Top Ten Common Myths about RA - Busted!!

Patient Expert

With such a tiny percentage of Americans living with RA, approximately 1.3 million adults according to NIAMS, it is no wonder that the general public knows so little about the disease and believes the many myths floating.  So let’s get started dispelling some of the most common myths.

Myth #1: Arthritis is only for OLD people.

Hey, I’m not old and I definitely have arthritis... rheumatoid arthritis, that is.  Some days I might feel ancient, but this is not due to normal aging or “wear and tear” on the joints as is caused by osteoarthritis.  Rheumatoid arthritis is an inflammatory autoimmune disease which is commonly diagnosed in early and middle adulthood, while children are diagnosed with Juvenile RA as young as 6 months through 16 years.  In most people who develop RA, the disease starts between the ages of 30 and 55.  RA is also an equal opportunity offender affecting men and women of all ages at a 1:2 or 1:3 ratio.

Myth #2: Arthritis is arthritis - It’s all the same thing, right?

The Centers for Disease Control and Prevention (CDC) shares that the word arthritis actually means joint inflammation. The term arthritis is used to describe more than 100 rheumatic diseases and conditions that affect joints, the tissues which surround the joint and other connective tissue. The pattern, severity and location of symptoms can vary depending on the specific form of the disease. Typically, rheumatic conditions are characterized by pain and stiffness in and around one or more joints. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body.

Myth #3: In rheumatoid arthritis, swollen joints are alway red and thus easy to diagnose.

Doctors from Johns Hopkins Arthritis Center share that unlike gout or septic arthritis, redness of affected joints is NOT a prominent feature of RA.  Personally, this was one mistaken detail which delayed my referral to a rheumatologist prior to diagnosis.  Symmetric joint swelling (although not always) is characteristic of rheumatoid arthritis, often in the fingers, knuckles, wrists, elbows, knees, ankles, and toes. Careful palpation of the joints helps to distinguish the swelling of joint inflammation from the bony enlargement seen in osteoarthritis.  Pain on passive motion is the most sensitive test for joint inflammation. Occasionally inflamed joints will feel warm to the touch. Inflammation, structural deformity, or both may limit the range of motion of the joint.

Myth #4: You must wait until the pain is severe and your have serious joint problems before starting treatment for your RA.

Do not wait  Doctors often give patients fairly powerful medicines early in the course of the disease, especially if they have a severe case of arthritis. This helps to prevent permanent joint damage by blocking proteins that lead to swelling, inflammation, and associated joint pain. Common drugs to treat the disease include methotrexate, sulfasalazine, Plaquenil, Rituxan, and anti-tumor necrosis factor drugs such as Enbrel, Humira, Remicade.  I really appreciate how Lene often summarizes her viewpoint on RA drugs - “better living through chemistry.”

Myth #5: All I have to worry about with RA are my joints; it doesn’t affect my health otherwise.

Wrong!!  Rheumatoid arthritis can cause serious damage and disability in other body systems beyond just the joints.  RA is associated with cardiovascular disease, heart failure, lung disease, fibromyalgia, depression, and more.  In addition to damage caused by inflammation, patients with RA and their rheumatologists should be mindful of possible complications (such as anemia or kidney and liver problems) which may be caused by the medications we use.

Myth #6: Painful, stiff joints from rheumatoid arthritis need to be rested most of the day and exercise is a "no-no" when you have RA.

Although rest is necessary during an RA flare, joints affected by rheumatoid arthritis need motion, stretching and exercise.  Immobility can be counterproductive for someone with rheumatoid arthritis. When joints are painful and stiff, it's natural to want to avoid movement. However, immobility sets up a vicious cycle. The muscles around a joint contribute a large part of the joint's strength and stability. All muscles need regular activity to stay healthy and research has shown that following an exercise program can decrease pain by keeping joints and cartilage healthy.  Exercise can also help to reduce the symptoms of depression which can be common among people with a long-term illness like RA.  Talk to your physician about the best exercise regimen for you. I have found water exercise to be soothing to my achy, arthritic joints as well as my soul.

Myth #7: Arthritis is caused by cold, wet weather.

For years, many people thought that arthritis is caused by cold wet weather. Dry weather has been regarded as a cure, prompting some individuals to move to drier areas. Unfortunately, populations in all types of climate are affected by arthritis. While warmth is soothing to everyone, it cannot prevent or reverse the effects of arthritis.  Interestingly the Arthritis Foundation estimates that nearly half of arthritis patients think they can predict the weather! Yet the studies have been inconclusive. Don't cancel your Florida vacation plans yet; milder weather may encourage people with arthritis to be more active, and that has been shown to help (see exercise myth above).

Myth #8: Arthritis is caused by poor diet or specific substances such as aspartame.

Except for individuals who are found to have specific food allergies that aggravate their arthritis, there is no proven connection between a particular food and arthritis. However, a nutritious, well-balanced diet and ideal body weight can improve health and wellness for everyone, arthritis or not. Weight control is especially important for people with arthritis, because being overweight puts added stress on your joints.

If certain foods seem to negatively affect you or your family, try to avoid them and see if that helps. Otherwise, follow the Arthritis Foundation recommendations for a diet low in calories and saturated fats, rich in "good" fats found in fish and olive oil and nuts, and full of vegetables, fruits and whole grains. Some research suggests that carotenoids (found in orange and yellow vegetables and fruits) and cruciferous vegetables (the broccoli and cabbage family) may be particularly effective at protecting joints.

Myth #9: If I have RA, my children are likely to get it as well.

This is not true. It’s a possibility that some types of arthritis run in the family, but it’s not like diabetes, where if both parents have it, the child will have it as well. Dr. Stephen Paget shares that we know 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. In some studies, for instance, smoking, along with a genetic predisposition, has been shown to increase the risk of RA.

Myth #10: Most people with rheumatoid arthritis end up in a wheelchair or nursing home because of the disease.

Many people with serious types of arthritis, which were severely disabling as recently as a generation ago, are now leading full and productive lives, thanks in part to many developments, including new drugs and treatments, exercise programs, surgeries and self-management.  A striking quote from the Arthritis Foundation - “fewer than 50 percent of rheumatoid arthritis patients younger than 65 who are working at the onset of the disease are still working 10 years later”- is becoming outdated.  As a person with arthritis, your future is full of possibilities that were only a dream 25 years ago.

See More Helpful Articles:

RA Versus OA: This Ain’t Your Grandfather’s Arthritis

Arthritis Awareness Month: over 100 Types of Arthritis and Related Diseases

Extra-Articular or Systemic Manifestations of Rheumatoid Arthritis

Cause of Rheumatoid Arthritis May Be Micro Bacteria in the Gut

Exercises for All Levels of RA