Are All the Tests and Treatments for Rheumatoid Arthritis Needed?

QUESTION: My sister has been told she has rheumatoid arthritis. From her
story, the doctor is treating this like a disease with dire consequences, and
is ordering all types of tests and treatments. Is all of this necessary? I
want to be a help to my sister and so need to know more.
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ANSWER: I'm not sure by what you mean by "dire." It is not a disease to be
ignored, because treatment as soon as possible lessens the damage it does.
Another reason for accurate diagnosis is because the symptoms of rheumatoid
arthritis are often confused with the symptoms of other diseases that also
require early treatment.
Aching, stiff joints may signal a host of illnesses. The alert physician
will be sure to follow up on this, striving for a clear and accurate
diagnosis. There are many kinds of arthritis, and rheumatoid arthritis is
only one of them. Rheumatoid arthritis is seen more often in women than men,
and it most often starts between the ages of 30 and 50. The first indication
may be a stiffness in the hands in the morning, which is relieved after about
30 minutes of activity. Swelling around the joints of the fingers is a sign
that shouldn't be ignored, and some people have hardened knots on their
joints. Rheumatoid arthritis is diagnosed by blood tests, analysis of the
fluid in the joints, and x-rays. Continuous communication between your sister
and her doctor will help in the diagnosis, because rheumatoid arthritis often
starts out with just some vague aches, difficult to describe or pinpoint. Her
doctor may be watching for further development of symptoms, keeping an eye out
for subtle changes in movement and strength. It's not uncommon for patients
experiencing the first aches of arthritis to become frustrated when their
doctor orders many tests to establish a "baseline", or level of findings that
will be used to judge just how much the disease is progressing.
When the diagnosis of rheumatoid arthritis is made, treatment may start
simply with aspirin, for it is an effective anti-inflammatory. Additional
medications are gradually added to the treatment as necessary. Also, we now
know that it may be wise to do surgery on joints affected by arthritis at an
earlier stage, before the joints and surrounding tissue are badly damaged by
the disease. Surgery was once reserved for only the very severe, advanced
case of arthritis. This is no longer the case, and new artificial joints and
microsurgical techniques are making surgery safer and more successful.
Surgery should, however, be delayed until more conservative treatment like
medication and physical therapy is tried. New methods and equipment for
physical therapy have aided the arthritis patient, and a good physical therapy
program should be part of arthritis treatment for most people.
Because arthritis is a chronic, painful and frustrating disease, its
victims fall prey to a particularly distressing situation. They become
victims for a second time, to the exploitation by promoters of quackery. The
promise of a quick cure and the end to pain is difficult to resist when one
is suffering, but caution is a must. Some of these "cures" are inexpensive
and harmless, but many are very expensive and may be harmful. In any case, do
not delay medical treatment while folk or unproven remedies are tried. You'll
be performing an enormous service to your sister if you stay informed, support
her emotionally, and prevent her from straying off into ineffective and
dangerous therapies.