There are so many arthritis myths! As a millennial with arthritis, I have heard so many of them. This month marks 21 years of my life living with arthritis, so I figured it was as good a time as any to bust some of these arthritis myths. 

I am not a medical professional. I always cite my sources, which can be found in links, especially those indicated by (x). 

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Arthritis Myth #1: There are only a few types of arthritis 

In truth, there are over 100 conditions that fall under the arthritis umbrella (x). 

So many people think that “arthritis” means osteoarthritis and osteoarthritis only. But there are, again, over 100 types. 

This includes things like rheumatoid arthritis, psoriatic arthritis, Sjögren’s Syndrome, fibromyalgia, ankylosing spondylitis, and more. 

(You can learn more about the differences between osteoarthritis and rheumatoid arthritis in this post.)

If we’re going to look at entomology, “arthritis” literally means “bone inflammation” or “bone pain.” (See also “colitis” being “colon inflammation,” vasculitis being “vein inflammation,” uveitis being “uvea inflammation,” etc.)

In practice, if you see a rheumatologist, you’re probably under the arthritis umbrella. 

Rheumatologists are doctors who “who received further training in the diagnosis (detection), and treatment of diseases that affect the muscles, bones, joints, ligaments, and tendons” (x). More specifically, they treat “systemic autoimmune diseases” and did extra years of training beyond medical school in the specialty of rheumatology (x). 

The Arthritis Foundation has a really, really good list of various forms of arthritis, and you can learn more about them on their website. It’s also designed for non-doctors to understand, which majorly helps.

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Arthritis Myth #2: Everyone gets arthritis when they age and you can ONLY get arthritis when you age

The type of arthritis that people often get when they age – the wear-and-tear type – is osteoarthritis. Not everyone gets it and you don’t have to be aging to get it. 

For example, a lot of athletes have osteoarthritis because of the wear and tear on their joints, especially pro athletes. You might also have osteoarthritis if you were in a car crash or some other accident. 

My dad had his hip replaced at a young-for-needing-hip-replacement-for-osteoarthritis age because he is a marathoner who easily walks 15,000 steps in a weekend if he’s doing his normal weekend stuff. 

Here’s another example. When I was a resident advisor for freshmen in college, we did what we called “passive programs”. Basically, we put up information around the building to help students learn something new. When it was my turn, I obviously did arthritis information, especially as this was at the beginning of my advocacy journey. 

Because I was an RA for freshmen, I had my door open a lot, and my room was near the elevator. I will never forget having my door open and hearing 2 freshmen see this information. One went, “What’s with all this arthritis stuff? No one our age has arthritis.” His friend turned to him and went, “Dude, I have arthritis,” and it turned out he had osteoarthritis from years of sports and injuries in sports.

So, yes, many, many people get arthritis as they age, but you can really be any age to get osteoarthritis, especially if you are a weirdo who finds marathons fun or were in a car accident or were an athlete for a long time. 

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Arthritis Myth #3: All rheumatoid arthritis patients test positive for the arthritis diagnosis blood test

When it comes to diagnosing autoimmune and/or inflammatory arthritis, doctors run a few blood tests. These are to check inflammation levels in the body and also some immune system components. 

One such test is the ANA, or Antinuclear Antibody Test. As you know if you’ve been paying attention to COVID vaccines in the last few years, “​​Antibodies are proteins that your immune system makes to fight foreign substances, such as viruses and bacteria” (x). While having some is normal – vaccines trigger your body to create antibodies for specific illnesses so you can fight them in the future – having too many is a sign of an autoimmune disease (x). 

Other tests they do are C-reactive protein and ESR. CRP is “a protein that is produced by the liver and released into the bloodstream in response to inflammation,” so this helps figure out if you have an inflammatory condition (x). It might not be inflammatory arthritis like RA, but it is active inflammation. ESR – or Erythrocyte Sedimentation Rate – also evaluates inflammation in the body (x). 

But, of course, the most specific blood test for rheumatoid arthritis is rheumatoid factor. Rheumatoid factor is a “protein produced by the immune system that can attack healthy joints, glands, or cells by mistake” (x). It can indicate other conditions, namely lupus or or some cancers, but if you have RA symptoms and a positive rheumatoid factor, you almost definitely have rheumatoid arthritis (x).

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HOWEVER!

Not everyone who has rheumatoid arthritis tests positive for rheumatoid factor. 

