Living with rheumatoid arthritis

Women are three times more likely to develop rheumatoid arthritis compared to men. Although it’s more common between the ages of 25 and 50, it can develop at any age.

It’s important to get treatment for rheumatoid arthritis as early as possible because delayed treatment can result in permanent joint deformity.

Rheumatoid arthritis symptoms

In the early stages, rheumatoid arthritis symptoms can be easily confused with other conditions.

Common symptoms to look out for include:

• Joints feel painful, swollen and hot
• Joint stiffness, especially in the morning
• Tiredness, fever
• Appetite and weight loss 
• Skin and nail changes

The onset of rheumatoid arthritis is usually slow and begins in the hands and feet but it may also develop in other parts of the body including the wrists, elbows, hips, knees and ankles. You’ll often notice the same changes in your joints on both sides of the body.

Rheumatoid arthritis can, in some people, develop very quickly. Most sufferers tend to experience symptoms in a come and go fashion. These recurring episodes (or flare-ups) may appear for no apparent reason or there may be some obvious trigger such as injury or stress.

For a small number of people, rheumatoid arthritis symptoms might affect them for a year or two only to disappear. Rheumatoid arthritis is a very unpredictable disease and everyone’s experience of it will be different.

Other symptoms

Because rheumatoid arthritis is an autoimmune disease that attacks your entire body, you may also experience:

• Flu-like symptoms and general tiredness
• Lung, kidney, heart, skin, eye and mouth problems
• Nerve and blood vessel issues

In some 25% of cases, small knobbly but firm lumps (rheumatoid nodules) appear around the joints. These won’t normally require treatment. You may also become anaemic (lack of iron) and this can add to your feeling of unwellness and general exhaustion.

Long-term effects

The constant inflammation and swelling can cause permanent damage to the cartilage, tendons, ligaments and even bones. This may result in permanent and painful deformity for about 1 out of 6 sufferers. That’s why it’s really important to seek treatment as soon as possible.

There is no cure for rheumatoid arthritis and the disease will usually get worse over time. Rheumatoid arthritis may also shorten your lifespan by as much as 10 to 15 years. 

Researchers believe that this is because rheumatoid arthritis patients have a greater risk of a number of diseases including: 

• Heart disease and stroke
• Non-Hodgkin lymphoma & lung cancer
• Kidney and respiratory diseases
• Diabetes
• Infections

Early diagnosis and treatment with effective drugs can not only reduce your symptoms but may also help you live a longer, healthier life. 

Sadly, New Zealand did not fund any modern medicines for the treatment of any form of arthritis in the years 2011 to 2020. In that same period, Australia funded four modern medicines for arthritis.

Many private medical insurance policies will cover you for the cost of expensive drugs from overseas that are either not available or not funded in New Zealand. Schedule a 5-minute callback with a Policywise adviser and we can show you how you can afford better healthcare.

We can help you compare some of the best health insurance policies available and answer all your questions. And you won’t have to pay us anything.

Rheumatoid arthritis causes

Normally, the immune system identifies and fights harmful invaders such as bacteria and other infections. With rheumatoid arthritis, the immune system starts attacking the healthy cells in the joints. We don’t really know why this happens. 

There are some risk factors that increase your risk of developing rheumatoid arthritis. These include:

• Genes and family history - a family history of rheumatoid arthritis increases your risk but does not guarantee that you’ll develop the disease
• Hormones -  hormonal deficiencies or changes ( associated with pregnancy, oral contraceptives, or breastfeeding)
• Obesity - people who are overweight have a higher risk of developing rheumatoid arthritis
• Smoking - increases your risk of developing rheumatoid arthritis by up to 40%
• Infection - an infection in someone with a genetic predisposition may trigger rheumatoid arthritis
• Gender - women are up to three times more likely than men to develop the condition.

Rheumatoid arthritis diagnosis

If you experience any of the common rheumatoid arthritis symptoms, then see your doctor. Early diagnosis can help manage the symptoms more effectively and prevent your joints from suffering significant damage. 

There isn’t any single test that will definitely confirm that you have rheumatoid arthritis but your doctor will begin by taking a detailed history of your symptoms. Rheumatoid arthritis can appear very similar to other joint diseases such as fibromyalgia or gout so your doctor will also carry out a number of tests including:

• Physical examination of the affected joints
• Blood tests for abnormalities that may indicate rheumatoid arthritis
• Joint fluid test or synovial fluid test
• X-ray or an MRI – for early diagnosis and for monitoring the disease progress
• You will most likely be referred on to a rheumatologist (specialist) who may recommend additional tests and outline the most effective treatment for you.

Rheumatoid arthritis treatment

There is no cure for rheumatoid arthritis so doctors will try to manage and reduce your levels of pain and inflammation while maximising your joint health and function.

