What is rheumatoid arthritis?
Rheumatoid Arthritis is a chronic autoimmune disease. In which, the body’s immune system, which is responsible for keeping the body safe from any bacteria and viruses, malfunctions and begins to attack the healthy tissue in the body, especially the joints in the body such as the wrists, fingers, elbows, knees and ankles.
This disease generally affects more than one joint and affects both sides of the body simultaneously. It erodes the lining of the joints causing inflammation, pain, swelling and deformity.
As mentioned above, Rheumatoid arthritis is an autoimmune disease that can cause joint pain and damage throughout your body.
The joint damage that this disease causes typically happens on both sides of your body. So if a joint is affected in one of your legs or arms, the same joint in the other leg or arm will probably be affected, too.
This is the possible way that doctors distinguish Rheumatoid Arthritis (RA) from other forms of arthritis, such as osteoarthritis (OA).
How does rheumatoid arthritis occur?
The immune system cells travel along with the blood and then reach the joints of the body.
Once they reach the joints, they begin to cause irritation, which can cause inflammation, and subsequently begins to erode the cartilage between the joints.
If the cartilage completely erodes the bones may rub against each other and gradually become deformed.
The exact cause for the sudden offence the immune system launches against the healthy tissues in its own body is still unclear.
Some medical experts believe it can be bacteria which make the immune system malfunction, some others believe it could be because of excessive smoking and yet some others think this disease is due to genetic factors.
Hormones are also believed to cause this disease.
As mentioned above, the exact cause of Rheumatoid arthritis isn’t known. However, some factors seem to have a role in increasing the risk of developing RA or triggering its onset.
Factors that increase the risk of RA can be:
- Being a woman
- Having a family history of RA
Factors that can trigger the onset of RA include:
- Exposure to certain types of bacteria, like those associated with periodontal disease
- Having a history of viral infections such as infection with the Epstein-Barr virus, which causes mononucleosis
- Trauma or injury, like bone breakage or fracture, dislocation of a joint, and ligament damage
- Smoking cigarettes
What are the symptoms of rheumatoid arthritis?
People suffering from rheumatoid arthritis typically complain of:
- Painful, stiff and swollen joints
- The stiffness of joints for more than an hour during the morning
- Constant fatigue
- Carpal tunnel syndrome
- Injuries take time to heal
- Inflammation of the forefoot
- Experience of suddenly locked joints
- The growth of lumps under the skin nearby the affected joints
Diagnosis of rheumatoid arthritis
In its early stages, rheumatoid arthritis can be difficult to diagnose. The early signs and symptoms mimic those of many other diseases and disorders.
A rheumatologist will check the joints for any pain and swelling. He will also check muscles strength and joint flexibility.
The most common medical tests that diagnose rheumatoid arthritis can be:
These tests can help to diagnose the severity level of the disease in the body.
It can help to determine whether there is inflammation in the body.
- Rheumatoid factor test
- Anticitrullinated protein antibody test (anti-CCP)
- Antinuclear antibody test
- Erythrocyte sedimentation rate
- C-reactive protein test
What are the complications of rheumatoid arthritis?
Complications of rheumatoid arthritis (RA) include:
Heart problems: People having rheumatoid arthritis are 50 % more likely to die from heart problems. They are twice higher on risk to have a heart attack or a stroke. (Read: Why heart attack comes most commonly in early morning?)
Eye Problems: Rheumatoid arthritis increases the chances of eye problems like dry eyes, pain, blurred vision or loss of vision, and eye inflammation.
Osteoporosis: This condition is also known as ‘bone loss’ that can occur in people suffering from rheumatoid arthritis. It is necessary for people with rheumatoid arthritis to get their bone density checked every 2 years.
Blood Vessel Disease: This condition is uncommon among the patients, but when it does occur, it can affect the blood flow in the body and hence affect all the vital organs.
Lung Problems: Inflammation occurs with rheumatoid arthritis, which can affect the lining of the lungs, resulting in fluid collection. (Read: Lung Cancer)
Nodule Formation: Firm lumps of tissue begin to grow under the joints in the body, like fingers, and elbows. These nodules may grow anywhere including in the lungs.
Carpal tunnel syndrome: If your wrists are affected by rheumatism, then the nerve which serves the fingers and the hand largely may get affected.
