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Rheumatoid arthritis is a long-term autoimmune disorder that affects joints. It typically results in warm, swollen, and painful joints which often worsen following rest. The disease may also affect other parts of the body that may result in a low red blood cell count, inflammation around the lungs, and inflammation around the heart.
The underlying mechanism of RA involves the body’s immune system attacking the joints. Treatment reduces the pain, decreases inflammation and improve a person’s overall functioning.
As of 2015, RA affected about 24.5 million people as of 2015. It is most frequent during middle age and women are affected 2.5 times as frequently as men. In India, more than 1 million cases are reported every year.
How Does Rheumatoid Arthritis Affect Your Body?
Rheumatoid arthritis is an auto-immune disorder where the immune system attacks the synovium, the lining of the membranes that surround the joints. Inflammation of the joints thickens the synovium, which can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch, gradually losing its shape and alignment.
What Are The Causes of Rheumatoid Arthritis?
Cause of rheumatoid arthritis is not clear and it is believed genetic and environmental factors are involved in triggering the disease.
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What Are The Risk Factors For Rheumatoid Arthritis?
- Sex – Women are more likely to develop RA than men.
- Age – Although it can occur at any age, it most commonly begins between 40 and 60 years of age.
- Family history – If a member of the family has rheumatoid arthritis, there is an increased risk of the disease in the next generation.
- Smoking – Smoking cigarette increases the risk of developing rheumatoid arthritis, particularly if having a genetic predisposition for developing the disease.
- Environmental exposures – It is believed that some exposures such as asbestos or silica may increase the risk of developing rheumatoid arthritis.
- Obesity – Overweight and obese people appear to be at somewhat higher risk of developing rheumatoid arthritis.
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What Are The Symptoms of Rheumatoid Arthritis?
- Stiffness – The joint is harder to use and doesn’t move as well as it should and is common in the morning. It takes people with rheumatoid arthritis more than an hour before their joints feel loose.
- Swelling – Fluid accumulation in the joint makes it puffy and tender.
- Pain – Inflammation in joint hurts whether moving it or not. Redness and warmth- The joints may be warmer and show changes in colour related to the inflammation.
- Heart and blood vessels – People with rheumatoid arthritis are more prone to atherosclerosis, and risk of heart attack and stroke is markedly increased.
- Blood – The chronic inflammation caused by rheumatoid arthritis leads to raised hepcidin levels, leading to anemia of chronic disease where iron is poorly absorbed and also sequestered into macrophages.
- Kidneys – Renal amyloidosis can occur as a result of untreated chronic inflammation.
- Liver – Liver problem is may be due to the underlying disease process or as a result of the medications used to treat the disease.
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How is Rheumatoid Arthritis Diagnosed?
Rheumatoid arthritis can be difficult to diagnose in its early stages because the early signs and symptoms resemble those of many other diseases.
- Blood tests – People with RA often have an elevated erythrocyte sedimentation rate or C-reactive protein (CRP), which may indicate the presence of an inflammatory process in the body. Other blood tests look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies.
- Imaging tests – X-rays of the joint is done to help track the progression of rheumatoid arthritis in joints over time. MRI and ultrasound tests can help know the severity of the disease in the body.
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How To Prevent And Control Rheumatoid Arthritis?
There is no known prevention for this condition other than the reduction of risk factors. When RA flares up, it’s important to prevent damage to the joints. Following measures can help to prevent damage:
- Get treated early – If you experience symptoms similar to RA get it checked early to start treatment.
- Exercise – Exercising makes the joints stronger.
- Rest – Do not overdo and look for a balance between downtime and exercise.
- Quit smoking – Quitting smoking may decrease the chance of having RA.
Treatment of Rheumatoid Arthritis – Allopathic Treatment
- NSAIDs – These can relieve pain and reduce inflammation and includes ibuprofen (Advil and naproxen sodium (Aleve).
- Steroids – Corticosteroid such as prednisone, reduce inflammation and pain and slow joint damage.
