A tube of toothpaste exploding from the crimped end. The toothpaste spilling out is in the rough shape of a flare.

The Toothpaste Tube Theory of Inflammation

Growing up with juvenile rheumatoid arthritis (JRA), I learned to believe that finding the correct treatment would serve as the balm that could calm my out-of-control inflammation. It was sort of a switch button theory. Apply the right pressure to the right button and “blammo!” my inflammation and resulting JRA would disappear.

We never found the right switch as I grew from child to adult. Some treatments would calm my disease somewhat for a time. Nothing turned the inflammation switch to the off position. It was always there, churning and lurking.

Only recently have I been on a biologic that has lowered by CRP (C-Reactive Protein) to within the normal range. This is good news! But unfortunately, I still have 40+ years of joint damage. While my day-to-day disease experience is better overall, I know that I still have inflammation.

Chronic inflammation with RA

I honestly believe that I have an extreme case of the disease. It’s not just that I was diagnosed at age two and have had it for decades. I also believe that my inflammation is just really high. It’s my superpower and kryptonite all wrapped into one package.

Popup inflammation throughout the body

Maybe it’s anecdotal, but my evidence for this theory is lifelong. I’ve always had inflammation and it shows up in multiple ways, not just my joints. For example, I get skin inflammation and stomach inflammation. I get headaches sometimes that feel like the heat of inflammation.

I call this my “Toothpaste Tube Theory of Inflammation.” The story goes like this. When my joint inflammation is calmed by a treatment (such as my current medication), I experience pop-up inflammation in other places. Basically, I think my inflammation will always be there and make its appearance in different forms. Squeeze the tube and the toothpaste comes out where it can.

RA inflammation presents itself in different ways

Previously, I’ve had stomach problems that caused me to feel hot, irritated, and sick—which affected my digestion. On another medication, I had terrible recurring migraines. And on my current medication (which has worked the best of any treatment on my joints), I have constant, roving psoriasis or inflamed skin.

In sum: my tube of inflammation is full and is going to come out in some fashion. The question is how the inflammation is released and how can I manage to live with it? In my theory, my inflammation is a zero-sum game. I will always have it, but can I learn to live with the form that it will take?

Coping with different types of inflammation

It is not easy, but I have learned to live with the JRA. I know what it is. I have adapted. And I can live my life and enjoy it. When I was grappling with other inflammation spikes, it was surprising, uncomfortable, and difficult to adjust.

For example, last year when the psoriasis flared and I was not yet diagnosed, I developed a serious secondary skin infection. With the help of my doctors, we solved the infection and identified psoriasis as the underlying cause. Now that I have some cortisone (steroid) cream and know how to identify the psoriasis, I can keep it fairly-well managed.

Inflammatory diseases are not easy. It’s hard to find a treatment that helps and it’s difficult to manage with the resulting side effects and complications. I’ve come to believe that my inflammation may be calmed, but it is always there lurking. If I can manage with how it chooses to attack, then I’m able to carry on living my life.

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