Rheumatoid Arthritis, Symptoms, Causes, Diagnosis and Treatment
An autoimmune disease called rheumatoid arthritis can lead to joint pain, swelling, and stiffness. Even though there is no cure, early identification and treatment can help control symptoms and avoid permanent joint damage.
When you have rheumatoid arthritis, the tissue lining your joints on both sides of your body is attacked by your immune system. It might also affect on other body parts. It's unclear what exactly caused it. Modifications in lifestyle, medicine, occupational therapy, physical therapy, nutritional therapy, and surgery are among the available treatment options.
What is Rheumatoid arthritis?
One chronic (continuous) autoimmune disease is rheumatoid arthritis (RA). It differs from other forms of arthritis in that it affects the joints on both sides of your body. Pain and inflammation symptoms could be present in your:
- Hands
- Fingers
- Ankle
- Knees Wrists
- Toes and feet
Inflammation that is not under control damages cartilage, which typically serves as a "shock absorber" in your joints. This can cause joint deformation over time. Your bone itself eventually deteriorates. Your joint may fuse as a result of this—your body's attempt to protect itself from constant pain.
This process is aided by particular cells in your immune system, which is your body's defense against infections. Although these compounds are made in your joints, they circulate throughout your body and generate discomfort. Rheumatoid arthritis can occasionally affect other body parts in addition to your joints, such as your:
- Skin
- Eyes
- Heart
- Lungs
- Mouth
Causes:
An autoimmune condition is rheumatoid arthritis. Your immune system often aids in defending your body against diseases and infections. Your immune system targets the healthy joint tissue when you have rheumatoid arthritis. Additionally, it may result in health issues with your skin, eyes, nerves, heart, and lungs.
The etiology of this process is unknown to medical professionals, while a hereditary component seems likely. Although there is no known cause of rheumatoid arthritis, genetics may increase your susceptibility to environmental factors that may increase the condition, such as infection with specific viruses or bacteria.
Also Read: Osteoarthritis: Symptoms, Causes, Diagnosis, Treatment & Prevention
Risk factors:
Age. Adults in their 50s have the highest rate of onset of RA. For those who are born with a male gender assignment, the risk increases with age. RA frequently affects individuals who were assigned female at birth and are in their reproductive years.
Sex. People assigned female at birth are two to three times more likely to experience RA than people assigned male at birth.
Genetics. HLA class II genotypes are a set of genes that increase a person's risk of developing RA. Those who carry these genes may be more susceptible to RA if they are obese or have been exposed to environmental factors like smoking.
Live birth history. People with ovaries who have never given birth may be more susceptible to having RA than women who have.
Exposure in the early years. Children whose mothers smoked had a doubled risk of acquiring RA as adults, according to the Centers for Disease Control and Prevention.
Smoking. Studies show that cigarette smokers have a higher chance of developing RA.
Obesity. Being overweight can raise one's chance of developing RA.
Eat a diet. Elevated intake of sodium, sugar, particularly fructose, red meat, and iron has been linked to a higher chance of developing RA.
Diagnosis:
A rheumatologist, or doctor who specializes in treating arthritis, may be recommended to you by your healthcare provider. Several variables are combined by rheumatologists to diagnose patients with rheumatoid arthritis. They will examine you physically and inquire about your symptoms and medical background. Your rheumatologist will prescribe imaging and blood testing.The blood tests search for blood proteins, or antibodies, that indicate rheumatoid arthritis and inflammation. These might consist of:
- The "sed rate," often known as the erythrocyte sedimentation rate (ESR), confirms joint inflammation.
- CRP, or C-reactive protein.
- Rheumatoid factor (RF) is positive in about 80% of RA patients.
To check for indications that your joints are deteriorating, your rheumatologist may prescribe imaging studies. Your joints may experience deterioration of the bone ends due to rheumatoid arthritis. The imaging examinations could consist of:
- X-rays.
- Ultrasound
- Scans using magnetic resonance imaging (MRI).
What are the objectives of rheumatoid arthritis treatment?
Reducing joint discomfort and swelling is the main objective of rheumatoid arthritis treatment. By doing this, joint function ought to be maintained or improved. Treatment's long-term goal is to reduce or eliminate joint deterioration. Your quality of life is enhanced and your discomfort is decreased when joint inflammation is under control.How is treat rheumatoid arthritis?
It's crucial to visit your doctor as soon as you get symptoms because joint damage usually develops within the first two years of diagnosis. By treating rheumatoid arthritis at this "window of opportunity," long-term effects may be avoided.Rheumatoid arthritis is treated with medication, surgery, treatments, and alterations in lifestyle. When choosing a course of treatment, your doctor takes into account your age, health, medical history, and the severity of your symptoms.
Which drugs are used to treat rheumatoid arthritis?
Certain medications used early in treatment can enhance your long-term results. Drug combinations seem to be just as safe and may even be more successful than single-drug therapy.Medications: that affect rheumatic disease (DMARDs). DMARDs function by preventing the immune system's reaction in your body. This aids in slowing down the progression of RA.