Treatment for rheumatoid arthritis
Currently there is no treatment which can completely treat arthritis; however, the right medical interventions can greatly help to reduce the symptoms.
Your doctor may prescribe medications to control the arthritis pain or to reduce the inflammation and swelling.
Steroids are often given to treat inflammatory arthritis. Steroids can be given in tablet form, and can also be injected into the joints.
The following medicines help reduce the pain and inflammation during arthritis flares:
The following drugs work to slow the damage that this arthritis can cause to your body:
- Disease-modifying antirheumatic drugs (DMARDs)
- Biologics – New generation DMARDs
- Janus kinase (JAK) inhibitors: New subcategory of DMARDs
Based on the seriousness of the condition the doctor can also advise you to opt for joint surgery. If your joint(s) such as hip, knee, shoulder, and elbows have been damaged beyond repair, you will benefit greatly from the joint replacement surgery.
The doctor can also advise you to undergo different forms of exercise therapy such as:
Hydrotherapy: wherein you will be advised to exercise in a warm pool, which will relax your muscles and joints.
Physiotherapy: This consists of following an exercise regimen tailored to suit your exact needs. It can also include pain alleviating treatments like ice-packs, heat-packs, and massage.
Occupational Therapy: It consists of enabling people to manage their daily activities efficiently by using specialized aids or tools.
Rheumatoid arthritis diet
Your dietitian may recommend an anti-inflammatory diet for you to help reduce your symptoms. This type of diet includes foods which are rich in omega-3 fatty acids.
Foods rich in omega-3 fatty acids include:
- Fatty fishes, such as salmon, tuna, herring, and mackerel
- Chia seeds
- Flax seeds
Antioxidants, including vitamins A, C, and E, and selenium, can also help reduce inflammation.
Foods high in antioxidants include:
- Berries, like blueberries, cranberries, goji berries, and strawberries
- Dark chocolate
- Kidney beans
Eating a good amount of fiber is also important because according to some researchers, fibre can help reduce inflammatory responses which can be seen as a decrease in C-reactive protein levels.
Select whole grain foods, fresh vegetables, and fresh fruit. Strawberries can be particularly beneficial.
Foods containing flavonoids can also help to manage inflammation in the body, Such as:
- Soy products, like tofu and miso
- Green tea
Types of rheumatoid arthritis
There are several different types of this disease. Knowing which type you have can help your doctor provide the best type of treatment for you.
Types of RA include:
If you have seropositive type of RA, you have a positive rheumatoid factor blood test result. This means you have the antibodies which cause your immune system to attack your joints.
If you have a negative rheumatoid factor blood test result and a negative anti-CCP blood test result, but you still have rheumatoid arthritis symptoms, you may have seronegative RA. You may eventually develop antibodies, changing your diagnosis to seropositive type of RA.
JIA (juvenile idiopathic arthritis):
Juvenile idiopathic arthritis refers to rheumatoid arthritis in people younger than 17 years of age. The condition was previously known as juvenile rheumatoid arthritis (JRA).
The difference between rheumatoid arthritis and osteoarthritis
Like rheumatoid arthritis, people with osteoarthritis can experience painful and stiff joints that can make moving around difficult.
People with osteoarthritis may have joint swelling after extended activity, but osteoarthritis doesn’t cause any significant inflammatory reaction that typically results in redness of the affected joints.
Unlike rheumatoid arthritis, osteoarthritis isn’t an autoimmune disease. It’s linked to the natural wear and tear of the joints as you age or it can develop as a result of trauma.
Osteoarthritis is most often seen in older adults. However, it can sometimes be seen in younger adults who overuse a particular joint like tennis players and other athletes or those who have experienced a severe injury.
Rheumatoid arthritis is an autoimmune disease. The joint damage from this condition isn’t caused by normal wear and tear but by your body attacking itself.
Is rheumatoid arthritis hereditary?
Rheumatoid arthritis isn’t considered a hereditary condition or disease, yet it does appear to run in families. This may be because of environmental causes, genetic causes, or a combination of both.
If you have family members who have or have had this disease, consult your doctor, especially if you have any symptoms of persistent joint pain, swelling, and stiffness, unrelated to overuse or trauma.
Having a family history of this disease increases your risk of getting the disease, and early diagnosis can make a big difference in how effective treatment will be.
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