Today we’d like to shed a bit of light on something that people very rarely think about. Some may have it and some may yet develop early signs of it in the years to come. It can be debilitating, but if managed carefully then one can lead a relatively normal life with ease. Today marks Rheumatoid Arthritis Awareness Day and we’d like to clue you up as to what it actually is – it’s more than a mere condition where elderly people suffer a bit of joint pain.
According to Medical News Today, rheumatoid arthritis (RA) is a long-term, progressive, and disabling autoimmune disease. It causes inflammation, swelling, and pain in and around the joints and other body organs. RA usually affects the hands and feet first, but it can occur in any joint. It usually involves the same joints on both sides of the body. Severe cases of RA are relatively rare, too, as only one percent of the population suffers from it.
The problem with RA is, if left untreated, is that it is systemic. This means that it can affect the whole body. Most associate the disease with various joints in the body to many may be surprised to find out that it can also affect the lungs, heart and eyes. The immune system is designed to combat foreign invaders in the body and responds by targeting a particular area. This may cause localised inflammation in a wrist, for example. It may subside, but in most cases it is aggravated as time passes.
At this point it is not exactly known what causes RA. Most medical experts, though, agree that it is likely a genetic issue – the bacteria will attack joints in people who have this feature. What is known is that the immune system’s antibodies attack the synovium, the smooth lining of a joint. If left untreated the cartilage in a joint eventually wears away. This can damage other parts that form the joint like tendons and ligaments. Discomfort will eventually turn to severe pain. Oddly, three times as many women between 20 and 60 have or will develop RA than men.
The diagnosis isn’t particularly easy, too. Doctors usually have to resort to a standard, but thorough medical examination. They’ll typically go through a patient’s medical history and they’ll look out for persistent joint pain, tenderness, swelling or stiffness. Morning stiffness that lasts for more than a half-an-hour is also a tell-tale sign. Blood tests can be done to find the presence of rheumatoid factor, but these aren’t always accurate. Blood tests can be negative while a patient shows signs and symptoms of RA.
Symptoms of RA Include:
- pain, swelling, and stiffness in more than one joint
- symmetrical joint involvement
- joint deformity
- unsteadiness when walking
- a general feeling of being unwell
- loss of function and mobility
- weight loss
Some people who have a higher likelihood of developing RA can be those who:
- are aged 60 years or above
- are female
- have specific genetic traits
- has never given birth
- has obesity
- are smokers or had parents who smoked when they were children
There is unfortunately no cure for RA at present. Those who have it are encouraged to treat it early and aggressively though to ensure that some form of remission of the symptoms may occur. It is manageable on the other hand; the Mayo Clinic suggests the following treatments. Your doctor, depending on severity, should recommend one or a combination of the following.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription. Side effects may include ringing in your ears, stomach irritation, heart problems, and liver and kidney damage.
- Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, weight gain and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication.
- Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall, Otrexup, Rasuvo), leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine).
- Side effects vary but may include liver damage, bone marrow suppression and severe lung infections.
- Biologic agents. Also known as biologic response modifiers, this newer class of DMARDs includes abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), rituximab (Rituxan), tocilizumab (Actemra) and tofacitinib (Xeljanz).
- These drugs can target parts of the immune system that trigger inflammation that causes joint and tissue damage. These types of drugs also increase the risk of infections.
- Biologic DMARDs are usually most effective when paired with a nonbiologic DMARD, such as methotrexate.
Self-care may include sustained periods of moderate exercise and the use of an occupational therapist. Surgery will usually be the last resort. While it can restore the joints ability to move and reduce pain and inflammation, it does carry with it a few complications like bleeding, infections and severe pain.