New Company Links Rheumatoid Arthritis Patients With Trials

Costs Go Up. Treatment Goes Down.

The cost of new medicines for Rheumatoid Arthritis (RA) is again going up, and pricing many patients out of their medicine. If you have been diagnosed with Rheumatoid arthritis, and have taken methotrexate but still have joint pain, there are ongoing studies across the country. A new service has been created to help match patients with these clinical studies. Many of the studies are using the newer medications that have been tested and found safe in other conditions, or they are studies wanting to see how the medicines works after others have failed.

In the past, it was difficult finding these studies on government websites, but a new company is helping people match with studies across the globe. It’s a very simple, free website, very informative and has helped thousands of patients with many diseased find studies and treatment options. You can access the company from the box below.

What Is Rheumatoid Arthritis?

Rheumatoid arthritis is a chronic disease of multiple joints on both sides of the body. When rheumatoid arthritis is present, the lining of the inside of joints (called the synovium) becomes thickened and inflamed (synovitis).

Rheumatoid arthritis is due to an abnormality in the function of the immune system. It is an example of an autoimmune disease; the body attacks itself. It may cause inflammation and damage to other parts of the body such as the skin, lungs, eyes and blood vessels.

When the joint lining becomes thickened and inflamed, damage may occur to the joint and to the surrounding tendons and ligaments. The cartilage lining becomes thinner, and the bones around the joints become eroded. Rheumatoid arthritis is an example of an inflammatory joint disease. Other types of joint inflammation may be due to other diseases such as gout. Some people with psoriasis develop inflammatory arthritis, called psoriatic arthritis. Permanent joint damage is a danger with all types of inflammatory joint disease.

Swelling, redness, warmth and tenderness of joints lasting longer than six weeks suggests rheumatoid arthritis. It may start in the large and middle hand knuckles, or the wrists. Rheumatoid arthritis sometimes starts slowly in just one or two joints. Sometimes it begins in the toes, with swelling and pain felt in the balls of the feet.  The elbows, shoulders, knees and ankles are frequently involved with rheumatoid arthritis. The joints feel unusually stiff, especially in the mornings. Joint stiffness lasts an hour or longer. In comparison, the extra morning stiffness from osteoarthritis (‘wear and tear arthritis’) rarely is longer than 30 minutes. Inflammation in the body causes fatigue, and sometimes mild fevers.

The cause of rheumatoid arthritis is unknown. It may be related to having particular genes, and abnormalities in the signals that immune cells send to each other. There may be something in the environment, (either in a person’s system or in the external environment) that triggers rheumatoid arthritis to start. Smoking is linked to a higher risk for developing rheumatoid arthritis.

The diagnosis of rheumatoid arthritis is usually made by or confirmed by a rheumatologist, (a specialist trained in arthritic diseases). Usually several joints, both large and small, are involved on both sides of the body. Once it begins, the symptoms usually do not improve without treatment. In addition to swelling and tenderness of the joints, blood tests and x-rays help to confirm the diagnosis. Having a positive blood test called a rheumatoid factor is not enough to diagnose rheumatoid arthritis. In recent years, a newer blood test called anti-CCP has been found more specific than rheumatoid factor in helping to diagnose rheumatoid arthritis. Most patients with inflammatory joint diseases such as rheumatoid arthritis are treated by specialists called rheumatologists. In order to prevent permanent joint damage, it is very important that the diagnosis is made promptly, and that treatment is started as soon as possible. No cure has yet been found, but there are many types of medications (often used in combination) which are very effective in treating rheumatoid arthritis. Remission is now possible, and is considered to be the target of treatment.

These medications are called disease-modifying anti-rheumatic drugs (DMARDs for short). Traditionally effective DMARDs include methotrexate, sulfasalazine, plaquenil and leflunomide. Treatment may be started with one of these, or a combination of two or three. Several other similar medications are occasionally used.

Recent discoveries of how the immune system causes inflammation in rheumatoid arthritis has led to an increasing number of injectable medications called ‘Biologics, or biologic DMARDs’. They inhibit a protein called TNF which has been linked to inflammation in rheumatoid arthritis. Examples of these TNF inhibitors are Cimzia, Enbrel, Humira, Remicade, and Simponi.

Other new and effective medications also approved for the treatment of rheumatoid arthritis include Actemra, Orencia, Rituxan, and Xeljanz. They also effectively reduce damage caused by rheumatoid arthritis by affecting certain cells or chemical signals in the immune system.

Although both traditional DMARDs and the newer biologic medications have been thoroughly tested, they all may cause side effects, and should be prescribed by a licensed health care provider with training and experience in their use.

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What is Enbrel?