Numerous drugs are available to reduce swelling, inflammation, and joint discomfort as well as to either stop or halt the progression of the disease. Rheumatoid arthritis is treated using the following medications:
NSAIDs, or non-steroidal anti-inflammatory medicines:
Pain and inflammation are reduced by non-steroidal anti-inflammatory medications. Among them are goods such as:
- Ibuprofen (Motrin®, Advil®).
- Naproxen ( Aleve®).
- Aspirin.
Steroids. Prednisone is one example of a corticosteroid medicine that reduces pain and inflammation while slowing joint deterioration. Diabetes, weight gain, and bone thinning are possible side effects. To promptly alleviate symptoms, doctors frequently give corticosteroids taper off the medication gradually.
Customary DMARDs. These medications can prevent irreversible damage to the joints and other tissues by slowing the course of rheumatoid arthritis. Methotrexate (Trexall, Otrexup, and similar brands), leflunomide (Arava), hydroxychloroquine (Plaquenil), and sulfasalazine (Azulfidine) are examples of common DMARDs.
Biological agents.
Biological products. Rather than completely inhibiting your body's immune system response, these biologic DMARDs of the new generation provide a targeted response to inflammation. They work well as a treatment for patients who don't react well enough to traditional DMARDs.
- Abatacept (Orencia),
- Adalimumab (Humira),
- Anakinra (Kineret),
- Certolizumab (Cimzia)
- Etanercept (Enbrel),
- Golimumab (Simponi),
- Infliximab (Remicade)
- Rituximab (Rituxan),
- Tocilizumab (Actemra)
JAK (junctional kinase) inhibitors. These are a more recent class of DMARDs that prevent certain immunological reactions. When DMARDs and biologic DMARDs are ineffective for you, your healthcare practitioner may turn to JAK inhibitors as a means of reducing inflammation and halting joint degeneration.
Focused on synthetic DMARDs. If standard DMARDs and biologics haven't worked, then baricitinib (Olumiant), tofacitinib (Xeljanz), and upadacitinib (Rinvoq) might be utilized. Elevated tofacitinib dosages may raise the risk of lung blood clots, major cardiac events, and cancer.
When is rheumatoid arthritis treated surgically?
For severely injured joints, surgery might be the best option to restore function. If medicine isn't controlling your pain, your physician might potentially suggest surgery. Treatments for RA with surgery include:- Knee replacement.
- Replacement of the hip.
- Further surgeries to correct a deformity.
Self-care
You can manage your RA and reduce pain and fatigue on your own, but working with your doctor to ensure you receive the right treatment is also essential. The keys to general health and managing RA are diet, exercise, smoking cessation, and mental health. Use our pain resources to get assistance managing your pain and creating health goals.Healthy Eating. In addition to promoting wellness, a well-rounded and nutrient-dense diet that includes the required quantities of all kinds of foods makes it easier to maintain a healthy weight.
Regular movement. Make an effort to move throughout your day, even if you don't have time to exercise. Instead of taking the elevator, use stairs. Park such that you have to walk a short distance to enter the building. When you have an office meeting, take the longer route.
Balancing activity and rest. While it's important to make an effort to continue exercising even during a flare-up, rest is as important when RA is active and joints feel sore, swollen, or stiff. The weariness and inflammation that can accompany a flare-up are lessened by rest. Taking short pauses throughout the day helps to maintain energy and protect joints.
Both hot and cool treatments. Warm baths and heat pads are two common forms of treatment that are most effective in relieving tense muscles and stiff joints. For severe discomfort and swollen joints, cold is ideal. It may reduce inflammation and numb sore places.
Products for the skin. These gels, lotions, or stick-on patches can reduce muscular or joint pain. Some utilize substances that irritate your nerves to divert your attention from pain, while others contain the medication that is found in pills.
Reducing stress and using complementary therapies. There are various techniques to de-stress and cease thinking about your pain. These consist of deep breathing, meditation, and visualizing happy images in your head. A massage may reduce stress or anxiety, alleviate painful muscles, and lessen discomfort. In order to treat pain, acupuncture uses tiny needles inserted into the body at specific locations. If needles bother you, acupressure applies forceful pressure in its place.
Supplements. Studies shows that rheumatoid arthritis discomfort and morning stiffness may be helped by taking omega-3 fish oil supplements plus curcumin/turmeric. Before taking any supplements, though, see a doctor to go over possible side effects and how they can interact with other medications you are taking.
References:
- American College of Rheumatology. 2010 Rheumatoid Arthritis Classification Criteria (https://pubmed.ncbi.nlm.nih.gov/23221588/). 2010 Sept;62(9):2569-2581. Accessed 2/18/2022.
- Rheumatoid Arthritis Support Network. RA progression: what are the signs of rheumatoid arthritis progression (https://www.rheumatoidarthritis.org/ra/symptoms/progression/)? Accessed 2/18/2022.
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