Symptoms
Many people experience pain, swelling, tenderness, and warmth of the affected area. Smaller joints may be affected first such as your fingers, hand, wrist, feet, toes or ankle joints. They may become swollen and red. There may also be bumps of tissue under the skin on your arms which are known as rheumatoid nodules. Others report feeling fatigued with a low-grade fever or even weight loss.
As the disease progresses, it can advance and develop in your hips, shoulders, elbows, knees, neck and jaw. Rheumatoid arthritis symptoms will have periods of activity and inactivity. The periods of activity are called flare-ups or flares. The symptoms generally fade or disappear during the inactive periods.
Other reported, and sometimes more severe symptoms can include joint deformities, anemia - due to failure of the bone marrow to produce sufficient red blood cells, eye burning, itching and discharge, lung inflammation – known as pleurisy, limited range of motion, and numbness.
What is Rheumatoid Arthritis?
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Most commonly affecting the lining of the small joints in your hands and feet, Rheumatoid arthritis (RA) is a chronic inflammatory disorder that occurs when your immune system mistakenly attacks your own body’s tissues – otherwise known as an autoimmune disorder.
RA may affect tissues and organs and it can cause fatigue, fever, painful swelling and stiffness in the joints.
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RA may also result in bone erosion and joint deformity.
Affecting approximately 1% of the world’s population and generally occurring between the ages of 40 and 60 years old, RA is three times more common in women than men. There is no official cause, but it may have a genetic component associated with it.
While there's no known cure for rheumatoid arthritis, there have been more treatment breakthroughs in the past few decades. Early detection utilizing a blood test or X-ray, is a key to helping prevent joint and bone destruction and slow the progression of RA. An expert in the diseases of joints and connective tissues, called a rheumatologist, can help you explore treatment options.
Treatment
Since there is no known cure for RA, the goal of treatment is to start it as early as possible to aid in the reduction of joint pain and inflammation. Treatment will also help to prevent joint destruction and maximize joint performance. Treatment is customized depending on age, affected joints and the progression of the disease. Exercises to strengthen supporting muscles around the joints and medication may be assigned.
The two categories of medications used include disease-modifying antirheumatic drugs (DMARDs) to slow progression of the disease, and NSAIDs - nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, and steroids taken for only a short time and in low doses when possible. Analgesics may also be prescribed for pain. Since some medications have serious side effects such as liver and kidney damage, stomach bleeding and heart problems, talk to your doctor first about the potential effects.
Many RA sufferers have reported utilized moist heat, acupuncture, or relaxation remedies to relieve pain. Also, avoiding foods high in fat such as ice cream, cheese, and butter may help reduce inflammation in the body. Some also report foods high in omega-3 fatty acids such as flaxseeds, walnuts, and salmon are helpful.
Keeping muscles and bones strong and helping reverse joint stiffness may be established with exercise. Your doctor may recommend exercises such as resistance training, low-impact aerobics, swimming, water aerobics, and stretching. Occupational and physical therapy can teach you how to protect your joints, and approach tasks in a way that takes stress off your painful joints. 8 to 10 hours of sleep per night is also advised.
Surgery may be an option for some if the pain becomes debilitating or intolerable. Surgery can relieve pain and improve function. Joint replacement is the most frequently performed surgery for RA patients. Arthroscopy to repair abnormal tissues, tendon reconstruction, joint fusion and surgery to correct deformities may also be recommended.
Causes
Rheumatoid arthritis is caused when your immune system attacks the lining of the membranes that surround your joints, or synovium. When the synovium thickens, it can eventually invade and destroy the cartilage and bone within the joint. The joint then weakens and stretches, gradually losing shape and alignment. RA is considered and autoimmune disease because the body is attacking itself. Researchers believe a combination of genetics and environmental factors may be the source of ones immune cells, such as lymphocytes, not protecting the body from foreign invaders, allowing the lymphocytes to target healthy joint and tissue.
Tests & Diagnosis
No one test can diagnosis Rheumatoid arthritis. Instead, doctors diagnose RA based on symptoms that are associated with the disease such as morning stiffness of the joints, swelling or fluid around three or more joints simultaneously, at least one swollen area in the wrist, hand or finger joint, arthritis on both sides of the body or rheumatoid nodules.
A blood test to search for abnormal amounts of rheumatoid factor in the blood can be performed. Rheumatoid factors are a variety of antibodies that are present in 70% to 90% of people with RA. They will also look for antinuclear antibodies (ANA) since these are found in 30% to 40% of people with RA.
An X-ray, MRI or ultrasound may be performed to look for and track bone damage around the involved joints.
Diagnosis can be difficult sometimes since several other diseases such as gout, fibromyalgia, lupus or osteoarthritis have similar symptons. Because of these difficulties, an accurate diagnosis is often missed early on. In fact, the average time between the onset of symptoms and the official diagnosis of rheumatoid arthritis is almost nine months in some cases. To assist in a precise diagnosis, patients can help by taking and providing careful, thorough notes on frequency, severity, and time of day of your symptoms.
Prognosis
Since Rheumatoid arthritis varies from person to person, it’s difficult to provide a set prognosis. Prior to today’s improved treatment options, the average life expectancy for a patient with RA could be shortened by 3-7 years. However, individuals with severe RA would often die 10-15 years earlier than average. Approximately 33% of sufferers will not be working after 5 years with RA, and if not managed properly, after 10 years, approximately half will have significant functional disabilities. However, many people now lead normal lives since severe disability and life-threatening complications have decreased considerably.
Scheduled blood or urine tests should be done to determine how well medications are working and to discuss any side effects you may be experiencing.
Prevention
Although there is no known prevention regimen for Rheumatoid arthritis, further joint damage can be preventable with early treatment.
Research also indicates that vitamin D may help to protect older women from RA, and that the risk of developing RA is nearly double for current smokers as compared to non-smokers.
Complications
The joint damage that Rheumatoid arthritis causes and be disfiguring and debilitating and may make it difficult or even impossible to perform your regular activities. Not being able to perform your regular activities may also lead to depression. One study showed that 11% of people with RA were more likely to be depressed if these activates were restricted.
Rheumatoid arthritis can involve almost all organs, not just joints. It can affect the eyes, lungs, skin, heart, blood vessels, and other organs. If the outer lining of the heart swells (pericarditis), or if the heart mussel becomes inflamed (myocarditis), it can cause heart failure. Vasculitis (inflammation of the blood vessels) can affect the heart, brain and nerves and lead to a heart attack or heart failure, skin ulcerations and infections, painful nerve problems, bleeding stomach ulcers, and numbness or tingling.
Early detection to prevent, stop or slow down joint damage can allow you to continue the activities you enjoy.
Helpful Links
Arthritis Foundation
Psoriatic Arthritis
ArthritisRxAssist Program
The experts at BioPlus ArthritisRxAssist Program are here to help you understand your disease and your treatment options.
The challenges of your disease and the Biologic medicines used to treat them can be difficult to face. You are not alone. Once you contact us, numerous specialty teams begin acting on your behalf. From working with your prescriber, dealing with your insurance, getting authorizations, seeking the best financial option including financial assistance, home delivery, assistance with side effects and more.
Nurse teaching is also available thru the ArthritisRxAssist Program. Contact a specialist now to learn more about having a nurse come to your home and help you with your injections.
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