Rheumatoid Arthritis basically is a chronic inflammatory disorder which can also affect more than just joints. This condition can eventually damage a wide range of body systems in some people, including heart, lungs, eyes, skin & blood vessels. Rheumatoid arthritis is an autoimmune disorder which occurs when the patient’s immune system mistakenly attacks his/her own body tissues. Unlike wear & tear damage caused by osteoarthritis, rheumatoid arthritis is found to affect the lining of joints & thereby causing painful swelling which can eventually result in joint deformity & bone erosion. Inflammation, which is associated with rheumatoid arthritis, will subsequently damage other parts of the body as well. However, there are some new types of medications which are available & have dramatically improved treatment options. Nevertheless, severe rheumatoid arthritis is still capable of causing physical disabilities.
Signs & Symptoms of Rheumatoid Arthritis
Signs & symptoms of rheumatoid arthritis may include the following.
- Warm, tender & swollen joints.
- Stiffness of joints which is usually worse in mornings & after inactivity.
- Fever, fatigue & loss of weight.
Early phase of rheumatoid arthritis tends to affect the smaller joints first, particularly those joints which attach fingers to hands & toes to feet. With progression of the disease symptoms often spread to wrists, elbows, shoulders, ankles, knees & hips. Moreover, in most cases of rheumatoid arthritis symptoms occur in same joints on both sides of the body. About 40% of people having rheumatoid arthritis also experience signs & symptoms which do not involve joints. Rheumatoid arthritis can also affect several non-joint structures including the following.
- Blood Vessels
- Bone Marrow
- Nerve Tissue
- Salivary Glands
Signs & symptoms of rheumatoid arthritis may vary in severity & may also in some cases come & go. Heightened periods of disease activity are called flares, alternate with periods of relative remission when pain & swelling completely disappear. Moreover, rheumatoid arthritis can also cause joints to deform & shift out of place in some cases. People should therefore make an appointment with doctors in case they experience persistent swelling & discomfort in joints.
Causes of Rheumatoid Arthritis
Rheumatoid arthritis is found to occur when the immune system attacks the synovium, which is the lining of membranes surrounding the joints. This usually results in inflammation which thickens the synovium & can eventually destroy cartilage & bone within the joint. Ligaments & tendons which hold the joints together subsequently stretch & weaken. Thereby, gradually joints begin to lose their alignment & shape. Although a genetic component most likely appears to influence, doctors still do not know as to what starts this process. However, genes do not in fact cause rheumatoid arthritis, but they can make people more susceptible to environmental factors which can affect, like infection with certain bacteria & viruses, which may trigger rheumatoid arthritis.
Risk Factors for Rheumatoid Arthritis
Factors which can increase risk of rheumatoid arthritis include the following.
- Gender – Women are more likely to develop rheumatoid arthritis than men.
- Age – Although rheumatoid arthritis can occur in people of all ages, it is most commonly found to begin between ages of 40 – 60 years.
- Family History – In case any member of the family is having rheumatoid arthritis, this will pose an increased risk of the disease in other members as well.
- Obesity – People who are obese or overweight appear to be at higher risk of developing rheumatoid arthritis, especially among women who are diagnosed with this disease while they are 55 years old or younger.
- Smoking – Smoking cigarettes will increase risk of developing rheumatoid arthritis. This is particularly true when the person is having a genetic predisposition for developing this disease. Smoking is also found to be associated with greater severity of the disease.
- Environmental Exposures – Although this fact is uncertain & still poorly understood, exposures to silica or asbestos may increase risk of developing rheumatoid arthritis. Emergency workers who were exposed to dust arising from collapse of World Trade Center were found to be at higher risk of developing autoimmune diseases like rheumatoid arthritis.
Complications Associated with Rheumatoid Arthritis
Rheumatoid arthritis increases the risk of developing the following conditions.
- Osteoporosis – Rheumatoid arthritis itself & some medications which are used for treating rheumatoid arthritis can increase risk of developing osteoporosis. Osteoporosis is a condition of the bones which weakens them & makes them more prone to fractures.
- Rheumatoid Nodules – These are found as firm bumps of tissue which most commonly form around pressure points like the elbows. Moreover, these nodules can also form anywhere else in the body as well, including the lungs.