- Disease-modifying anti-rheumatic drugs (DMARDs) – These can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall, Otrexup, and Rasuvo), leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine).
- Biologic agents – This newer class of DMARDs includes abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), rituximab, tocilizumab (Actemra) and tofacitinib (Xeljanz). These agents target parts of the immune system that trigger inflammation that causes joint and tissue damage. Biologic DMARDs are usually most effective when paired with a non-biologic DMARD, such as methotrexate.
- Synovectomy – This surgery is done to remove the inflamed synovium (lining of the joint) and can be performed on knees, elbows, wrists, fingers, and hips.
- Tendon repair – Inflammation and joint damage may cause tendons around the joint to loosen or rupture which can be repaired by this surgery.
- Joint fusion – When a joint replacement is not an option, surgically fusing a joint may be recommended to stabilize or realign a joint and for pain relief.
- Total joint replacement – During joint replacement surgery, the surgeon removes the damaged parts of the joint and inserts a prosthesis made of metal and plastic.
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Treatment of Rheumatoid Arthritis – Homeopathic Treatment
- Causticum – This is used to treat rheumatoid arthritis when there are joint deformities. The patient usually loosens muscle strength over time.
- Caulophyllum – This is effective for rheumatoid arthritis and is commonly used for women. This medicine is used when small joints are affected more, compared to the larger joints in the limbs.
- Colchicum – This is usually required during chronic stages of rheumatoid arthritis.
- Ledum Pal – This medicine is used when the rheumatoid starts in the feet and travels upwards spreading to the upper joints of the body. Swelling in the toes and ankles is a common symptom to be looked for.
- Bryonia – This medicine is used when all the joints and joint membranes are swollen and affected.
Rheumatoid Arthritis – Lifestyle Tips
- Exercise regularly to help strengthen the muscles around the joints, and it can help fight fatigue you might feel.
- Apply heat to help ease your pain and relax tense, painful muscles and cold may dull the sensation of pain and also has a numbing effect and decreases muscle spasms.
- Relaxing and reducing stress in life can help ease the pain in muscles.
What Are The Recommended Exercises For a Person With Rheumatoid Arthritis?
- Low-impact aerobic exercises such as walking or biking for 150 minutes every week.
- Flexibility activities like stretching for 5 to 10 minutes daily.
- Strengthening through lifting weights or other resistance exercises at least two days every week.
Rheumatoid Arthritis & Pregnancy – Things to Know
- It was observed that more than 75% of women with rheumatoid arthritis have symptoms improve during pregnancy but might have symptoms worsen after delivery.
- Medicines like methotrexate and leflunomide are teratogenic (harmful to foetus) and not used during pregnancy.
- It is recommended that women of childbearing age should use contraceptives to avoid pregnancy and to discontinue the medicine if pregnancy is planned.
- A low dose of prednisolone, hydroxychloroquine and sulfasalazine are considered safe in pregnant women with rheumatoid arthritis.
Common Complications Related to Rheumatoid Arthritis
- Rheumatoid nodules.
- Dry eyes and mouth.
- Abnormal body composition.
- Carpal tunnel syndrome.
- Heart problems.
- Lung disease.
Q. Which joints are commonly involved in RA?
A. The most common joints are the small joints in the hands and feet. Joints in wrists, elbows, shoulders, neck, hips, knees and ankle can also all be involved.
Q. What is the difference between RA and osteoarthritis?
A. RA is an autoimmune disease, while osteoarthritis is a wear and tear disorder where the cartilage in the joints can wear out because of mechanical damage from years of use.
Q. Can RA affect more than just joints?
A. RA is not always just limited to joints and can affect other parts of the body, including skin, eyes, heart, lungs, nerves, blood and blood vessels.
Q. Is there a cure for rheumatoid arthritis?
A. No, only medications have been shown to be effective in treating RA, reducing patient symptoms and slowing bone changes.