People who do are called seropositve, and the nearly 20% RA patients who don’t are called seronegative (x). And, of course, I’m one of those 20%. 

Seronegative patients still have all the same symptoms that a seropositive patient does: chronic inflammation, morning stiffness, fatigue, joint pain, etc. What is especially interesting is that a 2016 study found that seronegative RA patients might in fact have higher inflammation levels than seropositive (x). 

Additionally, some researchers contend that a potential difference between seronegative and seropositive patients might be the joints affected (x). This refers to which joints are affected, so seropositive patients might have different affected joints than seronegative ones. Regardless, seronegative patients still need as aggressive treatments as seropositive ones.

All of this is to say that no, you do not have to test positive for rheumatoid factor in order to have rheumatoid arthritis. 

You can learn more about my arthritis diagnosis story in this post, which also contains diagnosis stories from 2 other patients.

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Arthritis Myth #4: The only arthritis medication is Advil or Aleve

Advil and Aleve are NSAIDs, or non-steroidal anti-inflammatory drugs, and they’re some of the only over-the-counter medications for inflammation. This means that most people are only aware of them, but most people aren’t aware that they’re not the only ones available for arthritis patients. 

There are a lot of medications available now for people with autoimmune arthritis, and if you’re an American who watches TV – like, traditional cable with commercials – you might be familiar with some names. Let’s talk about some of them. 

TNF-inhibitors are drugs that go after the tumor necrosis factor (x). This helps reduce or stop inflammation in people for whom the TNF is the problem, namely that they have too many TNF cells (x). The immune system releases “TNF to alert other immune system cells as part of an inflammatory response” (x). These drugs are usually taken via a shot that you give yourself or an infusion that you get at a doctor’s office. There are a LOT of TNF-inhibitors out there, but some you might know are Humira or Enbrel. You are only ever on 1 TNF-inhibitor at a time.

Anti-IL-6 drugs are drugs that go after the interleukin-6 receptors (x). As Rheumatology Advisor says, “Numerous proinflammatory cytokines are involved in the disease process, and studies have suggested that IL-6 also has a significant impact on the development of RA” (x). Essentially, IL-6 does inflammation stuff. These medications are usually taken via a shot that you give yourself or an infusion that you get at a doctor’s office. One anti-IL-6 drug you might know is Kevzara. You are only ever on 1 anti-IL-6 drug at a time.

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JAK-inhibitors are drugs that go after janus kinases. They “decrease your immune system’s ability to make certain enzymes that can lead to RA symptoms” (x). One JAK-inhibitor you might know is Xeljanz. I’m not positive, but I believe that you are only ever on 1 JAK-inhibitor at a time.

DMARDs are disease-modifying anti-rheumatic drugs. These drugs can be either pills or injections, and some can be both. DMARDs are the first line of treatment that you take. One you might know is methotrexate. You can be on a bunch of DMARDs at once; I personally take 3.

B-cell inhibitors are drugs that go after, well, b-cells. B-cells are a type of white blood cell, and they’re actually the part of the immune system that build antibodies (x). While many of the other medications go after inflammation specifically, b-cell inhibitors go directly after a whole cell in the immune system (x). These medications are given via infusion at a doctor’s office. This is one you probably aren’t familiar with, but I take Rituxan, and the other ones approved for RA patients are biosimilars of Rituxan. You are only ever on one b-cell inhibitor at a time.

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Arthritis Myth #5: Arthritis only feels one way

I mean, if you’ve read this blog before or you follow me on social media, you know how untrue that is. 

My rheumatoid arthritis symptoms include morning pain and stiffness, which is different than my pain later in the day. “Morning stiffness” means pretty much what it sounds like: I’m extra stiff in the morning. For me personally, this also means some morning pain. It’s different than pain later in the day, as it’s more like pain from my joints taking a while to warm up in the morning. 

My traditional daily pain is like an ache focused around the particular joints that are affected and bother me. When it is really bad, that “ache” radiates out from the joint. I put ache in quotation marks because while it is the best description for it, I personally feel like it downplays the pain because that pain can hurt a LOT. 

Something I’ve experienced in a variety of joints is my RA damaging my cartilage. The abstract of a 2016 study said, “Even successful treatment with complete resolution of synovial inflammatory processes does not lead to full reversal of joint functionality, pointing to the crucial contribution of irreversibly damaged structural components, such as bone and cartilage, to restricted joint mobility” (x). Basically what this means is that even if your RA improves, if it has already damaged your cartilage or bone, there is still pain and difficulty using it.

