Rheumatoid Arthritis-Symptoms, Causes and Treatment
Medikoe Health Expert
Koramangala, bengaluru, karnataka, india, Bengaluru Sep 17, 2020
Rheumatoid arthritis is a chronic inflammatory disorder that can cause joint pain and damage throughout your body. In a few people, the condition can harm a wide variety of body systems, including the skin, eyes, heart, lungs and blood vessels.
Rheumatoid arthritis is an autoimmune disease that occurs when your immune system mistakenly hits your own body's tissues.
Unlike the wear-and-tear impairment of osteoarthritis, rheumatoid arthritis affects the lining of your joints, beginning a painful swelling that can ultimately result in bone erosion and joint deformity.
The inflammation associated with rheumatoid arthritis is what can impair other parts of the body as well. While new categories of medications have advanced treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.
Rheumatoid Arthritis Symptoms
Signs and symptoms of rheumatoid arthritis may include:
Soft, warm, swollen joints
Joint stiffness that is generally worse in the mornings and after inactivity
Fever, fatigue and loss of appetite
Early rheumatoid arthritis leads to impacting your smaller joints first — especially the joints that connect your fingers to your hands and your toes to your feet.
As the disease advances, signs often reach to the wrists, elbows, hips, knees, ankles, and shoulders. In most of the cases, symptoms occur in the same joints on both sides of your body.
Approximately 40% of the people who have rheumatoid arthritis also encounter signs and symptoms that don't include the joints. Rheumatoid arthritis can attack many non-joint structures, including:
Rheumatoid arthritis symptoms may differ in severity and may even come and go. Stages of increased disease activity (called flares), alternating with periods of relative remission — when the inflammation and pain fade away. Over time, rheumatoid arthritis can make joints to distort and move out of place.
Rheumatoid Arthritis Causes
Rheumatoid arthritis develops when your immune system attacks the synovium — the wall of the membranes that encompass your joints.
The resulting infection solidifies the synovium, which can ultimately damage the cartilage and bone within the joint.
The tendons and ligaments that support the joint together weaken and expand. Progressively, the joint loses its shape and adjustment.
Doctors don't know what begins this process, although a genetic element resembles it. While your genes don't actually bring about rheumatoid arthritis, they can make you more sensitive to environmental factors — such as infection with certain viruses and bacteria — that may trigger the disease.
Types of rheumatoid arthritis
There are various types of Rheumatoid Arthritis (RA), knowing which your healthcare provider provides you with the best kind of treatment.
Types of RA include:
Seropositive rheumatoid arthritis. If you have a positive rheumatoid factor blood test result, you have seropositive RA. This implies that you have the immunizers that cause your immune system to attack joints.
Seronegative rheumatoid arthritis. If you have RF blood test results as negative and a negative anti-CCP result, yet you have RA symptoms, then it might be a seronegative RA. You may finally develop antibodies, turning your diagnosis to seropositive RA.
Juvenile idiopathic arthritis (JIA). They indicate to RA in children of 17 years and younger. The illness was earlier known as juvenile rheumatoid arthritis (JRA). The symptoms are identical to those of other types of RA, but they may also introduce eye inflammation and problems with physical development.
Risk factors of rheumatoid arthritis
Factors that may increase your risk of rheumatoid arthritis include:
Age. Although rheumatoid arthritis can occur at any age, it commonly arises in middle age.
Your sex. Women are more prone to develop rheumatoid arthritis.
Family history. If any member of your family has rheumatoid arthritis, then you may have increased chances of getting the disease.
Obesity. People — mainly women age 55 and younger — who are overweight seem to be at a slightly higher risk of developing rheumatoid arthritis.
Smoking. Smoking cigarettes doubles up your risk of developing rheumatoid arthritis, especially if you have a genetic predisposition for catching the disease.
Environmental exposures. Although inadequately understood, some exposures such as silica or asbestos may develop the risk of rheumatoid arthritis. Emergency workers imperilled to dust from the breakdown of the World Trade Center are at greater risk of autoimmune diseases such as rheumatoid arthritis.
How is rheumatoid arthritis diagnosed?
