What Is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune disorder (damage that occurs due to one's own immune system), an inflammatory condition that particularly affects the joints of the knee, hand, and wrist. This condition causes inflammation of the lining of the joint cavities leading to pain, loss of balance, and deformity of the joints.
What Are the Symptoms of Rheumatoid Arthritis?
Rheumatoid arthritis mainly affects the joints in the body, but 40 percent of the cases show signs and symptoms in organs other than joints.
Symptoms of the Joints Include:
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Rheumatoid arthritis in the early stages attacks the small joints - joints of fingers, hands, toes, and feet. As the disease progresses other joints are also involved - joints of wrist, wrist, elbows, shoulders, knees.
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Joints become stiff, this is especially in the mornings when trying to get up from the bed, stiffness can also be observed after a prolonged inactivity.
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Pain, redness, and swelling at the joints. Movements get restricted and flexibility is lost.
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Fever associated with tiredness, and anorexia (loss of appetite) is seen.
Symptoms Seen in Different Parts of the Body Other Than Joints:
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Eyes become dry, delicate, and sensitive to light, and loss of vision can also be seen.
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Rheumatoid Nodules - Small nodules can be detected under the skin.
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Inflammation can be noted around the heart and lungs, leading to breathlessness.
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Damage to the blood vessels, bone marrow, and nerves.
Flare-Ups and Remissions: Patients with rheumatoid arthritis undergo ups and downs in symptoms. There is an initial phase when the intensity of the symptoms increases (flare-ups), and then there is a symptom-free period (remission) during which the symptoms go away. Over time, joints get distorted and move out of place.
What Are the Risk Factors?
Certain conditions increase the chances of getting the disease, these factors are called risk factors. Risk factors of rheumatoid arthritis include:
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Age: Affects middle-aged people.
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Sex: More commonly seen in women than in men.
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Obesity: People with overweight whose BMI (body mass index) is more than their age.
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Family History and Genes: People with a family history of rheumatoid arthritis are at risk of developing this disease rather than those with no history.
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Smoking: Increases the chance of disease when it gets matched up with obesity and family history.
What Are the Causes of Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune disorder. In general, immunity is provided by the immune system in the body, and this immunity helps protect the body against infections (caused by bacteria, and viruses) and diseases. In rheumatoid arthritis, the immune system destroys its healthy cells in the joints, creating inflammation. The reason the immune system attacks its cells is unknown, although risk factors such as infections and genes can lead the immune system to react negatively.
What Distinguishes Rheumatoid Arthritis From Other Forms of the Disease?
There is always confusion between rheumatoid arthritis and other types of arthritis. Different types of inflammatory arthritis are as follows:
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Psoriatic Arthritis: This form of arthritis is associated with individuals suffering from psoriasis (itchy and scaly skin).
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Ankylosing Spondylitis: In this type, the pelvis and spine are most frequently affected.
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Systemic Lupus Erythematosus: A long-lasting autoimmune illness that can harm internal organs and cause joint discomfort and skin rashes.
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Juvenile Idiopathic Arthritis: A highly prevalent kind of arthritis in kids.
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Osteoarthritis: It is the most prevalent form of arthritis and does not cause any inflammation similar to rheumatoid arthritis. It is a completely different condition and has various treatment modalities.
How to Diagnose Rheumatoid Arthritis?
Diagnosis of rheumatoid arthritis becomes difficult in the early stages as the signs and symptoms would mimic those of joint pains, and osteoarthritis. The diagnosis starts with:
1. Physical Examination: This doctor would examine the joints and check for flexibility, stiffness, redness, and swelling. The presence of rheumatoid nodules is also examined by the doctor. During this check, the doctor would ask for any family history, medical conditions, or medication used by the patient.
2. Blood Tests: These are important in confirming rheumatoid arthritis. These include:
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ESR (Erythrocyte Sedimentation Rate): A blood sample is collected and sent to the lab, increased ESR rate indicates increased inflammation levels in the body than normal and inflammation is a major sign of rheumatoid arthritis.
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CPR: C-reactive protein is a test done to check the inflammatory conditions in the body.
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Rheumatoid Antibodies: These are usually present in the patient’s blood as a response to inflammation, the presence of these antibodies indicates the presence of disease.
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Anti-CCP Antibodies: Anti-cyclic citrullinated antibodies present in the blood indicate the presence of rheumatoid arthritis.
3. Imaging Tests: These tests can help in visualizing the anatomy of the joints, such as ultrasounds, MRI (magnetic resonance imaging), and X-rays.
How to Treat Rheumatoid Arthritis?
Treatment for this condition is mainly supportive, which includes:
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To reduce the pain.
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Improve the flexibility of the joint to perform routine functions.
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Protecting the joints from further damage.
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Contributing to the overall well-being of the patient.
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Reduces the complications caused by rheumatoid arthritis.
Rheumatoid arthritis can be treated by:
1. Medications (Drugs): Medications are mainly intended to reduce the pain and swelling in the joints. And the commonly used painkillers are:
2. NSAIDS: Non-steroidal anti-inflammatory drugs. For example, Naproxen sodium.
3. Corticosteroids: Such as Prednisone prevent further joint damage.
4. DMARDS (Disease-Modifying Anti-rheumatic Drugs): These slow down the disease process in the body and protect the joints, and other body parts from complete damage. They are of three types:
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Conventional DMARDS: Example Methotrexate
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Targeted DMARDS: Example: Baricitinib, and Upadacitinib. The risk of blood clotting is seen with these drugs.
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Biologic DMARDS: Advanced DMARDS, are more successful when given along with conventional. Example: Abatacept, Sarilumab.
5. Therapies: Help the patient to improve joint function and flexibility.
6. Physiotherapy: The physiotherapist advises exercises to improve the strength of the muscles.
7. Hydrotherapy: Exercises are advised by placing the affected joint in warm water. This reduces the pain and increases the stretching ability of the joint.
8. Surgery: Surgery is an alternative to continuing with regular activities if therapy and medicines fail to reduce discomfort and increase flexibility.
9. Joint Replacement: The affected joint is completely replaced with artificial prosthesis.
What Are the Home Remedies to Manage Rheumatoid Arthritis?
Lifestyle modifications and following simple exercises could improve joint function.
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Weight Management: This can be achieved by healthy and balanced eating.
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Regular Exercise: Helps to manage weight, and also improves the muscle activity of the affected joint.
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Hot and Cold Packs: By applying hot and cold packs, patients with rheumatoid arthritis can get relief from pain, swelling, and stiffness of the joints.
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Intake of Supplements: Vitamins and omega-3 supplements are suggested in patients with rheumatoid arthritis.
Conclusion:
Patients should carry rheumatoid arthritis for life long, there is no cure for it. Dealing with flare-ups and remissions is very challenging for the patient. Early diagnosis, avoiding risk factors, and timely treatment could keep the disease under control