This study found that “cartilage damage and bone erosion, but not synovial inflammation, are the most important determinants for progressive functional impairment in this chronic erosive arthritis model” (x). This means that, for people who have cartilage damage and bone erosion, those things are bigger factors in the day-to-day use of the joints than synovial inflammation itself.

(For those of you unfamiliar with how inflammatory autoimmune arthritis works, the immune system causes inflammation in synovium, or lining of the joints, and that inflammation leads to cartilage damage and bone erosion.)

I have had bone erosion in both of my feet, as well as my right TMJ. Both of my feet have had synthetic bone grafts to deal with it, but the erosion in my TMJ is so severe – and the joint works so differently than the bones in my feet – that if I have TMJ surgery, it will almost definitely be a TMJ replacement. (Learn more about TMJ arthritis here.) 

Additionally, I had or have cartilage damage in both of my feet, my right knee, and my right wrist. It’s possible I have it elsewhere, but those are the places I’ve had imaging and/or surgery. 

All of these things feel differently, so arthritis doesn’t only feel one way. And this is all just rheumatoid arthritis! You can learn how other forms of arthritis feel in this post. 

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Arthritis Myth #6: Arthritis prevention exists

Unfortunately, there’s not much you can do to prevent arthritis. Sure, you can do normal things to stay as healthy as possible like eating healthy and exercising some. But there’s really nothing you can do to prevent developing arthritis. 

Since osteoarthritis is wear-and-tear, often over decades, you can’t do anything to prevent yourself from getting arthritis when you age. Sure, moderately exercising and not being an intense athlete can help to a certain extent. But you can’t prevent someone else from causing a car accident. 

There is also a genetic component to autoimmune diseases (source). A 2009 article published in the Annual Review of Immunology says, “Autoimmune disorders have a complex genetic basis; multiple genes contribute to disease risk, each with generally modest effects independently. In addition, it is now clear that common genes underlie multiple autoimmune disorders” (x).

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Hell, I’m one of five people on my dad’s side and one of three on my mom’s side who has an autoimmune disease. And that’s just the descendants of my great-grandparents; my great-grandmother almost definitely had an autoimmune disease. My dad is one of seven and four of those seven branches have diagnosed autoimmune diseases. 

I can’t do anything about that. 

There’s also a type of arthritis called reactive arthritis. The Mayo Clinic says, “Reactive arthritis develops in reaction to an infection in your body, often in your intestines, genitals or urinary tract” (x). Sure, you can practice safe sex to prevent a genital infection. But if you eat food at a restaurant that’s contaminated with E. coli, you can’t control how that restaurant works, and E. coli can trigger reactive arthritis.

All of this is to say that, unfortunately, arthritis prevention doesn’t exist.

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Arthritis Myth #7: It will be really obvious when you develop arthritis

By and large, arthritis is something you develop over time. You don’t wake up one day and have arthritis symptoms. The amount of time it takes to develop it might differ, of course; for most people who develop osteoarthritis, you develop it over the course of decades. 

But no, it will not be really obvious when you develop arthritis. 

Many, many forms of arthritis are system illnesses. You might have joint pain, but it might not be as big a deal as your other symptoms. Systemic symptoms include regular low fevers, fatigue, digestive issues, and more (x). I often get costochondritis, which is inflammation of the lining of the ribs, and it is extremely painful (x). But because your ribs are over, you know, your heart and lungs, it can be unclear if you’re having chest pain because of ribs or because of those important organs. Costochondritis is often mistaken for a heart attack because of its location (x). Since some autoimmune diseases like system forms of arthritis develop when people are in their 30s to 60s, a prime time for heart attacks, it’s easy to see why someone would think “heart disease” before “arthritis” (x).

On the other hand, there are around 300,000 American kids with some form of juvenile arthritis (x). If a kid starts having joint pain, most people are going to think it might be anything other than arthritis. That’s how it was for me.

As I’ve said before, it took 9 years after my symptoms developed for me to be diagnosed, and my systems started at the age of 10. It took surgical imaging from my foot showing arthritic damage (that wasn’t blatantly osteoarthritis) and imaging of a destroyed TMJ to be diagnosed. It’s not always obvious, especially if you don’t know what to look for and/or you don’t have osteoarthritis.

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These are just some of the many arthritis myths out there. I hope that this helps you better understand this complicated set of conditions, whether or not you have arthritis.

Like this post? Share it! Then check out: 

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