Created on: 01/04/08 - Email to friend - Print Page

Frequently Asked Questions About Rheumatoid Arthritis

What the Future May Hold

Will I need surgery?

Whether you will need surgery will depend largely on how severe your disease is and whether medications have been effective at controlling its damaging effects.

With the development of new medications and more aggressive, early treatment of RA, the need for some surgeries may be reduced – or even nonexistent – in the future. But for now, surgery remains a viable important treatment option. The development of surgical options for arthritis over the past few decades is one of the major breakthroughs in helping people remain active and continue to enjoy life after their diagnosis.

People with RA can face surgery at various points in the course of their disease. For example, in the early stages of the disease, synovectomy (the surgical removal of the synovium, or lining of the joint) may be performed when one or two joints are affected by inflammation more than other joints; however, this procedure is much less common than it once was. In later stages, an arthrodesis or fusion of a joint may greatly relieve pain. If severe damage of a joint (most commonly a hip or knee) has occurred, a total joint replacement or arthroplasty may dramatically relieve pain and improve a person’s ability to function.

Will I be able to have a baby?

Most women with arthritis are able to get pregnant and have healthy babies. But the decision to have a baby requires careful consideration and planning. Will you be able to care for a baby and, later, an active toddler and child? Do you have a supportive partner and family who can help?

Another necessary consideration is your medications. Some medications such as methotrexate, leflunomide (Arava) or mycophenolate mofetil (CellCept) clearly cause birth defects and should always be avoided during pregnancy. For most medicines, like aspirin, the risks are less clear.

If you think you are ready to have a baby, it’s important to talk with your rheumatologist. You’ll want to be sure your disease is well controlled, and you may need to stop some drugs at least a few months before you try to conceive. Your doctor can give you specific instructions and perhaps switch you to medications that are safer during pregnancy, such as prednisone.

Many women report that their disease symptoms ease or even disappear completely during pregnancy, so you may be able to get by with minimal medication during pregnancy. But after delivery, the disease often flares and medication will once again be a concern, and if you plan to breast feed, you’ll need to work with your doctor to find the safest medication for you and your baby.

Will my children be at risk for rheumatoid arthritis?

While it is certainly possible that your children could develop RA, it is not likely. That’s because RA is not caused by a single gene passed down from parent to child. It is a complex disease probably involving a number of genes. Each individual gene makes a small contribution to disease risk. Your children would likely need to inherit most if not all of those genes to be at great risk. And even if they did, that’s no guarantee they would have RA, because environmental factors also are involved.

Although the risk of having RA is slightly greater if a parent or other close family member has RA, most people with RA don’t have a family history of the disease.

Does having rheumatoid arthritis put me at risk for other diseases?

Unfortunately, if you have rheumatoid arthritis, you have a higher risk of other autoimmune diseases, such as type-1 diabetes and autoimmune thyroiditis, because these diseases share similar predisposing genes.

People with RA also experience many other health conditions more often than the average population, including infections, lung disease, kidney disease, cardiovascular disease and gastrointestinal problems.

This makes it all the more important to take care of your general health if you have RA. Lose weight if necessary or maintain a reasonable weight, don’t smoke, exercise regularly, eat a healthy diet and keep up with your doctor visits.

Keeping your arthritis under control and identifying and treating other problems early can help reduce your risk of developing more serious health problems and their complications.