within the first year of symptoms occurring. My initial flare was very intense, and I was fortunate to only have a week between being seen by my GP, who gave me a referral to a rheumy (and some anti-inflammatory meds), and being seen by the rheumy. But, this was also 6 months after my symptoms started.
So, I think you are still in the "early" part, now bring on the "aggressive" part! I wish your silly GP had at least given you an anti-inflammatory (preferrably NOT prednisone---I'm biased that way, sorry!). Are you taking anything over-the-counter?
I'm only saying that I wish that because it could have kicked in and given you some relief while you waited to see the rheumy.
And as far as the "just" pain (!!), I have been amazed that my xrays have been fine, because I have had pain that felt like my joints were in a vice grip! And redness, and swelling, and my hands especially look HORRIBLE to me. So, it was comforting to get good reads on my xrays!
Hope this helps! Let us know how the appt goes.
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