Frequently Asked Questions (FAQs)
Frequently asked questions
Information leaflets can be obtained from the Arthritis Research UK or Arthritis Care websites (http://www.arthritisresearchuk.org) or York Hospital Rheumatology clinic.
Rheumatology advice line can be contacted via
Telephone: 01904 721854
How many people have arthritis?
There are 10 million people living with arthritis in the UK. One in five of the adult population in the UK has arthritis.
Does arthritis affect young people?
Arthritis affects people of all ages. There are 12,000 children in the UK with arthritis and approximately 27,000 people living with arthritis are under the age of 25.
Do many people visit their GP because of their arthritis?
One in five GP visits involves the symptoms of arthritis, such as joint pain, stiffness, fatigue and impaired mobility.
How do I know if I have arthritis?
For most people, arthritis causes discomfort or pain, stiffness and perhaps swelling in one or more joints. If your arthritis is causing significant symptoms, getting worse or you are worried about your joints you should visit your GP who will be able to make a further assessment. You may then be referred to a specialist consultant if necessary.
Is there a cure for arthritis?
At the moment, there is no cure for arthritis. However, there are many ways of treating the symptoms of arthritis. There is also much you can do to protect your joints and keep mobile with drugs, therapies and self-management techniques, such as by maintaining a healthy diet, weight control and taking regular exercise.
Is arthritis hereditary?
There are over 200 types of arthritis. The majority are not hereditary and you will not pass it on to your children. However some types of arthritis can affect members of the same family. Recent evidence suggests that certain types of arthritis such as osteoarthritis in the hands can be hereditary, but further studies are needed to confirm this. Some people may have a genetic predisposition to certain types of arthritis (e.g. lupus, ankylosing spondylitis), but this is not the same as a type of arthritis being hereditary.
Do arthritis symptoms go away during pregnancy?
Many women who have arthritis find that their symptoms lessen when they are pregnant. However, once the pregnancy is over, the arthritis returns. If a woman has Axial Spondyloarthropathy (a type of inflammatory arthritis of the spine) pregnancy does not usually help and may worsen symptoms in the last phase of pregnancy.
How long do I have to stop taking my arthritis medication before I start a family?
Women and men taking stronger medication for their arthritis such as methotrexate or other disease modifying anti-rheumatic drugs (DMARDs) will have to consult their doctor or consultant about the best course of action. Those on anti-TNF therapy can continue to take the medication whilst pregnant (until the third trimester) but we would like to know if you are planning a pregnancy to discuss this further with you. Some medications such as hydroxychloroquine can be continued throughout pregnancy.
The amount of time taken for a drug to leave the body can be very variable. However, it is recommended that if you are taking drugs such as Methotrexate then you should allow at least 3 months from stopping this medication before trying for a pregnancy.
Do I need to stop my medicines if I am having an operation?
If you need to have an operation, it is likely that you will need to stop your rheumatology medication a few weeks before the surgery. You will be able to re-start your medication a few weeks after the operation so long as the wound is fully healed and you are well. This is because there may be an increased risk of infection if you are taking some rheumatology medications such as methotrexate or biologic therapies. You should ask your surgeon or contact the Rheumatology Department if you require further information on this.
Some doctors or dentists may advise additional antibiotic medicines for certain surgical or dental procedures if you are taking certain rheumatology medication such as methotrexate or biologic therapies.
Do I need to stop my medicines if I develop an infection?
If you develop mild infection symptoms, you should monitor how you feel and be prepared to stop your rheumatology medication if your infection symptoms get worse. If you are unsure what to do, you should contact your GP or the Rheumatology Department for advice.
You should stop your rheumatology medication and seek advice from your GP or the Rheumatology Department if you develop any moderate or severe infection symptoms.
If you are prescribed antibiotics for an infection, you should stop your rheumatology medication and only restart them when you have completed the course of antibiotics and your infection symptoms have fully improved.
Do I need to stop my medications if I develop side effects?
All medications have the ability to cause side effects. In the majority of cases these are mild and with rheumatology drugs often settle a few weeks after starting them. If your side effects are mild our usual advice would be to continue the medication. If the side effects continue, worsen or are severe you should stop the medication and either contact the rheumatology department if you have recently started the medication (less than 3 months ago) or contact you GP. You will have been told about more common or serious side effects of medications that the rheumatology team have started and you can also refer to the drug information leaflets and the information that you receive from the pharmacist.
Further information about the drugs used in rheumatology and possible side effects can be found in the medication leaflets on the arthritis research UK website (http://www.arthritisresearchuk.org).
