How do we know when we achieve remission?

This week we’re bringing you the another question submitted by our one of our clients and social media followers! If you have a question you’d like to submit, please email us here.

Question:
How do we know when we achieve pharmaceutical remission? Does remission have any pain?  Fatigue?

Answer:
There are different ways to look at remission. For patients this can mean being pain free, but having no pain does not necessarily mean the disease process is not active.  To truly assess remission, rheumatologists evaluate inflammatory markers in blood work as well as images of the joints such as ultrasound, X-Ray or MRI, in addition to asking questions about your pain, morning stiffness, and ability to function at home, work, and socially. In addition the “hands on” assessment of your joints is also important.  Achieving full remission is easier to achieve when treatments to stop disease progression are started early; ideally within the first year after symptoms are first identified. Remission can also be easier to achieve in non-smokers and those who are not overweight as fat cells produce inflammation themselves.  The goal of treatment ideally is to achieve remission, but as this is not always possible, achieving low disease activity can still make a significant difference in a person’s quality of life and preventing joint damage.

Fatigue can certainly be reduced when disease is under control, however, some people can continue to have fatigue despite their arthritis being well controlled. Pain, inflammation and the stress of illness overtime can place a large burden on the body if a disease has not been well managed. This may lead to adrenal stress, whereby fatigue can remain despite low disease activity. The same can be said for pain. An increased sensitization to pain can occur in people who have experienced untreated pain overtime. If the pain is coming from tissue beyond the joints and it is experienced as a generalized pain sensitivity, then this type of pain may not necessarily resolve even though the inflammatory condition is in good control.

Carolyn Whiskin is the Pharmacy Manager for Charlton Health.  Carolyn specializes in the treatment of autoimmune diseases, pharmaceutical compounding, women’s health, pain and smoking cessation. Carolyn has won provincial and national awards for her commitment to patient care and public service.

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