Q: I am 37 years old and live in California. After my fathers death in 1997 , which was very traumatic for me as I was close to him - I suddenly developed finger joint aches one night. Consequently, my ankles, toes, elbows and wrists were affected. The doctor did tests for suspected RA . The factor was negative. But the pain/swelling got worse so I went on steroids and it magically reduced. I did not want to stay on steroids for too long so I tapered it off in about five months. I then went on chloroquine (malaria drug ) and that helped too and I was eventually weaned off that drug also. Since 1998, I have not been taking any drugs. I have had my second child in 99. I do feel aches and pains in my joints every now and then, stiffness during the mornings, and pain during heavy lifting, opening tight lids on bottles, getting up after sitting with knees bent etc. My question to you is whether I should be taking any medication at all? I don't feel the need to do so as the pain is minimal and very bearable. But hopefully I am doing the right thing and not causing any more damage to my condition and future health by not taking any medication. I just don't feel comfortable drugging my body when I don't feel the need for it. Meanwhile, my rheumatoid factor is still negative so it is not a confirmed RA condition. The doctor here has educated me on the disease and its management - I am willing to take drugs if absolutely necessary. Please do give me some advice as to whether it is necessary to take medication to prevent further damage of the joints when pain is minimal. I am apprehensive about my future with this disease. Also, would you recommend aerobic exercise along with light weight training for anyone with this conditon? Also, is it possible that inspite of my test results coming out negative regularly, I do have RA ?

A:It is certainly possible that one can have rheumatoid arthritis (RA) in the absence of the rheumatoid factor (RF). If one has been diagnosed to have RA- and this is mainly a clinical diagnosis to be made by the treating rheumatologist - then the general rule is, that one needs to be on some medication, to control the disease, virtually life-long. This decision however, is best made by the treating rheumatologist, as is the decision regarding need for exercises and the type of exercises.