Enbrel is an injectible medication used to treat several forms of arthritis and psoriasis. It was first approved in 1998. According to the manufacturer’s website, it is currently FDA approved to treat these conditions:

  • Moderate to Severe Rheumatoid Arthritis (RA)
  • Active Polyarticular Juvenile Idiopathic Arthritis,
  • Psoriatic Arthritis,
  • Ankylosing Spondylitis,
  • Moderate to Severe Plaque Psoriasis.

How Effective is Enbrel? 66% of people with moderate to severe RA saw less pain and stiffness with Enbrel at three months. Over half (55%) of people who were still taking Enbrel five years after starting therapy had no additional joint damage.

How Safe is Enbrel? Generally it is safe, in one six month study 25% (39 of 152)  of patients with RA taking placebo and 14% of patients (50 of 349) taking Enbrel developed infections, including bacterial, viral and fungal infections. The most frequent infections were upper respiratory tract infections, sinusitis and influenza. Further information may be found here.

Other side effects include:

Other rare side effects of Enbrel have been reported:

  • Hepatitis B can become activated if you are a carrier.
  • Tuberculosis can become active if you have been exposed in the past.
  • Nervous system problems such as multiple sclerosis, seizures, or inflammation of eye nerves may occur
  • Occassional blood problems such as low white blood cells or anemia (very rare, but some fatal)
  • New or worsening heart failure.

How is Enbrel given? There are three ways to receive Enbrel; the first is an autoinjector pen called ‘Sureclick’, the second is a prefilled syringe and the third is a multiple use vial that requires mixing. Videos of all methods can be viewed here.

How much does Enbrel cost? The cost to patients varies wildly, based upon insurance coverage. Without insurance the cost is estimated at several thousand dollars per month.  There are several patient assistance programs and foundations that can be found here.

Enbrel is most commonly used to treat Rheumatoid arthritis, and the six warning signs of RA can be found here. To see if your symptoms place you at risk of having RA, take the interactive quiz at


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It’s Poor Medical Care If The Doctor Isn’t Asking These 8 Questions.

(Print this out, fill it in before your appointment.)

  1. Where is your pain?

  2. When did it start?

  3. How bad is it?

  4. What kind of pain is it? (sharp, dull, aching, burning etc.)

  5. How often do you feel the pain? (is it constant, comes and goes, daily, hourly, monthly etc.)

  6. What makes it hurt more?

  7. What makes it feel better?

  8. Are there any other symptoms that are associated with the pain? (such as fever, redness, rashes, swelling etc.)

For an interactive symptom checker with pain questions and descriptions, visit

Posted in arthritis medicines, back pain, foot pain, Gout, hand pain, hip pain, knee pain, Leg Pain, neck pain, Pain Locator Tool, pain website resources, rheumatoid arthritis, shoulder pain | Leave a comment

5 Ways to Get Your Doctor to Listen to You About Your Pain.

5 Ways to Get Your Doctor to Listen to You About Your Pain.Listen megaphone

Organize your symptoms to make it easy for them to categorize pain in the way they learned to diagnose your condition. Write down the following (and provide him or her a copy).

  1. Location. Not just ‘my hip hurts’. Be specific. “The side of my hip hurts, or “the front of my hip hurts”. This immediately begins to narrow what is causing your pain (side – often bursitis, front – could be hip arthritis).

  2. When did it start? Try to be specific, and if it started all of a sudden or gradually. This kind of example is helpful and would help; “I tripped over my cat, and felt a loud pop in my knee” (ACL tear possible).

  3. History of your other painful conditions (be brief here). For example; “I never had any hip problems before”, or “I have rheumatoid arthritis“. This provides context.

  4. What the pain is like. In general terms – most helpful things here are really sharp, aching, throbbing, stiffness, numbness, burning. This helps decide if the pain is from joints, muscles, nerves etc.

  5. What makes it hurt, or when does it hurt. For example; “This shoulder pain is constant, never lets up even at night I can’t find a comfortable position (this suggests it might be bad, a tumor or infection) as opposed to “My shoulder hurts when I lift it in front of me to get something off a shelf, and I can’t lie on that side at night” (bursitis or rotator cuff problem is possible).

Leave it at that. Wait for them to ask the next questions. You have given them an excellent foundation of understanding to take over from this point. You can also describe your symptoms by visiting or have a free history taken through the Pain Care Accelerator which organizes your history into a more detail, and have the report sent to your health provider.

Posted in arthritis medicines, back pain, foot pain, hand pain, hip pain, knee pain, rheumatoid arthritis, shoulder pain | Leave a comment

Foot and Knee Pain: Symptoms and Common Causes

The immediate indicators of something being wrong in a musculoskeletal area of the body are two: pain and point tenderness, as it is the muscles and tendons around the joints that move the body around the joints. Any kind of inflammation, tear or strain one of these can result in pain and further injury. Sometimes there is pain without movement involved, and this should always be evaluated as it may be due to tumors or diseases of the nerves.

