Many people with rheumatoid arthritis also develop a little-known disease called Sjögren's syndrome. These strategies will help you deal with the challenges of managing both conditions.

Rheumatoid arthritis is frustrating enough on its own. But about 15 percent of people with RA develop a complication that causes dry mouth, dry eyes, dry skin, and additional symptoms that further aggravate their arthritis. It’s called Sjogren’s syndrome (SS).

Like rheumatoid arthritis, Sjögren’s syndrome is an autoimmune disorder that develops when your body is attacked by its own immune system. Complicating your care, Sjögren’s syndrome offers up its own list of symptoms, including a painful burning or gritty feeling in the eyes that can leave you prone to eye infections. You may also have a dry sensation in your mouth that increases the chances of dental decay or gum inflammation. In more extreme instances, Sjögren’s syndrome can affect other parts of the body, including your skin and internal organs like the lungs, liver, and kidneys. 

Sjögren’s syndrome occurs by itself (primary Sjögren’s syndrome) or in conjunction with rheumatoid arthritis and other rheumatic conditions (secondary Sjögren’s syndrome), explains Philip L. Cohen, MD, chief of rheumatology at Temple University Hospital in Philadelphia. “Secondary SS usually occurs long after the diagnosis of RA and generally is less severe than primary SS.”  

Living With Rheumatoid Arthritis and Sjögren’s Syndrome

Neen Monty of Queanbeyan, Australia, is no stranger to the challenges of living with the pain and swelling of joints, dry mouth, and dry eyes related to rheumatoid arthritis and Sjögren’s syndrome. She was diagnosed with rheumatoid arthritis five years ago; earlier this year her doctors suspected she was also dealing with Sjögren’s syndrome. Her challenges with her health inspired Monty to start a blog for others with arthritis called Arthritic Chick.

Monty (pictured above) admits that dealing with rheumatoid arthritis all on its own was very challenging and that coping with both rheumatoid arthritis and Sjögren’s syndrome can feel overwhelming at times.

“The No. 1 challenge of RA is the pain,” she says. “I have pain every day, though which joints are affected and how intense the pain is varies. It’s been that way for about four years now, so I’ve reached a certain level of acceptance. Sjögren’s seems minor compared to RA, but when my eyes flare up, I look like the elephant man! I can’t drive because I can’t see properly. My eyes are so painful and light-sensitive that I just have to sit in a darkened room for a few hours with my eyes closed.”

Monty has met the challenges of rheumatoid arthritis and Sjögren’s syndrome by being diligent about taking her prescribed medication. She also fights to keep a good attitude, no matter what symptoms she faces on a specific day. “For me, the most important thing is attitude,” Monty says. “I always try to stay positive. I try not to dwell on the pain, and I don’t talk about it much. I focus on what I can do rather than what I can no longer do. For example, I have always been a gym junkie. There are days when I can’t exercise, but most days I can do something -- yoga, lift light weights, ride a recumbent bike, or just some stretches. Even doing a little bit is better than nothing. Plus it gets me out of the house and gives me a goal.”

Monty also focuses on eating a healthy diet, which she believes further helps her in her fight against rheumatoid arthritis and Sjögren’s syndrome.

Rheumatoid Arthritis and Sjögren’s Syndrome: Tips for Coping

Nathan Wei, MD, director of the Arthritis Treatment Center in Frederick, Md., seconds Monty’s opinion that strict adherence to medication is the best course of action for both rheumatoid arthritis and Sjögren’s syndrome. And the good news, says Dr. Wei, is that treatment might not require you to do anything different.

“Both are systemic diseases, so biologic therapy for the RA will also treat the Sjögren’s,” he says. “Sjögren’s may require some local therapy for the dryness of the eyes and mouth. Also, with severe Sjögren’s, we'll sometimes use systemic drugs that increase secretions, such as Salagen and Evoxac.

Also, some small steps may bring big relief. Avoid sweets but try sugarless gum or candy to counter mouth dryness, suggests Wei. Special toothpastes and ointments are often helpful. Drink water frequently and try over-the-counter eye drops (artificial tears). If OTC products don’t help, your doctor may be able to prescribe medications that stimulate the flow of saliva and tears.

Photo credit: courtesy of Neen Monty