Rheumatoid arthritis is a systemic, autoimmune, and inflammatory disorder. It occurs as a result of your body’s tissues being attacked by your immune system. Its effect can extend beyond the joints and can affect other body systems such as the eyes, lungs, skin, heart and blood vessels. It causes painful swelling in the joints which can eventually lead to joint deformity and bone erosion. The joint damage caused by RA occurs on both body sides such that if a joint in one of your legs or arms get affected, the same joint in the other leg or arm will be affected as well. This is a way in which doctors differentiate RA from other types of arthritis, such as osteoarthritis (OA).
In the US, about 1.5 million people have rheumatoid arthritis (RA). The rate is higher in women than in men. In women, it occurs between ages 30 and 60 while it often occurs later in life in men. Having a family member with the disorder or disease increases the chances of having RA; yet, the majority of people who have RA do not have family history of the disease.
According to the Centers for Disease Control and Prevention (CDC), the following people have a higher risk of developing rheumatoid arthritis; those who:
- are female
- are aged 60 years and above
- have obesity
- have never given birth
- have specific genetic traits
- smoke tobacco or have their parents smoked while they were children
- are exposed to asbestos or silica
Symptoms of Rheumatoid Arthritis
People with RA don’t have it revealed on their faces. Rather, it is marked by symptoms of pain and inflammation in the joints which occur during the period known as a flare. When the symptoms disappear completely, the period is known as remission. Some symptoms of RA include:
- joint swelling
- joint stiffness which is usually worse every morning and after inactivity
- joint pain
- loss of joint function
- loss of appetite, fatigue, and fever
- unsteadiness when walking
- weight loss
Early RA tends to affect the smaller joints first. The progression of the disease makes the symptoms extend to the wrists, elbows, ankles, knees, hips, and shoulders. It may also affect nonjoint structures such as skin, lungs, eyes, heart, salivary glands, kidneys, nerve tissue, blood vessels, and bone marrow. Symptoms vary from mild to severe and should therefore not be ignored, even if they are unstable.
Causes of Rheumatoid Arthritis
RA is caused when the body’s immune system mistakenly attacks the joints. The result is the creation of inflammation which thickens the synovium (the tissue lining the inside of joints). It then causes the joint to be painful and swell. Unchecked inflammation can damage both cartilage and bones. Over time, the joints may become unstable, loose, painful, lose their mobility, or even get deformed. Joint damage cannot be reversed. Thus, doctors recommend early diagnosis as well as aggressive treatment to control RA.
Despite that, nobody seems to know what makes the immune system to malfunction. Some people may have genetic factors that increase their probability. One theory states that virus or bacteria triggers RA in such people with this genetic feature.
Complications of RA
People who have RA have a higher risk of getting affected with other conditions such as obesity and heart disease. People with obesity and RA have a higher risk of high blood pressure and diabetes. Other conditions include:
- Rheumatoid nodules
- Carpal tunnel syndrome
- Tendon rupture
- Cervical Myelopathy
- Dry eyes and mouth
- Susceptibility to infections such as cold, flu, and pneumonia
Diagnosis of RA
Diagnosing RA requires multiple lab tests for confirmation of clinical examination findings. It may include, but not limited to, the following steps:
- Doctor’s request for symptoms and your medical history
- Physical examination of your joints to check for swelling, redness, warmth, and tenderness
- The rheumatologist tests your blood and checks your acute phase reactants
- He may also perform certain imaging tests such as ultrasonography, magnetic resonance imaging (MRI), and x-ray exams
Treatment for RA
There is no cure for this disease; however, there are treatments that can assist you in managing the pain and controlling the inflammatory response which often results in remission. It also helps to reduce any loss of function resulting from pain, joint damage or deformity. A decrease in this inflammation can help to prevent further organ and joint damage.
Treatment options may include:
Medications. Some drugs such as Advil, Motrin, Aleve, steroid, Arava, methotrexate, sulfasalazine, minocycline, adalimumab, infliximab, hydroxychloroquine, etc. can help to relieve symptoms as well as reduce the progression of the disease. However, some of these medications come with certain side effects which may range from cataracts, obesity, high blood pressure, liver damage, blood disorders, among others. It is, therefore, advisable to use them according to the doctor’s or rheumatologist’s recommendations.
Surgery. Surgery may as well be recommended to reduce pain, correct deformities, and repair damaged joints. Some of the procedures include arthroplasty, tendon repair, synovectomy (removal of inflamed synovium), and arthrodesis.
Exercise. The symptoms of RA get mild during the remission period. At this period, the individual should engage in low-impact exercises (such as gentle yoga and swimming) regularly; this will improve their general health and mobility while also strengthening the muscles around the joint.
Dietary changes. Following a varied diet with enough vegetable and fresh fruits can assist a person in getting better while also maintaining a healthy weight. Also, foods that have a high quantity of omega-3 fatty acids (such as flax seeds, chia seeds, walnuts, among others) and antioxidants (such as spinach, kidney beans, artichokes, pecans, berries, etc.) should be consumed more. Avoid processed carbohydrates and trans or saturated fats.
Rest. The individual should rest more when a flare-up occurs and less during remission. Over-exerting painful and swollen joints can worsen symptoms. Therefore, get enough sleep to help reduce inflammation, pain, and fatigue. Also, relieve yourself of mental stress by taking a deep breath, meditating, and relaxing your muscle.
Apply cold or heat. Ice packs can help to minimize pain and inflammation. Also, they may be effective against muscle spasms. Alternating warm showers and hot compresses can help to reduce stiffness.