How symptom-free should I expect to get? | Arthritis Information

I am still in the early and relatively mild stages of RA. I am currently taking sulfasalazine and plaquenil with ultram for pain. While I'm certainly not pain-free like I was before RA, my mobility is better than it was 8 months ago before meds. If I had to function like this for the rest of my life, I'd be okay with it. The next step in meds will probably involve mtx and/or other meds that are going to be harder on my liver, etc. The primary reason I'm using meds is to prevent permanent damage. While the pain isn't gone, it doesn't seem to be progressing. Is the goal for meds to be pain/symptom free or just to hold it at bay? Should I expect complete remission? I guess the bottom line question for me is in the big picture would I be making a mistake to not up the meds? I'm trying to find the balance between protecting my joints from the RA and protecting my organs from the meds.As long as your doc isn't seeing any swelling or damage he/she will probably keep you on this regimen.

I have had swelling with no pain and pain with no swelling. I would personally like to see you get off the Ultram though. I believe that if the DMARDs are working properly you should not need that.

I'm a firm believer that you should seek clinical remission. Why be satisfied with just some pain, some inflammation, some swelling and some damage? As long as there is ANY pain, inflammation, or swelling damage is being done. An RD can examine your joints and to the eye there's no inflammation or swelling but you can't be sure unless you have an MRI of the joint. One doesn't hold rheumatoid arthritis at bay. Either you have symptoms or you're in clinical remission. You can have less symptoms or a relief of the symptoms but it still means you have active disease and damage is ocurring.

It took me a long time to achieve clinical remission. I wasn't going to give up because I spent 5 years thinking that I only have a little pain, it's so much better and I can do everything I did before. I had some severe damage done to ankle and fingers because of those 5 years of denial. Don't settle for less.

I know you're going to hear different stories but you really need to talk to your RD about achieving clinical remission and not settling for just some symptoms and more damage in the future. Lindy

I consider myself to be in clinical remission and still have some pain. Keep in mind that it is relative. I have a strenuous cardiovascular routine and lift weights three time a week. I ski in the winter and hike most of the year. This pain could be overuse, osteoarthritis, or tendonitis for all I know. I do alter my routine somewhat(no running or other high impact exercises, no soccer with the kids) because my feet are more sensitive but basically don't hurt otherwise. Would I have pain if I didn't do all these things? Perhaps. But that is not how I intend to live.

So ask yourself if the pain is really something you can live with. I know the tough choice you have between joint damage versus stronger drugs. I was there too. I was nervous about MTX and Enbrel but so far they have been worth it. Hopefully I will be saying that 10 years from now.

But I repeat, if inflammation or swelling is present your meds are not working.I'm with LinB - aim for REMISSION!

And you might consider and search 'sulphasalize' and pribiotics. It's a super mild antibiotic (like a poor cousin 3X removed) and adding probiotics might improve your performance on the meds.

Pip

[QUOTE=hessalina]I consider myself to be in clinical remission and still have some pain. Keep in mind that it is relative. I have a strenuous cardiovascular routine and lift weights three time a week. I ski in the winter and hike most of the year. This pain could be overuse, osteoarthritis, or tendonitis for all I know. I do alter my routine somewhat(no running or other high impact exercises, no soccer with the kids) because my feet are more sensitive but basically don't hurt otherwise. Would I have pain if I didn't do all these things? Perhaps. But that is not how I intend to live.

So ask yourself if the pain is really something you can live with. I know the tough choice you have between joint damage versus stronger drugs. I was there too. I was nervous about MTX and Enbrel but so far they have been worth it. Hopefully I will be saying that 10 years from now.

But I repeat, if inflammation or swelling is present your meds are not working.[/QUOTE]

Exactly. My husband (no RA) has periodic aches and pains from his strenuous exercise routine (free weights, heavy-duty core exercises and running a few miles) 3-4x/week. He's over 50; he certainly doesn't expect to be pain-free.
JasmineRain2008-10-06 11:42:15I'd shoot for feeling as good as you possibly can, period. Unfortunately for me, I've only had a few days where I felt symptom free but I can live with that, because I'm not in a constant "flare" which is more than I can handle for sure!I'm with Lin on this. I thought I was doing quite well and stopping the progression because my symptoms were nearly gone and I had very mild or no pain on most days. But when I was two days late with my MTX just once, all my old symptoms came back, plus new ones, which told me that I had not been keeping the disease at bay. I had no idea. I thought I was in good shape. What a wake-up call. I completely understand your reluctance to go to anything stronger. Believe me, if I could I would stop all medications but it's so important to stop the progression of your disease. I'd definitely shoot for clinical remission too. I used to think a little pain was o.k. until I tried Enbrel and found out I could achieve clinical remission. I'm hoping this little setback I'm having now will be short lived.

Like I said earlier, talk to your doctor about achieving clinical remission and not just feeling good. Because you can bike, hike, lift weights, etc. does not mean you're in clinical remission. Your labs need to be normal, no stiffness on awakening other than the normal 15 minutes of getting things going, no inflammation or swelling, no pain other than the normal, and no fluid on MRI. Clinical remission will stop damage from occuring, nothing else will. Lindy

[QUOTE=LinB]

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Funny...I had never really thought about clinical remission. If what you wrote is the definition, then I guess I am in clinical remission because I meet that criteria.

I am also able to maintain a high cardio routine and lift weights...increasing my weights week by week.

Based on that I think you should try to achieve clinical remission. The key is to stop further damage. That is what is of utmost importance. Everyone is different though. People respond to medication differently.