Rheumatoid Arthritis

This is an inflammatory condition that affects not only the joints and some people may experience damage in different body parts including skin, eyes, lungs, heart, and blood vessels. This is an autoimmune disease known as rheumatoid arthritis and happens when the immune system attacks its own body cells.

The difference between osteoarthritis and this condition is that the first condition provokes wear-and-tear damage while the second causes painful joint swelling that often leads to bone erosion and deformities in the joints.

However, there are different treatment options that help against this autoimmune condition but severe rheumatoid arthritis cases still can lead to physical disabilities.

Symptoms

  • Swollen, warm, and tender joints
  • Joint stiffness that usually worsens due to inactivity or in the mornings
  • Fever
  • Lack of appetite
  • Fatigue (extreme tiredness)

Commonly, early stages of this condition impact small joints only such as those that attach the fingers to hands and toes to feet. When the disease progresses the symptoms can spread to other body parts including knees, wrists, ankles, elbows, hips, and shoulders. Mostly, rheumatoid arthritis symptoms happen on both sides of the body in the same joint.

Approximately 40% of people with this arthritis type experience symptoms that are not linked to joints. Check below other body parts that often affect rheumatoid arthritis:

  • Skin
  • Eyes
  • Heart
  • Nerve tissues
  • Salivary gland
  • Bone marrow
  • Lungs
  • Blood vessels
  • Kidneys

Those who suffer from this autoimmune disease can experience different symptoms from mild to severe and they usually come and go. Unfortunately, over time this arthritis type can provoke joint deformities and shifting of place.

In case you experience any of the previous symptoms or any others, visit your doctor right away.

Causes

In normal circumstances, the body’s defense (immune system) protects you from different infections and diseases. However, rheumatoid arthritis is an autoimmune condition in which the body’s defense attacks its own cells. Other health problems are not excluded such as heart, lung, nerves, eyes, and skin issues.

Experts do not fully understand why this condition occurs but maybe genetics are involved. However, genes do not cause rheumatoid arthritis but they can make you more prone to react to environmental factors including infections, bacteria, and others.

Risk Factors

The following factors can increase your risk of getting this arthritis type. For example:

  • Sex – Females are more prone to get this arthritis type than males.
  • Age – While this condition can happen at any age, most diagnosed cases occur in middle age.
  • Family history – if someone from your family has rheumatoid arthritis, you are more likely to develop one.
  • Smoking – Using tobacco products increases your risk of rheumatoid arthritis, especially if you have a genetic predisposition. Moreover, smoking is associated with severe forms of rheumatoid arthritis.
  • Excess weight – People high in weight are also at increased risk of getting rheumatoid arthritis.

Complications

People who have rheumatoid arthritis over time may experience also certain complications. Examples include:

  • Osteoporosis – A health condition in which the bones become weakened and more likely to fracture.
  • Rheumatoid nodules – Most commonly, this condition appears in elbows but can happen in any part of the body. It is a condition in which certain bumps of tissue appear around pressure points.
  • Dry eyes and mouth – You are at elevated risk of developing Sjogren’s syndrome if you have this arthritis type. This syndrome reduces the moisture in the mouth and eyes.
  • Infections – Medicines used to treat rheumatoid arthritis may suppress the immune system which makes you more likely to develop infections. Therefore, it is recommended to get vaccinated against influenza, pneumonia, shingles, or COVID-19.
  • Abnormal body composition – Fat and lean mass proportions are higher in people with this autoimmune disease despite normal body mass index (BMI).
  • Carpal tunnel syndrome – In such cases, the nerves located in the hand and fingers are negatively affected.
  • Heart issues – People with rheumatoid arthritis can develop heart problems including blocked arteries, inflammation of the pericardium (a sac that encloses the heart), and others.
  • Lung conditions – An increased risk of lung disease have those who suffer from this autoimmune disease. For example inflammation and scarring of the lung tissues, breathing problems, and others.
  • Lymphoma – This is a blood cancer that appears in the lymphatic system.