When it comes to the foot there are various reasons that can cause the pain and these include injury, overuse, overloading and arthritic conditions.

Any problems with the foot and the knee can greatly hamper and restrict movement, which can be a big problem. For the knee one of the most common inflammations; Pre-patellar Bursitis is a condition of the patellar bursae and sometimes called housemaid’s knee is often caused by prolonged periods of kneeling. The small fluid sac (bursa) in front of the kneecap gets swollen because of extra pressure and over use. Other reasons could be a sudden injury to the knee, infection or repeated minor injuries to the knee.

For the foot, a foot pain locator can be initially used for self-assessment of the affected area. Thereafter, if the pain persists and gets unbearable, a doctor needs to be consulted.

For the knee, in most cases, the problem come into light due to a pain in the knee, redness and swelling of the kneecap. Inflammation of the Patellar Bursae is easily diagnosed and mostly treated without medication by giving the knee some rest, avoiding the kneeling position and even going to a physical therapist in some cases.

For the foot, depending upon where and how bad the pain is, various methods of treatment can be used. If one has used a foot pain locator and found the cause of the problem initial help can be in the form of pain-relieving sprays and giving the foot area some rest or arch supports.

The outcome and treatment all depend upon the intensity of the pain and a defined course of treatment should be undertaken accordingly to avoid developing chronic pain, and especially for persistent or severe pain, professional medical help should be sought.

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Four Common Foot Conditions

Foot pain is one of the most common painful conditions. The causes can be many, and can in fact be due a problems in bones, tendons, ligaments, fascia, muscles, nerves, toenails, blood vessels, and skin.

Here’s a look at four most common and painful conditions that afflict people.

1. Nerve Problems – Foot pain can be caused by an inflamed, pinched or irritated nerve. Those who suffer from the tarsal tunnel syndrome experience shooting or burning pain that spreads from the inner side of the ankle towards the arch and the sole. This is caused by pinching or compression of a nerve near the inside of the ankle bone. Morton’s neuroma is another nerve related condition which may cause sharp shooting pain, usually with walking often between the third and fourth toes.

2. Heel Pain – Heel pain can be caused by a number of things but the most common cause is that of plantar fasciitis. If on the bottom of the foot near the heel, it may be due to plantar fasciitis and caused by inflammation of the attachment of the plantar fascia ligament to the heel bone. Pain behind the heel may be due to Achilles tendonitis, or bursitis.

3. Ingrown Toenails – An ingrown toenail can be a painful condition where the edge of a toenail grows into the edge of the skin. The most common signs apart from pain include swollen or red skin which is usually a sign of infection.

4. Arthritis – Physical wear and tear often breaks down the cartilage and leads to osteoarthritis. Rheumatoid arthritis, lupus and gout are some of the less common forms of arthritis, but may be causes of severe joint pain in any part of the foot or ankle.

If you suffer from foot pain, visit and then consult your doctor to locate the exact area where it’s giving your problems so to avoid further complications.

Read one of our other blogs to know about the different kinds of foot pain.

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What’s Causing Pain In Your Hand?

Have you been experiencing right or left hand pain?

Hand pain can be caused due to a variety of reasons, from something as simple as a strain or sprain to as painful as a fracture, arthritis or infection. But knowing what’s causing your hand pain is important. Some of the common reasons for pain in the hand (except for sprains and strains) include-

Arthritis- Gradually increasing pain and stiffness in hands, with associated swelling in fingers, hand or wrist or joints can be a sign of arthritis. It is recommended that you take an online diagnosis quiz to see if you may have the condition and then visit a doctor.

Carpal Tunnel Syndrome- Palm and finger pain in the thumb, middle and part of the ring fingers (especially at night), problems of pain starting in wrist and going up the forearm, weakness, burning pain, tingling and numbness or difficulty in gripping objects can be caused due to nerve disorder called carpal tunnel syndrome.

Finger Fracture- Of course, you would recall an injury.  Pain in Hand can be a result of a cracked finger bone. If you have had an injury, and have been experiencing pain, bruising and decreased range of motion in the hand with pain on the affected pain, it is time to go and see a doctor.

Paronychia- An infection, usually manifested in the left hand’s around the fingertip and fingernail. It may present with pain, redness and swelling around the nail.

You can take an online diagnosis quiz to which what kind of medical condition may be causing your hand pain. Visit the website for diagnosis quiz and list of medical conditions associated with hand pain.

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Causes And Treatments Of Neck Muscle Pain And Pain In The Top Of The Wrist

In the busy schedule and stressed life, people often tend to ignore pain in the top of the wrist or pain in the neck muscles.  Leaving such pain could lead to further complications and chronic pain.

Neck Muscle Pain:

Pain in the neck muscles is often caused when a person sits with a head position forward or in front of the shoulders, such as while reading or working on computer for a prolonged period without a change in position, and may result in neck muscle pain. Sometimes a prior injury such as an unusual and sudden twisting injury or an accident could result in a risk for developing pain in neck muscles.