What if my arthritis flares?
Sometimes your arthritis may flare despite being on medication. The majority of these are short-lived and can be self-managed.
The following websites may be helpful.
inflammatory arthritis: http://arthritisresearchuk.org/arthritis-information/conditions/rheumatoid-arthritis/self-help/managing-a-flare-up.aspx
Ankylosing spondylitis/axial spondyloarthropathy: http://nass.co.uk/about-as/just-diagnosed/flare-ups-and-burn-out/
If your symptoms continue or you feel they are severe please initially contact your GP and then the advice line if needed.
Does the weather affect my arthritis?
The links between arthritis and the weather are inconclusive. There is no overwhelming evidence to support this and information has been anecdotal and subjective. Many people with arthritis say that their joints ache before a storm, and, according to experts, this is due to a drop in pressure and a rise in the humidity causing pain and stiffness in the joints. However, a change in the weather will not cause arthritis.
Does diet affect my arthritis?
There are no diets or dietary supplements proven to cure arthritis. However, some people find their symptoms improve as a result of changing what they eat or taking some dietary supplements. Some people do find that certain foods and beverages make their arthritis worse. If this is the case you should avoid these foods/beverages. If you have been diagnosed with gout you should follow a more prescriptive diet and this will be discussed with you. Generally everyone should try to eat a well-balanced and varied diet. If you are overweight, losing weight will reduce the strain on your joints.
Are complementary and alternative therapies helpful for people with arthritis?
Complementary medicine uses therapies that work alongside conventional medicine. Alternative medicine includes treatments not currently considered part of evidence-based Western Medicine.
Some herbal medicines are not recommended for people with arthritis and some may interfere with your Rheumatology medications. You should not start any new complementary or alternative therapies without first discussing with your Rheumatologist or Rheumatology Specialist Nurse.
What vaccinations are recommended if I have arthritis?
If you are taking immunosuppressive medications or have a long term condition such as arthritis, you should receive regular vaccinations against Pneumococcus and Influenza. Your GP can arrange for you to have these.
If you are taking immunosuppressive medication, including moderate to high dose steroids for more than two weeks, you should not have live vaccines or oral vaccines. Examples of live vaccines include yellow fever; measles, mumps and rubella (MMR); BCG (against tuberculosis); chicken pox vaccine.
If you are taking immunosuppressive medication or moderate to high dose steroids, you should stop these at least three months before receiving a live vaccine.
If you have a live vaccine before starting immunosuppressive medication, you should wait at least 2 weeks, and preferably four weeks, before starting the medication.
Should I have the shingles (herpes zoster) vaccine (Zostavax) if offered it by my GP?
There is currently an immunisation programme for the shingles vaccine in those age 70-80. If you are eligible the GP surgery will be in contact with you. If you are >50kg (7st 12Ib) and taking DMARDS including methotrexate and sulfasalazine you can have this vaccine. If you are on steroids of 10mg prednisolone or less per day you are also able to have this vaccine.
Those on high dose steroids (greater than 10mg prednisolone a day) or more a powerful immunosuppressant such as anti-TNF or rituximab should not have the vaccine.
If you are unsure please check with your GP or one of the rheumatology team.
When will I find out my test results from clinic?
You will be informed of any investigations that need to be acted upon. All the rest of the investigations can be discussed at your next clinic appointment. If you are waiting for a routine MRI, CT or DEXA scan and have not received an appointment through the post within 8 weeks of being seen in clinic please contact your consultant’s secretary via switchboard. If you are unsure and wish to discuss this please contact the rheumatology department.
How do I change or cancel an appointment?
If you need to change or cancel an out-patient appointment or telephone appointment, please phone York Hospital Contact Centre – Tel: 01904 726400.
Please ensure that you do cancel your appointment if you cannot attend so other patients can be contacted to take your appointment slot.
How do I order a new prescription for my rheumatology medication?
When you start a new rheumatology medication, the rheumatology department is responsible for monitoring your blood results and providing your prescription (this can be requested via the helpline). Once you are safely established on your new medication, responsibility for monitoring your blood results, and providing the prescription, is handed to your GP (this is called Shared Care). For hydroxychloroquine, this usually occurs by four weeks. For other medications such as methotrexate or sulfasalazine, your GP will be asked to take over at approximately eight weeks. Some medications, such as biologic therapies or mycophenolate mofetil are prescribed solely by the rheumatology department. You will be advised accordingly at your appointment.