4 myths about rheumatoid arthritis

September is National Arthritis Month in Canada, and while many people may think they understand the condition, persisting myths and misconceptions can sometimes get in the way of the latest information on the disease. With over 233,000 Canadian adults affected by the condition, it’s important to get the facts straight.

What is rheumatoid arthritis, anyway? 

Arthritis means inflammation in a joint. In rheumatoid arthritis (or RA), the immune system – which is designed to protect our health by attacking foreign cells such as viruses and bacteria – instead attacks the body’s own tissues, specifically the synovium (a thin membrane that lines the joints). What’s more, RA is characterized by ‘systemic’ inflammation, meaning that it can affect not only the joints but every other system of the body (i.e. lungs, eyes, vascular system). Frequent symptoms include fatigue and joint stiffness, especially in the morning and after prolonged periods of rest. 

While the condition can’t be cured, early diagnosis and aggressive treatment can successfully put the disease into remission and is widely accepted as the best way to prevent joint destruction, loss of mobility and damage to other organs. With treatment that aims to control levels of inflammation in the body, people with rheumatoid arthritis can therefore go on to lead full, active lives. Research continues, in particular to find out what causes RA and how it can be cured.


Myth #1: Only old people get rheumatoid arthritis. 

Fact: “In women, RA most commonly begins between the ages of 30 and 55. In men, it often occurs later in life. However, even older teens and people in their 20s can get RA. Children can also be diagnosed with a distinct but related form of inflammatory arthritis called juvenile arthritis,” says Dr. Inès Colmegna, rheumatologist at the Royal Victoria Hospital of the McGill University Health Centre (MUHC). 


Myth #2: Rheumatoid arthritis isn't all that serious. 

Fact: Rheumatoid arthritis can threaten an individual’s overall functioning, independence and working ability. 

“Without appropriate treatment, RA can cause chronic pain, disability, and in some cases, premature death,” explains Dr. Colmegna. RA causes joint damage in 80% to 85% of patients, and in most cases the damage occurs during the first 2 years of the disease.  

“To improve the prognosis for patients with RA, our efforts are directed towards diagnosing patients earlier and introducing optimal therapy immediately after the diagnosis has been made”, says Dr. Peter Panopalis, rheumatologist at the Royal Victoria Hospital of the McGill University Health Centre (MUHC). 


Myth #3: Most people with rheumatoid arthritis end up in a wheelchair because of the disease. 

Fact: “RA is a chronic disease but with greater advances in medications, and technology supported by research, today’s patients have several options to control the disease,” says Dr. Colmegna.

The combination of the arrival of newer medications and having patients take them as early as possible after diagnosis has greatly improved the outcomes that can be expected by most patients. 

“Effective management of RA based on early treatment with pharmacological agents that are appropriate for the degree of disease activity and the presence or absence of indicators of poor prognosis has changed the prognosis of patients with RA,” she says.  By keeping inflammation down and through constant monitoring of disease activity, patients can minimize further joint damage.


Myth #4: Most people with rheumatoid arthritis can't work.

Fact: Work tasks or habits may need to be adapted with rheumatoid arthritis, but the diagnosis doesn't equal a lifetime of disability.

”Canadian studies show that RA patients face challenges at work posed by the invisibility, fluctuation, and unpredictability of arthritis; complexity of interpersonal relationships; reluctance to disclose or draw attention to arthritis; numerous barriers to using available support and requesting job accommodations, including fear of disclosure and concern it could be perceived by coworkers as favouritism; loss of self-efficacy at work; and many emotional challenges,” says Dr. Colmegna. Early and optimal medical treatment of RA improves the patients' ability to perform their jobs and housekeeping. 


Managing rheumatoid arthritis: it takes a team