Physical therapy

Exercise is vital to maintain joint health, strength and mobility. And a physiotherapist will be able to suggest an exercise plan that includes targeted exercises for your specific needs. You’ll also need to make sure you don’t overdo the exercise; rest is equally important especially when symptoms flare up.

Try to get a good balance of exercises that do the following:

• Improve the range of motion – these should also include stretching type exercises – e.g. tai chi, yoga
• Support cardiovascular function – walking or swimming but avoid high-impact exercises
• Strengthen muscle tone – e.g. weight training – helps protect joint function 

Symptom relief

You’ll want to avoid stress, over-exertion, fatigue and those other triggers that can make your symptoms worse. Try some of the following:

• Meditation or other relaxation techniques
• Heat packs, saunas can help relieve pain but may also make inflammation worse
• Cold, ice packs can reduce pain and inflammation
• Cushioned footwear to protect joints and ease pain caused by impact and joint use
• Physical aids such as larger zip tags, shoe horns and splints can reduce the strain on joints

Lifestyle factors

There are some really important lifestyle factors that you need to know about. Making changes in these areas will help you manage your rheumatoid arthritis more successfully.

Smoking: smoking not only increases your risk of developing rheumatoid arthritis by 40% but it also can make the disease outcome worse in other ways including:

• Increased joint damage
• Faster thinning of the bones (osteoporosis)
• Lowered effectiveness of rheumatoid arthritis medications

Being overweight: studies show that obesity makes rheumatoid arthritis symptoms significantly worse and may also make some medications less effective. Overweight people report greater pain and disability, and a poorer quality of life in general.

Being overweight may also place more strain on inflamed joints.

Healthy diet: a balanced, healthy diet will give you more energy and promote better overall health and will also support healthy joint function. You’ll probably need to experiment a little here as some foods may make your symptoms worse. 

Foods that are rich in omega-3 fatty acids, such as fish oils, can reduce inflammation and support better joint health.

Rheumatoid arthritis medication

Although we do not have any drugs that will cure rheumatoid arthritis, doctors may prescribe a number of medicines that will help reduce inflammation and pain. Some drugs work on slowing down the disease itself. Common medicines used include:

• Painkillers such as panadol or codeine
• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen reduce pain, swelling and inflammation
• Corticosteroids reduce inflammation and swelling–good for initial treatment while doctors identify your best options
• Disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate & sulfasalazine slow the disease progress are best started as soon as possible after diagnosis
• Biologics (TNF inhibitors) work by reducing inflammation and are often used alongside DMARDs

There is restricted Pharmac funding for TNF inhibitors but your specialist rheumatologist must apply on your behalf. Pharmac is the government agency that chooses which drugs to fund for New Zealanders. Pharmac’s lack of funding and its incredibly slow decision-making processes mean many Kiwis may miss out on any exciting new drugs that become available for the treatment of rheumatoid arthritis.

Many health insurance policies will pay for you to access non-Pharmac funded drugs. This means you can get the very best treatment available. Schedule a 5-minute callback with one of the Policywise experts and we can help you compare the best health insurance policies on the market today.

SURGERY

Sometimes, when pain has become severe and there is significant joint deformity, doctors might recommend surgery. Surgery might be for joint replacement (especially hip or knee) or it might be to repair damaged tendons or nerves.

Living with rheumatoid arthritis

Living with rheumatoid arthritis is about maintaining your health and wellbeing while reducing your symptoms. You can help make your day-to-day disease management easier by:

• Working around your limitations
• Learning about your medicines
• Monitoring responses and reactions to your medications 
• Making a plan for any flare ups; they can take you by surprise
• Going back to your doctor if things are not going as you had anticipated

Some rheumatoid arthritis medications can have dangerous side effects so if there is anything you don’t understand or you notice anything unusual, let your doctor know.

Are you prepared for life’s uncertainties?

You may not have a serious disease and it may not even run in your family but that’s no guarantee it won’t happen to you or someone you love. Remember, rheumatoid arthritis isn’t restricted by family genetics.

You need to think about how health insurance can cover you for that possibility. And not all health insurance plans are the same. Some plans only pay for a tiny fraction of your cancer treatment expenses. 

Don’t let this happen to you. Ask your Policywise insurance adviser about policies that include cancer cover. Make sure to consider insurance options that can help cover your daily expenses if a permanent disability like severe rheumatoid arthritis forces you to stop working. 

Some health insurance policies also include additional consultations with specialists who can offer second opinions and additional advice about your treatment plans. That’s priceless when dealing with all the questions that come up after your meeting with the specialist.

We provide clear, easy-to-understand plan comparisons from different insurers so you can choose the plan with the best cover. Schedule a 5-minute callback with a Policywise expert. Our service is free to you.