- Dry Eyes & Dry Mouth – People having rheumatoid arthritis are most likely to experience Sjogren’s syndrome which is a disorder decreasing amount of moisture in eyes & mouth.
- Infections – Rheumatoid arthritis disease itself & several meditations which are used in combating rheumatoid arthritis are capable of impairing the immune system which leads to increased risk of developing infection.
- Abnormal Body Composition – Proportion of fat when compared to lean mass is most often higher among people who are having rheumatoid arthritis. This is also true even in people who are having normal BMI (Body Mass Index).
- Carpal Tunnel Syndrome – In case rheumatoid arthritis affects the wrists, inflammation can compress nerves which serve most of the fingers & hand.
- Heart Problems – Rheumatoid arthritis is also found to increase risk of hardened & blocked arteries, including inflammation of sac which closes the heart.
- Lung Disease – People suffering from rheumatoid arthritis have increased risk of scarring & inflammation of lung tissues which can eventually lead to progressive shortness of breath.
- Lymphoma – Rheumatoid arthritis is found to increase risk of lymphoma. Lymphoma is a group of blood cancers which develop within the lymphatic system.
Diagnosing Rheumatoid Arthritis
Rheumatoid arthritis can at times be difficult to diagnose in early stages because early signs & symptoms generally mimic those of several other diseases. Moreover, there is no single blood test or physical investigation which can confirm diagnosis. Nevertheless, doctors will usually test for warmth, redness & swelling of joints during physical examinations. They will also check upon the patient’s reflexes & muscle strength.
- Blood Tests – People suffering from rheumatoid arthritis often have elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) which indicates presence of inflammatory process within the body. Other common blood tests also point out the rheumatoid factor & anti-cyclic citrullinated peptide (anti-CCP) antibodies in rheumatoid arthritis patients.
- Imaging Tests – Doctors also often recommend X-rays in order to help track progression of rheumatoid arthritis in joints over a period of time. Ultrasound & MRI tests can help doctors’ judge severity of the disease in the patient’s body.
Treatments for Rheumatoid Arthritis
Although there is no cure for rheumatoid arthritis, there however are some recent discoveries which indicate that remission of symptoms are most likely when treatment starts early with strong medications which are known as DMARDs or disease-modifying antirheumatic drugs.
- Medications – These are types of medications which are recommended by doctors depending upon the severity of symptoms & on how long the patient has been having rheumatoid arthritis.
- NSAIDs – Or Non-steroidal anti-inflammatory drugs can often relieve pain & reduce inflammation in rheumatoid arthritis patients. NSAIDs which are sold over the counter include naproxen sodium (Aleve) & ibuprofen (Motrin IB, Advil). Stronger NSAIDs are also available by prescription. Side effects of NSAIDs may include kidney & liver damage, heart problems, stomach irritation & ringing in ears.
- Steroids – Corticosteroid medications like prednisone are found to reduce pain & inflammation & slow down damage to joints. Side effects of steroids may include diabetes, weight gain & thinning of bones. Doctors often prescribe corticosteroids in order to relieve acute symptoms along with a goal to gradually taper intake of medication.
- DMARDs or Disease-Modifying Antirheumatic Drugs – These drugs effectively slow progression of rheumatoid arthritis & save joints & other tissues from permanent damage. Common DMARDs which are prescribed by doctors for rheumatoid arthritis include sulfasalazine (Azulfidine), hydroxychloroquine (Plaquenil), leflunomide (Arava) & methotrexate (Rasuvo, Otrexup, Trexall). Side effects of DMARDs vary but commonly include severe lung infections, bone marrow suppression & damage to liver.
- Biologic Agents – These are also known as biologic response modifiers. This is a new class of DMARDs which include tofacitinib (Xeljanz), tocilizumab (Actemra), rituximab (Rituxan), infliximab (Remicade), golimumab (Simponi), etanercept (Enbrel), certolizumab (Cimzia), anakinra (Kineret), adalimumab (Humira) & abatacept (Orencia). These drugs are meant to target parts of immune system which trigger inflammation causing tissue & joint damage. Moreover, these types of drugs also increase the risk of developing infections. Biologic DMARDs are found to be most effective when they are paired with non-biologic DMARDs like methotrexate.
