Browse Answers

While Ankylosing Spondylitis usually affects the back, it can affect other joints as well. Larger joint involvement is more common than smaller joints such as the hands or feet. Tendon involvement, particularly where the tendon attaches to the bone, can be seen.

Dallas from Edmonton asks: My fiancée and I are getting married in less than a month and we have starting talking about having a family. I’m currently taking Methotrexate injections once a week. We are worried that the methotrexate could increase the chance of birth defects. Has there been any studies done regarding the effects of methotrexate in men when trying to have a baby?

Certainly females should not get pregnant while on methotrexate, with recommendations suggesting that women should stop methotrexate at least 3 months before trying to become pregnant. The data for men is less clear. There are rheumatologists who recommend the same for men, avoidance of methotrexate for at least 3 months before trying to conceive. There are suggestions that methotrexate could affect sperm, however, no study has clearly shown any harmful effects.

Linda from Canada asks: My rheumatoid arthritis doctor mentioned that I have erosions. Could you please explain this…how serious is it? Is there something one can do for it?

Rheumatoid arthritis causes joint pain, stiffness, swelling, functional impairment, and if not controlled quickly enough, it can cause permanent damage to the joint. The first sign of permanent damage is an erosion, a small bite out of the bone about the joint. A small bite of the bone is not something that a person will notice, but if it continues to develop bigger and there are more of them, it can cause significant deformity in the future. Once an erosion occurs, it cannot be reversed. However, aggressive treatment to control rheumatoid arthritis can prevent further damage from happening.

Daniel from Edmonton asks: My friend has psoriatic arthritis. He is in a lot of pain and is getting treatment to help deal with his condition. One thing he would like to do is start a fitness routine to help. I’m looking for advice on how to help plan and work in a fitness routine that could account for his joint pain.

Great question! We encourage our patients with inflammatory arthritis to stay active despite having arthritis. We know that maintaining activity and muscle strength is a positive, and can be an important component of treatment and well being. Further, activity itself should not make the arthritis worse. That said, every individual is different and we need to ensure an appropriate balance between remaining active and not causing pain. Physical therapists with expertise in inflammatory arthritis are often involved in consulting and developing activity plans. Your rheumatologist should be able to recommend an appropriate physical therapist to you.

Linden from Montreal asks: My wife suffers from rheumatoid arthritis. She normally takes etanercept injections to mitigate the symptoms of her arthritis. She is now breastfeeding and has stopped taking the injections for some time. Her inflammation and pain are getting worse, and we are wondering if it is safe to use etanercept during breastfeeding.

There is limited data about the safety of entanercept or any of the other TNF antagonists during pregnancy and breastfeeding. From the available data, there is no clear indication that TNF antagonists are problematic in pregnancy and breastfeeding. As rheumatoid arthritis goes into remission for many women, and with some uncertainty of safety still present, most women will stop TNF blockers when they know they are pregnant. That said, there are many women who have had successful pregnancies while using TNF antagonists.

For breastfeeding, officially, it is not recommended by the pharmaceutical manufacturers of these medications. However, there is no data to suggest it is harmful to the baby. There is a very small amount of TNF antagonist that is excreted in mother’s milk; it is thought, though, that the medication is broken down in the baby’s gut and therefore is likely not harmful. Ultimately, each individual must balance this small unknown risk and the functional abilities of the mother to care for their newborn if they have active inflammatory arthritis.

Patti from Sherwood Park asks: I have osteoarthritis of my thumb. I have tried NSAIDs and glucosamine, and am thinking about trying Sierra Sil. Any suggestions?

Osteoarthritis to the base of the thumb is a common spot to have osteoarthritis. Treatment is aimed at managing symptoms and improving function. Because of this, treatment options that works well for one person may not be as effective for the someone else. We cover many treatment options on our page for osteoarthritis, but one could consider acetaminophen, NSAIDs, a splint, physiotherapy, topical anti-inflammatories, and/or a cortisone injection, amongst other options. In terms of natural products, please visit our pages on glucosamine, Sierra Sil, and other available natural health products to review them for yourself.

Lorna from Sherwood Park asks: How do I see a rheumatologist?

In Alberta, a rheumatologist sees patients when consulted by another physician. Most commonly, a family physician will feel their patient would benefit from seeing a rheumatologist, particularly if they feel their patient may have inflammatory arthritis or a related rheumatic disease.