Rheumatoid Arthritis

1 What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is an autoimmune arthritis characterized by inflammation of joints and other areas of the body. 

RA may affect organs like skin, eyes, lungs, and heart. A period of disease flare may alternate with remission.

 RA affects joints in both sides of the body like both hands, wrists, and knees. It is a chronic condition and progression of disease may result in joint damage and deformity. 

Blood test reveals the presence of rheumatoid factor, and helps in the diagnosis of the condition. There is complete cure for the condition. 

Combination of medications, physical therapy, and patient education are the treatment methods for RA. Earlier treatment of the condition has a good outcome.

rheumatoid arthritis

2 Symtoms

The most common symptoms of rheumatoid arthritis (RA) include: 

  • Stiffness of joint that is worse during morning or after a period of inactivity,
  • Weight loss,
  • Fatigue,
  • Swelling of joints,
  • Warmth and tenderness in the affected joints.

In the early stages, RA affects smaller joints like fingers and toes. This may gradually spread to the wrists, hands, ankles, shoulders, and hips with the progression of the condition. 

In most of the cases, symptoms are seen symmetrically, in joints of both the sides of the body. Symptoms are also seen in non-joint regions of the body like skin, eyes, lungs, heart, kidneys, nerves, bone marrow, and blood vessels.

Severity of RA may vary with time and in some cases a period of remission alternates with a period of disease flare. Over a period of time, RA may result in misalignment and deformity of bones in the joints.  

3 Causes

Rheumatoid arthritis (RA) is caused by an autoimmune condition in which the immune system attacks healthy tissues in the body. In this condition the immune system attacks the tissue lining the membrane that surrounds joints, called synovium. 

This leads to inflammation and thickening of synovium. The cartilage and bones in the joints undergo degeneration, affecting the range of motion of the joints. It may also lead to weakening and stretching of ligaments and tendons that support the joint. 

The actual cause of the autoimmune condition is not clear. A combination of certain genetic factors and environmental factors are implied in the development of RA. 

Women are more likely to develop RA when compared to men, and is more common in the age group of 40-60 years. 

Some of the risk factors for RA are family history, smoking, and obesity. Exposure to environmental factors like asbestos and silica also enhance the risk of this arthritis. 

4 Making a Diagnosis

There is no single test for the diagnosis of rheumatoid arthritis (RA). Diagnosis is usually based on signs and symptoms. Physical examination reveals swelling, warmth, reddishness, and stiffness in joints. 

Blood tests show elevated levels of erythrocyte sedimentation rate and C-reactive protein, both of which indicate inflammation. 

Presence of rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies are characteristic of RA. 

Progress of the condition is assessed using different imaging techniques. MRI and ultrasound images shows the extent of damage in the joints and the change in structures, if any. 

5 Treatment

There is no complete cure for rheumatoid arthritis (RA). Treatment focuses on reducing inflammation and preventing complications. Some common medications prescribed for RA include: 

  • Non-steroidal anti-inflammatory drugs (NSAIDs) provide relief from pain and inflammation. Ibuprofen and naproxen sodium are over-the-counter NSAIDs. They are available in the form of tablets, creams and gels. 
  • Disease-modifying anti-rheumatic drugs (DMARDs) block abnormal immune function in which the system attacks healthy tissues. Methotrexate and hydroxychloroquine are common DMARDs. Biologic response modifiers are medications that target the proteins involved in the abnormal immune response.
  • Corticosteroids suppress the immune system and control symptoms like pain and inflammation. These are available in oral form or as injections.  

Physical therapy is a set of exercises that improve flexibility, strength, and range of motion of the affected joint. Many assistive devices help to make routine tasks easier without putting strain on the joints. 

Surgery is recommended only when conventional treatment methods do not have the expected effect. Synovectomy is a surgical procedure to remove the inflamed synovium. It is mostly performed on the knees, elbows, and wrists. 

Damaged ligaments and tendons are also surgically corrected. Joint fusion is suggested to realign the bones and to stabilize the joint, especially when joint replacement cannot be performed. 

Damaged parts of the joint is removed and replaced with prosthesis in joint replacement surgery. 

6 Prevention

There are no specific prevention methods for rheumatoid arthritis (RA).

Avoiding risk factors like smoking, and exposure to silica reduces the chances of this form of arthritis.

7 Alternative and Homeopathic Remedies

Several alternative and homeopathic remedies exist for managing the symptoms of rheumatoid arthritis.

Tai chi, fish oil supplements, and plant oils are considered to be effective in controlling symptoms of RA.

Fish oil supplements and plant oils like evening primrose, borage, and black currant, help to prevent pain and stiffness of joints. 

Tai chi combines simple exercises with stretching and deep breathing. This helps to reduce stress and symptoms of RA.

Causticum is the homeopathic remedy for treating deformities caused by RA. 

Caulophyllum is suggested for RA affecting small joints.

Other homeopathic remedies include

  • Colchicum,
  • ledum pal,
  • bryonia.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with rheumatoid arthritis (RA).

Regular exercise, using heat and cold packs, and relaxation techniques are habits that are useful in controlling symptoms of RA. 

Pain and disability associated with RA may cause depression and anxiety in patients. Talking to the healthcare professional about the condition and treatment methods will help to understand the limits and methods to take control of the situation. 

Keep family and friends informed of the experiences and situations. Be a part of the support group to know more about the condition.

9 Risks and Complications

Rheumatoid arthritis (RA) increases the risk of:

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