This chronic inflammatory disorder can present in a number of ways, often making it difficult to diagnose in its early stages. There is presently no cure for this disease, but a number of treatment options are available to help control its symptoms.
What is Rheumatoid Arthritis (RA)?
Rheumatoid arthritis is a chronic inflammatory disorder that typically affects the small joints in your hands and feet.In this disorder the body tissue is mistakenly attacked by its own immune system. Various organs can be affected including the skin, eyes, lungs, heart, blood, or nerves. Early, aggressive treatment is key to slowing or stopping the progression of rheumatoid arthritis. Rheumatoid arthritis is not osteoarthritis that is seen commonly in many older individuals.
What are the symptoms of Rheumatoid Arthritis?
Common symptoms include joints that are painful, warm and swollen.
Other signs and symptoms of rheumatoid arthritis may include:
• Morning stiffness that may last for hours
• Firm bumps of tissue under the skin on your arms (rheumatoid nodules)
• Fatigue, fever and weight loss
Symptoms typically develop gradually over years, but can come on rapidly for some people.
Who gets Rheumatoid Arthritis?
This disorder is three times more common in women than men, and tends to occur more frequently in the ages 30-60 but other ages can be affected as well. Other risk factors include cigarette smoking and family history.
Why does Rheumatoid Arthritis occur?
Immune cells normally protect the body from foreign invaders. What causes them to target healthy joints and tissue in individuals with rheumatoid arthritis is unknown. Researchers believe some combination of genetics and environmental factors may play a role.
Effects of Rheumatoid Arthritis
Inflammation of the lining of the joints can destroy cartilage and bone, causing deformity of the joints. As the condition progresses, joints can develop considerable pain and loss of function.
Rheumatoid arthritis can affect organs and areas of the body, other than the joints, including:
• Rheumatoid nodules: firm lumps under the skin and in internal organs
• Sjogren’s syndrome: inflammation and damage of the glands of the eyes and mouth. Other parts of the body can also be affected
• Pleuritis: inflammation of the lung lining
• Pericarditis: inflammation of lining surrounding the heart
• Anaemia: reduction of red blood cells
• Felty syndrome: reduction of white blood cells, associated with enlarged spleen
• Vasculitis: blood vessel inflammation which can impair blood supply to tissues
Juvenile Rheumatoid Arthritis (JRA)
Juvenile RA is the most common type of arthritis in children. Like adult RA, it causes joint inflammation, stiffness, and damage. However, it can also affect a child’s growth. Juvenile RA is also known as juvenile idiopathic arthritis.
Making the Diagnosis
Symptoms of rheumatoid arthritis may come and go, so diagnosing rheumatoid arthritis in its early stages is challenging. After a detailed history and examination your doctor might order a number of tests like a blood test for rheumatoid factor and anti-CCP. An X-ray is very helpful in diagnosing rheumatoid arthritis.
Treatment
At this time there is no known cure for RA. The goal of treatment is to reduce joint inflammation and pain, prevent joint damage, and maximize joint function. Aggressive treatment should be started as early as possible. Treatment includes a combination of medication and exercises to strengthen supporting muscles around the joints. Treatment may also include surgery. Treatment is tailored to the individual, taking into account his or her age, affected joints, and the progression of the disease.
Rheumatoid Arthritis and diet
The most important diet is a healthy one that is balanced in nutrients. Many individuals with Rheumatoid arthritis claim that eating or avoiding certain foods helps their symptoms. Foods high in saturated fats (bacon, steak, butter) have been shown to increase inflammation in the body. Some people with Rheumatoid Arthritis find a diet high in omega-3 fatty acids (salmon, walnuts) helpful. Some people feel that other foods — such as tomatoes, citrus fruits, white potatoes, peppers, coffee, and dairy — worsen rheumatoid arthritis symptoms.
The Importance of Exercise
It may seem counterintuitive, but regularly exercising those stiff, painful joints can reduce the overall pain of RA. In addition, it can keep bones and muscles strong, and help reverse joint stiffness. Choose exercises such as stretching, resistance training, and low-impact aerobics (swimming, water aerobics). Use caution with any exercise that puts pressure on the joints, like jogging and heavy weight lifting. Talk to your doctor before starting an exercise programme.
Complications of Rheumatoid Arthritis
If not treated rheumatoid arthritis can progress and cause several complications.
Rheumatoid arthritis increases your risk of developing:
• Osteoporosis. Rheumatoid arthritis itself, along with some medications used for rheumatoid arthritis, can increase your risk of osteoporosis — a condition that weakens your bones and makes them more prone to fracture.
• Carpal tunnel syndrome. If rheumatoid arthritis affects your wrists, the inflammation can compress the nerve that serves most of your hand and fingers.
• Heart problems. Rheumatoid arthritis can increase your risk of hardened and blocked arteries, as well as inflammation of the sac that encloses your heart.
• Lung disease. People with rheumatoid arthritis have an increased risk of inflammation and scarring of the lung tissues, which can lead to progressive shortness of breath.
Conclusion
Rheumatoid arthritis is a chronic inflammatory disorder that tends to affects the small joints of individuals. The symptoms at first might vary from one person to another, but joint pain is often very common. The exact cause for this disease is not known, and there is no cure at this time, but there are several treatment options available to help control symptoms and help prevent the progression of this disorder.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty nine years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
