‘My Rheumie says my RA is controlled, but I still have pain’ What could be the cause?

As Rheumatologists, we try and assess the RA activity every time a RAer consults us. There are times when we feel that the RA is well controlled while the RAer keeps having pain. I’m sure many amongst you must have faced a similar situation on the other side of the table. Ever wondered what could be the cause of this situation?

Simply speaking, if none of the joints seem inflamed, your Rheumie would always consider the RA activity to be controlled. (Of course, it is not as simple as that!) You can help him help you with this little questionnaire. So take a paper, pencil & start marking…

1.      Where do you have persistent pain?

a.      Knee

b.      Back/ neck

c.      Headache

d.      All over the body

e.      All the joints

2.      Are you better on Sundays/ holidays? Are you OK in the morning & experience tiredness/ pain especially in the evening after office hours.

3.      Are you ok during the day & have pain especially in the night? ‘Nights are horrible & I just cannot sleep’ situation?

4.      Can you mark the painful areas of your body on a body diagram? Is it localized to joints/ muscles/ around the joints.

5.      Is the present pain similar to the joint pain you had when your joints were swollen?

6.      Do you have swelling in the joints off & on? Does the same settle by the time you reach your Rheumie’s clinic?

7.      Are you a pure vegetarian?

8.      Do you suffer from hypothyroidism?

We would discuss the relevance of each question in the subsequent blogs & this would enlighten you more about yourself/ your body & help your Rheumie fix the problem for you.