- Therapy – Doctors may send rheumatoid arthritis patients to physical or occupational therapists who can help in teaching them keep the joints flexible. Therapists may also suggest newer ways to perform daily tasks which will be easier on their joints. Like for example, patients may want to pick up objects using forearms when their fingers are sore. Assistive devices can also make it easier for patients to avoid stressing painful joints. Like for instance, kitchen knives which are equipped with saw handles help protect finger & wrist joints. Moreover, certain tools like buttonhooks can also make it easier for patients to get dressed. However, catalogs & medical stores are great places to look for more ideas like these.
- Surgery – When medications fail to slow or prevent joint damage, rheumatoid arthritis patients in consultation with their doctors may consider employing surgery to repair damaged joints. Surgery may eventually help restore ability to use joints. It can also correct deformities & reduce pain. Rheumatoid arthritis surgery may involve any one or more of the following surgical interventions.
- Synovectomy – This is surgery which is used to remove the inflamed lining of the joint (synovium). Synovectomy surgery can be effectively performed on knees, hips, fingers, wrists & elbows.
- Tendon Repair – Inflammation & joint damage can cause tendons around joints to loosen or rupture. Orthopedic surgeons may be able to effectively repair tendons around joints.
- Joint Fusion – Surgical fusion of a joint may be recommended in order to realign or stabilize a joint & for pain relief in cases where joint replacement cannot be an option.
- Total Joint Replacement – Orthopedic surgeons may remove damaged parts of the joint & insert prosthesis made out of plastic or metal during joint replacement surgery.
All types of surgeries carry risk of pain, infection & bleeding. Rheumatoid arthritis patients must therefore discuss risks & benefits of surgery with their doctors.
Alternative Medicine for Rheumatoid Arthritis
Following is the list of some common alternative & complementary treatments which have shown considerable promise for rheumatoid arthritis patients.
- Fish Oil – Preliminary research has revealed that fish oil supplements are able to reduce stiffness & pain in rheumatoid arthritis patients. However, side effects of this treatment includes, belching, nausea & fishy taste in mouth. Rheumatoid arthritis patients should nevertheless check with doctors as fish oil can also interfere with medications.
- Plant Oils – Seeds of black currant, borage & evening primrose contain certain type of fatty acids which can help with morning stiffness & pain caused by rheumatoid arthritis. Side effects caused by plant oils include nausea, gas, & diarrhea. However, rheumatic arthritis patients must sensibly check with their doctors as some plant oils can interfere with medications & cause liver damage.
- Tai Chi – This is a movement therapy which involves gentle stretches & exercises combined with deep breathing. Several people, including healthy humans, use tai chi to relieve stress in their lives. Smaller studies have revealed that tai chi can effectively reduce pain caused due to rheumatoid arthritis. Tai chi is also absolutely safe when led by a knowledgeable instructor. However, rheumatoid arthritis patients should not perform any moves which cause them pain.
Living with Rheumatoid Arthritis
Consider the following points which are important for people living with rheumatoid arthritis.
- Studies show that people suffering with rheumatoid arthritis, especially those whose disease is not reasonably controlled, have higher risk of stroke & heart disease. Patients should therefore talk to their doctors about these risks & ways to lower them.
- It is important for rheumatoid arthritis patients to be physically active most of the time; but should also be able to scale back activities whenever the disease flare. Rest is generally helpful when joints are inflamed or when patients feel tired. It is ideal to do gentle range-of-motion exercises like stretching during these times as this will effectively keep the joints flexible.
- When rheumatoid arthritis patients are feeling better, they should perform low-impact aerobic exercises like walking along with exercises to boost muscle strength. This will eventually help improve overall health alongside reducing pressure on joints. Physical or occupational therapists can help patients identify which type of activities, are best suited for them & at what pace or level they can practice them.
- It is a life-changing event when people find out that they are having a chronic illness like rheumatoid arthritis. This can also cause them to worry & at times experience feelings of depression or isolation. These feelings eventually tend to decrease with time with improvement in stiffness, pain & energy levels generated by greatly improved treatments. While health care providers can provide great help with information & resources, rheumatoid arthritis patients must make it a point to discuss these normal feelings with them.
Affordable Treatments for Rheumatoid Arthritis with IndianMedTrip
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