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• Are there any non-medicinal treatments for rheumatoid arthritis?
  
  

  My mother has rheumatoid arthritis in her feet and ankles. Are there any non-medicinal treatments for RA? She won't take medicine. - Jim, Needham, MA

  If your mother truly has rheumatoid arthritis (RA) - there are many forms of inflammatory arthritis that mimic RA - it is absolutely necessary that she understand more about the disease because treatment is very important. RA is an immunological condition in which the immune system is misguided, resulting in inflammation in the tissue that surrounds the joints. The result of the inflammation goes beyond just the pain, swelling, redness, and warmth that your mother may be having; it leads to permanent destruction of cartilage and bone, as well as deformity that can be crippling. Fortunately, we have extremely effective medicines to stop progression of the disease and prevent destruction of the joints. It is essential that your mother understand this. While home remedies, such as cold packs, rest, and elevation, may make her feel somewhat better, they will not prevent the progressive destruction of her joints. Thank you for your question! David Hunter, MD, Rheumatology

  
  
  
• Similarities/differences between spondyloarthritis and rheumatoid arthritis?
  
  

  I have been diagnosed with spondyloarthritis for several years. I know the disease is separate from rheumatoid arthritis, but I've been told they are related. What are the similarities/differences in the progression and symptoms and should they be treated the same? - Tom, Stanford, Connecticut

  Rheumatoid arthritis and spondyloarthritis are quite distinct. RA tends to affect the peripheral joints (small joints of the hands and feet) and dose not affect the spine. Spondyloarthritis tends to affect the spine with little or no effect on the peripheral joints. The pathogeneic basis for the disease, and associated genetic and autoantibody features are also different. Despite the differences, many of the same medications are used to treat both disorders. Your physician is the best source for more information. Thank you for your question! David Hunter, MD, Rheumatology

  
  
  
• What is the difference between rheumatoid arthritis and osteoarthritis?
  
  

  What is the difference between rheumatoid arthritis and osteoarthritis? - Mary, West Boylston, MA

  Rheumatoid arthritis usually affects joints on both sides of the body in the hands and feet, as well as the hips, knees, and elbows. Without proper treatment, rheumatoid arthritis can become a chronic, disabling condition. Aching joints are common in arthritis. In rheumatoid arthritis, the joint lining swells, invades surrounding tissues, and produces chemical substances that attack and destroy the joint surface. People of all ages may be affected. The disease usually begins in middle age. With osteoarthritis, the articular cartilage that covers the ends of bones in the joints gradually wears away. Where there was once smooth articular cartilage that made the bones move easily against each other when the joint bent and straightened, there is now a frayed, rough surface. Joint motion along this exposed surface is painful. Osteoarthritis usually develops after many years of use. It affects people who are middle-aged or older. Other risk factors for osteoarthritis include obesity, previous injury to the affected joint, and family history of osteoarthritis. Thank you for your question! William Harvey, MD, Rheumatology