Rheumatology

Rheumatoid arthritis

DESCRIPTION:

Rheumatoid arthritis refers to a chronic inflammatory disease that affects the body’s immune system, which begins attacking the joints and body tissues. This thickens the linings of the joints (synovium) causing swelling and immense pain around the joints. Early diagnosis of the disease can prevent further damage in the joints and relieve symptoms. If not treated on time, the condition can affect other areas such as eyes, skin, blood vessels and even the heart, and result in joint deformity and bone erosion.

The exact cause of rheumatoid arthritis is still unknown, but doctors do know that it occurs from an abnormal functionality of the body’s immune system. There may be some genetic, environmental and hormonal factors that are responsible for the immune system to perform differently, causing joint pain and swelling by destroying the bone and cartilage. Other risk factors include age (between 40-60), sex (preferably women), family history of RA, excessive smoking and obesity.

Symptoms of rheumatoid arthritis include:

  • Joint pain, especially small joints such as fingers
  • Swelling and tenderness for over 6 weeks
  • Morning stiffness that lasts over 30 minutes
  • Weight loss
  • Fatigue and weakness
  • Fever
  • Mouth dryness
  • Shortness of breath
  • Pain around eyes, causing vision issues
  • Inflammation

Diagnosis

A doctor can suspect rheumatoid arthritis after examining the signs and symptoms. Further medical tests can confirm the diagnosis of RA that includes:

  • Medical history
  • Physical examination
  • Blood tests
  • Imaging tests such as X-ray, ultrasound and MRI
  • After the diagnosis, further steps will be taken to prevent the disease from advancing.

    Treatment of Rheumatoid Arthritis

    The damage that is done to the bones cannot be reversed back, however proper treatment can prevent RA from advancing. The treatment of rheumatoid arthritis aims to stop inflammation, improve overall physical health, prevent joint damage and provide relief from symptoms. Below are mentioned a few ways by which this can be achieved:

    • Medications: Nonsteroidal anti-inflammatory drugs (NSAID) such as Advil, Aleve and Motin IB are the first line of treatment for rheumatoid arthritis where the doctor will prescribe a stronger dose of these drugs to make sure the damage to the bones can be prevented. Corticosteroid medications such as prednisone are given to the patient to reduce pain and inflammation, while commonly used disease modifying antirheumatic drugs (DMARD) slows the progression of RA.
    • Therapy : Physical and operational therapy can help you perform your daily tasks in a new way and teach you some exercises to keep your joints flexible. You will also be encouraged to use supporting devices to help you carry out certain tasks without putting much pressure on your joints.
    • Surgery : If medications do not provide a positive result in slowing down the RA, then your doctor may recommend a surgical procedure to repair damaged joint. Surgery can fix your joint deformities that reduce the pain and restore its ability to move freely. Some of the surgeries include:
      • o Synovectomy, where lining of the joint is removed.
      • o Tendon repair, where the surgeon will repair the loosened or ruptured tendons around the joints.
      • o Joint fusion is the surgical fusing of joints to relieve from pain.
      • o Total joint replacement, where the surgeon removes the damaged parts and insert a man made joint.

    Complications

    There are many complications associated with the treatment of rheumatoid arthritis, which are as follows:

    • Stomach irritation
    • Heart issues
    • Kidney and liver damage
    • Ringing sensation in the ears
    • Thinning of bones
    • Weight gain
    • Diabetes
    • Bone marrow suppression
    • Lung infection
    • Increased pain
    • Bleeding

    Care

    Care involves taking good care of your bones while following the guidelines and prescription as directed by the physician.

    Eat antioxidant rich foods, which can reduce inflammation such as vegetables, fruits, fish, olive oil, etc. Avoid consuming fast foods that can increase inflammation.

    Perform regular exercise to provide flexibility in your joints that could reduce pain and stiffness. Take extra rest to control inflammation and fatigue.

    Heat treatment such as having warm baths and wearing heat pads can relieve stiffness and tired muscles while cold therapy can reduce acute pain.

    Notify your doctor if you experience any of the above mentioned complications.