Rheumatoid arthritis can be challenging to diagnose in its initial stages because the early signs imitate those of many other diseases. There is no one blood test or physical conclusion to establish the diagnosis.
During the physical exam, your doctor will examine your joints for redness, swelling and warmth. He or she may also monitor your reflexes and muscle strength.
Blood tests: People with rheumatoid arthritis usually have a raised erythrocyte sedimentation rate (ESR, or sed rate) or C-reactive protein (CRP), which may symbolize the behaviour of an inflammatory process in the body. Other standard blood tests see for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies.
Imaging tests: You may be recommended for X-rays to help track the development of rheumatoid arthritis in your joints over time. Ultrasound tests and MRI can help your doctor decide the severity of the disease in your body.
Rheumatoid Arthritis Treatment
There is no permanent cure for rheumatoid arthritis; however, clinical researches show that relief from symptoms is more likely when treatment starts first with medications known as disease-modifying antirheumatic drugs (DMARDs).
The kind of medications prescribed by your doctor will depend on the severity of your symptoms and for how long you've had rheumatoid arthritis.
Disease-modifying antirheumatic drugs (DMARDs). These drugs can delay the progression of rheumatoid arthritis and protect the joints and other tissues from permanent impairment. Common DMARDs include methotrexate (Trexall, Otrexup, others), hydroxychloroquine (Plaquenil), leflunomide (Arava) and sulfasalazine (Azulfidine). Side effects differ but may incorporate bone marrow suppression, liver damage and acute lung infections.
NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain and minimize swelling. Over-the-counter NSAIDs include ibuprofen (Motrin IB, Advil) and naproxen sodium (Aleve). Stronger NSAIDs are accessible by prescription. Side effects may involve stomach upset, heart dilemmas and kidney impairment.
Steroids. Corticosteroid medications, like prednisone, decrease inflammation and pain and slow joint injury. Side effects may involve weight gain, diabetes and weakening of bones. Doctors usually prescribe a corticosteroid to help acute symptoms, to taper off the medication gradually.
Biologic agents. Also recognized as biologic response modifiers, this latest class of DMARDs involves adalimumab (Humira), abatacept (Orencia), anakinra (Kineret), golimumab (Simponi), infliximab (Remicade), rituximab (Rituxan), baricitinib (Olumiant), certolizumab (Cimzia), etanercept (Enbrel), sarilumab (Kevzara), tocilizumab (Actemra) and tofacitinib (Xeljanz). In people with rheumatoid arthritis, higher doses of tofacitinib can develop the risk of blood clots in the lungs. Biologic DMARDs are generally most useful when paired with a nonbiologic DMARD, such as methotrexate.
Your doctor may assign you a physical or occupational therapist who can guide you for exercises to help maintain your joints flexible. The therapist may also recommend new approaches to do everyday tasks, which will be lighter on your joints. For example, you may require to pick up an object applying your forearms.
Assistive devices can make it trouble-free to avoid stressing your aching joints. For example, a kitchen knife provided with a handgrip helps save your finger and wrist joints. Specific tools like buttonhooks can make it comfortable to get dressed. Catalogs and medical supply stores are the right places to view for ideas.
If medications become unsuccessful in preventing or slowing joint damage, you and your doctor may regard surgery to restore damaged joints. Surgery may help rebuild your ability to use your joint. It can also lower pain and better function.
Rheumatoid arthritis surgery may require one or more of the following methods:
Tendon repair. Swelling and joint injury may cause tendons around your joint to extricate or rupture. Your surgeon may be ready to fix the tendons around your joint.
Synovectomy. Surgery to eliminate the infected lining of the joint (synovium) can be implemented on elbows, knees, wrists, fingers and hips.
Total joint replacement. During joint replacement surgery, your surgeon separates the damaged parts of your joint and interpolates a prosthesis composed of metal and plastic.
Joint fusion. Surgically fusing a joint may be suggested to secure or realign a joint and for pain remission when a joint replacement isn't an alternative.
Surgery brings a risk of bleeding, pain and infection. Discuss the advantages and risks with your doctor and make the decision accordingly.
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