Treatment – Common advice used to treat the pain in neck muscles is:

1.  Obtain exercise instruction regarding neck treatment (posture, correct neck pillow use, intermittent soft cervical collar, stretch/strengthening exercises, and over the counter pain medications).

2.  Avoidance of aggravating activities (such as television or reading in bed, napping on the couch, cradling telephone).

3.  Try a low back (lumbar) support cushion for car, and chair at home. No TV in bed. No napping on couch. This helps to balance the neck over
the spine, and reduce neck muscle tension.

4.  Place the car seat in the car as upright as possible.

5.  A neck (cervical) pillow should used when sleeping on your side.

6.  Stretch and strengthen as instructed by a therapist or other health professional at nighttime, and in the morning.

7.  If you need to, trial of a soft foam rubber cervical collar for 1-2 hours two to three times daily as needed.

On the other hand if there are symptoms of nausea, dizziness, severe headache and extreme pain and stiffness with flexing the neck, fever etc. it is important to seek immediate medical assistance.

Pain in Top of the Wrist:

The wrist is made up of eight small bones which are connected to the bones in forearms and hand bones by ligaments and tendons which attach these bones to the muscles. A sudden impact or certain kinds of repetitive stress could lead to injury or strain of the ligaments and muscles and result in pain in the top of the wrist. The pain could also be due to arthritis.

Treatment – A person suffering from top of wrist pain should try to reduce strain on the wrist. The affected area should be massaged gently and a warm pack application is also advisable. Pain relieving medicines like Tylenol or Ibuprofen can also be taken. If the wrist is swollen, warm or red, seek the immediate advice of a health professional.

If the pain persists, it would be advisable to seek medical attention as an underlying arthritic disease or bony problem may be present.

Ignoring the symptoms of pain in the neck or wrist could lead to complications and thus should be attended to as soon as possible if they persist.

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Acute Lumbar Pain: Causes, Symptoms and Treatments

The lower back is also known as the lumbar spine. It is made of five bones called vertebrae that look like blocks. These are attached to a triangle shaped bone called the sacrum at the lower end of the spine. These bones have cartilage cushions between them which are called discs. The spine has muscles in four round columns around it and is supported by ligaments which are attached to the bones. If these muscles and ligaments are injured the resulting pain is usually called an acute lumbar strain.

Sometimes, while lifting weights or in case of a sudden twisting motion of the lower back, the ligaments and the muscles attached to the lumbar bone are strained and injured. This leads to painful stiffening of the back muscles and often muscle spasms and surface pain of the overlying skin. If the ligaments are injured it is called an acute lumbar strain.

The treatment for an acute lumbar strain usually begins with a short period of diminished activity; not moving around too much, gently massaging the area of pain and applying heating pads. Sometimes a cold pack alternating with heating pads is helpful. Over the counter pain relieving medicines like Ibuprofen or Tylenol may be taken to relieve the deep muscular or even the outer surface pain or sensitivity.

If there are symptoms like nausea, fever, severe pain, weakness or numbness in the legs, problems with bladder and bowel control, then immediate medical attention would be required.

If the pain is not relieved even after 4 -5 days or worsens, it is advisable to consult a health professional, who would be able to check and gauge the cause and severity of the problem.

Most adults will suffer from temporary pain in the lower back sometime during their lives. This is often due to bad posture or improper lifting technique but may be associated with obesity, weak lower back and core abdominal muscles.  It is well worthwhile participating in preventive core strengthening exercises (such as Pilates, Yoga, swimming or water aerobics) to protect the back from injuries.

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Bursitis: Overview And Suggested Treatment

Bursitis is a condition that relates to the swelling or inflammation of a bursa which is a small fluid containing sack-like structure that cushions the joints of the body as well as bones and tendons and muscles. Those that are affected by bursitis usually experience pain and tenderness at the point of inflammation.

There are a number of parts of the body that may be affected by bursitis and these include shoulder, elbow, ankle, knee, hips and low buttock regions. In most cases symptoms include pain in these areas, swelling, and pain with movement.

The reason for bursitis is usually overuse of the affected area, injury or incorrect use. Sometimes inflammatory diseases such as gout or rheumatoid arthritis may cause bursitis. If there has been a scrape or laceration type of injury, bursa infections may occur. This is more common over the knees and elbows – this kind of problem is commonly sports related.  Activities which require intensive use of any one part of the body especially hips, knees and shoulders should be reduced until the symptoms resolve.

Here are a few tips:

If the pain is severe, proper medical help might need to be sought. Sometimes cortisone injections are very helpful. However, this is not a common thing and very rarely surgery is required.

Want to check yourself for symptoms which might be bursitis? Go to and find out today!

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