Rheumatoid arthritis is a chronic disease that leads to inflammation and deformity of your joints. It is characterized by swelling, stiffness, pain, warmth and redness in the joints. As it progresses, the joints may become misaligned, misshapen and damaged. The tissues that line the joint can also thicken and wear away the surrounding cartilage, bones and ligaments. Rheumatoid arthritis normally occurs symmetrically, which means that if one hand or knee has it, the other one will also have it.
The condition affects approximately one percent of the population, and women are three times more likely to get it than men. Even though it can occur to people of all ages, it is more common to those between 25 and 50 years of age. Rheumatoid arthritis (or RA) is a severe, mostly progressive disease than can result in serious disability, lower the quality of your life and reduce your lifespan. Luckily, there have been significant advances in the management and treatment strategies of the disease, and this has led to improvement in the lives of many people who suffer from the condition. However, there is no cure for rheumatoid arthritis.
Causes and risk factors
The exact cause of rheumatoid arthritis remains unknown, though it seems to be an autoimmune disease. This means that it occurs when the white blood cells, which are an integral part of our body’s immune system, mistakenly attack the joint tissue ( or synovium). As the thin layer of cells that line the joint( known as the synovial membrane)become inflamed, enzymes are produced. With time, these enzymes and specific immune cells damage the bones, cartilage, ligaments and tendons around the joint
Some research studies suggest that this faulty immune response is triggered by a virus. However, there is no conclusive evidence that proves this. Meanwhile, it seems that some individuals are more likely to suffer from the disease because of their genetic makeup. Environmental factors are also thought to play a big part. For instance if you are a smoker, you have higher chances of developing rheumatoid arthritis.
The disease equally affects the joints on both sides .The most commonly affected areas include the fingers wrists, knees, ankles and feet. Rheumatoid arthritis often starts slowly, with only minor stiffness, fatigue and joint pain.
The joint symptoms include a morning stiffness which may last for one hour. The joints may feel tender warm and stiff if one is inactive for some time. The joint pains are often experienced on the same joint on each side of the body. As time goes by, the joint can lose its range of motion, leading to deformity.
Other symptoms include chest pain during breathing, dry eyes and mouth, burning itching or discharge in the eyes, nodules beneath the skin(normally a sign of a more serious condition),sleeping difficulties and numbness, burning or tingling sensation in the feet and hands.
If you notice the symptoms of rheumatoid arthritis, consult your doctor as soon as possible. Early diagnosis ensures faster treatment and prevents further damage to your joints. The doctor will perform a physical examination and inquire about your medical history. Symptoms such as morning stiffness are tell-tale signs of the disease. The doctor may also do a blood test to determine if you have the rheumatoid factor antibody, which is present in 80% of people suffering from the disease.
The doctor may perform the erythrocyte sedimentation rate test to identify whether you are inflamed. This test also distinguishes between RA and osteoarthritis, and this is vital for proper treatment of your condition. Unlike rheumatoid arthritis, osteoarthritis affects only joints in one side of the body. An x-ray can be done to show the extent of damage to the joints.
Treatment of the disease focuses on treating the symptoms. It aims at reducing pain and inflammation, minimizing and preventing joint damage and maximizing joint movement. To attain these goals, a combination of treatment is normally recommended. Such treatments include:
There are a number of medications that are used to treat the condition. NSAIDS ( or Non-steroidal anti-inflammatory drugs) work by treating inflammation and pain. Corticosteroids such as prednisone work by reducing inflammation. DMARDs (or disease-modifying anti-rheumatic drugs) are medications that are commonly used in the treatment of moderate and severe rheumatoid arthritis. These medications include those that suppress the immune system, anti-malarial medicines and those that treat cancer. One such drug, methotrexate, has proved to work particularly well in managing severe rheumatoid arthritis.
Tumor Necrosis Factor–alpha (also called TNF-a) are a group of medications that work by inhibiting the tumor necrosis factor, an inflammatory protein in the body. The medication used will depend on how severe the disease is. If it is found to be effective, the treatment regime may be continued for several years.
There are a number of physiotherapy treatments that can be used to minimize pain, strengthen muscles, improve movement and promote independence.
Rest and exercise
There should be a balance between rest and exercise. If the disease is active, it is better to get rest. But you need exercise to enhance muscle strength, reduce joint stiffness and deformity and sustain mobility. A physiotherapist can prescribe the right exercise regime for you.
Protecting your joints and simplifying work are effective ways of minimizing fatigue and joint pain. A physiotherapist or occupational therapist can guide you on these. They may suggest that you use splints or devices that can lessen the pressure on the joints such as long-handled shoehorns or zipper pullers.
If you are suffering from severe pain or serious deformities, surgery may be recommended. This often includes knee or hip joint replacement or other kinds of joint replacements. Your nerves, tendons or joint structures like the synovial membrane can also repaired.
There are people who find alternative therapies like meditation, acupuncture, homeopathy and relaxation techniques beneficial in managing symptoms of rheumatoid arthritis. Taking dietary supplements like fish oils can also help.