Diagnosis

It can be challenging to diagnose this condition, especially in the early stages because symptoms are very similar to other diseases. First, doctors will perform a physical examination to check for joint swelling, redness, or warmth. After that, you may need to do some tests. These include:

  • Blood tests – Those who suffer from rheumatoid arthritis usually have increased erythrocyte sedimentation rate (ESR or sed rate) or C-reactive protein (CPR) levels. Additionally, doctors may look for another rheumatoid factor such as anti-cyclic citrullinated peptide (anti-CCP) antibodies.
  • Imaging tests – Physicians can also perform some imaging tests to determine the progression and severity of rheumatoid arthritis. These include MRI (magnetic resonance imaging) and ultrasound.

Treatment

Unfortunately, there is no way to cure rheumatoid arthritis but with proper treatment, you can reduce the symptoms and improve your quality of life. Commonly doctors prescribe disease-modifying antirheumatic drugs (DMARDs) in the early stages of the disease. Check below other treatment options:

Medicines

The medicines your doctor will prescribe you depend on the severity and how long you experience this autoimmune disease. For example:

  • NSAIDs – These are nonsteroidal anti-inflammatory drugs used to reduce pain and inflammation. Over-the-counter NSAIDs include Naproxen sodium, Ibuprofen, and others. The most common side effects include stomach irritation, kidney damage, and heart issues.
  • Steroids – Usually, physicians prescribe Prednisone to decrease inflammation and slow down the progression of the disease. Thinning of bones, weight gain, and diabetes are the possible adverse reactions of steroids. However, this category of medicines is used for short periods.
  • Conventional DMARDs – These medicines help to prevent permanent joint damage and slow down the rheumatoid arthritis progression. The most common DMARDs include Methotrexate, Leflunomide, Hydroxychloroquine, and Sulfasalazine. Liver damage and lung infections are the potential negative effects of DMARDs.
  • Biologic agents – These medications are a part of DMARDs and are also known as biologic response modifiers. These include Abatacept, Adalimumab, Anakinra, Certolizumab, Etanercept, Golimumab, Infliximab, Rituximab, Sarilumab, and Tocilizumab. Physicians prescribe these medicines in combination with conventional DMARDs.
  • Targeted synthetic DMARDs – This category of medicines is prescribed by healthcare professionals when conventional DMARDs and biologics do not work. These include Baricitinib, Tofacitinib, and Upadacitinib. However, increased doses of Tofacitinib may elevate your risk of blood clots in the lungs, cancer, and serious heart diseases.

Therapy

An occupational or physical therapist can help keep your joints flexible by teaching you special exercises. Additionally, there are assistive devices that can help to prevent or avoid stressing your painful joints. Discuss with your doctors for more details.

Surgery

If you do not notice any improvements while using medicines, your doctor may recommend surgery to repair damaged joints. Commonly, surgery for rheumatoid arthritis involves one or more procedures listed below. For example:

  • Synovectomy – Surgery that helps to remove the inflamed tissue of the joint (synovium). This procedure helps to decrease pain and improve the flexibility of the joint.
  • Tendon repair – Serious tendon problems can happen due to joint damage and inflammation. Sometimes, surgeons can repair the affected tendons.
  • Joint fusion – This procedure is usually used to stabilize or realign a joint and pain relief when joint replacement is not possible.
  • Total joint replacement – During this procedure, surgeons will replace the damaged joint tissues with prostheses produced from plastic and metal.

Frequently Asked Questions

What is the primary cause of rheumatoid arthritis?

This is an autoimmune disease in which the body’s defense (immune system) attacks its own cells. However, the exact cause of this condition is not known.

What foods should be avoided by people with rheumatoid arthritis?

The following foods can trigger the symptoms or worsen existing ones. For example:

  • Fired, broiled, or grilled meats
  • Refined carbohydrates and sugars
  • Foods full of omega-6 fatty acids
  • Gluten
  • Alcoholic beverages
  • Preservatives and flavor enhancers

Talk with your doctor for more details.

Is rheumatoid arthritis curable?

No, it is not possible to cure this condition but early diagnosis and proper treatment can help to improve your quality of life and reduce the symptoms. Ask your healthcare provider if you have additional questions.

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