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when to visit the doctor

I was diagnosed in August of this past year. The rheumatologist prescribed methotrexate and I have responded well. However since the middle of December I have developed hip pain. Sometimes it wakes me up at night. I researched hip pain and RA and most of the info says that hip pain occurs later in RA so I'm not sure if this is related to RA. The hip pain is really on my right side. The left side has hurt some but not much. My next scheduled appointment with the rheumatologist is in late March My question is - when do I call the doctor about new joint pain? I don't want to run to the doctor with each new twinge but I also want to make sure that I am preserving my joints. Part of my hesitation of going to the Dr is that I really don't want to go on new medications. Should I go before March or just wait? Any advice?

  1. Hi Michelle, sorry for your recent diagnosis. But glad you found this site and community. Read all you can and stay connected with other RAers.

    It's sometimes difficult to pin any and all joint pain on RA without hard evidence like an image that shows erosion of a biopsy that shows lab evidence. While it could be that hip damage from RA comes later in disease progression, you can't ever rule it out as the disease progresses different in each patient. I had large joint damage before it moved to small joints like my fingers.

    Yes, may wish to contact your doctor if you don't have an upcoming appointment until late March...especially if it is bothering you to the point of affecting sleep or other daily activities. They may want to examine it. Maybe a cortisone shot is worth a try if it's really bothering you.

    You may not want to take more medication but it could be that methotrexate is not enough to keep the disease in check. The target is to get you as close to remission as possible and that may mean adding or changing treatments.

    Hope you get it figured out soon and find some relief.


    1. Hi Michelle - I am sorry to hear about your recent diagnosis and your hip pain. I think it is absolutely appropriate for you to call your doctor and ask about it, particularly if it will be a long time until your regularly scheduled appointment. Keep in mind that it is your doctor's job to help you manage your RA, so you don't ever need to feel bad asking for help if you have concerns! And while I certainly understand the desire to minimize the amount of medication you need to take, Andrew is right that it is possible the methotrexate is not enough to keep your disease in check. This was the case for me. I started out on methotrexate and it helped, but not enough. Eventually my doctor added a biologic (first Remicade then Enbrel). And while it may be scary to think about adding more medication to your regimen, I will tell you from personal experience that finding the right combination of medications can make a huge difference to your quality of life. Best of luck to you!

      1. Hello everyone,

        As you can see I'm new to all this, I have been recently diagnosed with RA at the age of 30. I'm a full time RN and mother of two boys ages 12 and 4, I'm trying very hard to accept what the doctors have told me but it seems like a death sentence, I seem old lol. But what I would like to know is what everyone suggests would help? What works what dosent? I see a rheumatologist in a few days and would like to go in with some knowledge from people who would know best. thank you for reading this.


        1. Hi Audra~

          I am so sorry to hear about your recent diagnosis and I want you to know that I understand what you are going through. I was diagnosed at 25, right in the middle of law school, and it took me a really long time to understand what was actually happening to me because I just felt too young to be dealing with such major health issues! And now I am 31 and the mother of a 2 year old, with another on the way, and so I also know what it's like to juggle a chronic illness and motherhood at the same time. So I want to start by saying that you are not alone and I am here to listen if you need someone to talk to about all of this!

          It's really great that you are going in to see a rheumatologist - you should know that he or she will be your very best resource to decide what will work best to treat YOUR RA. Unfortunately, one of the most frustrating things about RA is that it is so very different from person to person - which means that the treatments that have worked for me will not necessarily work for you and vice versa. This means that it will probably be a (hopefully short) process of trial and error to find a treatment that works for you.

          Here is some general information about drugs used to treat RA. As an RN, some of this is probably way too basic for you - but I thought I would pass it along anyways. Depending on your symptoms, test results, and how you respond to these medications, your rheumatologist will likely choose a combination of the following to treat your RA:


          If these options don't work, it may be necessary to move on to a biologic medication (It was for me):

          Hope this helps. Hang in there!

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