Rheumatoid Arthritis

Rheumatoid Arthritis is an autoimmune and inflammatory condition where our body’s immune system starts attacking the healthy cells. It causes inflammation in various parts of the body, which leads to pain, swelling, and deformity.

Rheumatoid arthritis mainly attacks the joints and, in most cases, many joints at a time. It affects mainly the hand, wrist and knee joints. In a joint affected with rheumatoid arthritis, the lining of the joint becomes inflamed, gradually leading to damage in that area. Arthritis can cause serious pain, unsteadiness, and deformity.

Rheumatoid arthritis usually develops in four stages:

1. In stage 1, the tissues around our joints are inflamed, and you might experience mild pain and stiffness
2. In stage 2, damage to the cartilage in the joints will take place due to the inflammation; pain and stiffness will become more noticeable
3. Stage 3 will lead to severe damage to the bones; physical changes will appear in this stage
4. And lastly, in stage 4, even though the inflammation subsides, arthritis will continue to worsen; severe pain, stiffness and other difficulties will be prominent

Rheumatoid arthritis can also affect a number of organs and tissues, such as the lungs, heart, and eyes.

Rheumatoid arthritis typically starts to develop between the ages of 30 and 60, but anyone might develop RA. The development of rheumatoid arthritis symptoms in young adults between ages 16 and 40 is called young-onset rheumatoid arthritis (YORA). 

And for those who develop rheumatoid arthritis symptoms after age 60 are called later-onset rheumatoid arthritis (LORA). RA affects women more than men. Around 75% of women are affected by rheumatoid arthritis.

Rheumatoid arthritis can fluctuate in severity, and it’s categorized into periods of flares when symptoms flare up and periods of remission, when symptoms subside.

In the initial stages, rheumatoid arthritis typically affects the smaller joints – particularly those that connect our fingers to our hands, toes with their feet, etc. 

As the disease grows, it starts affecting different parts of the body. Some people may later experience symptoms in the knees, ankles and elbows. Others might have symptoms in their shoulders and hips too.

Rheumatoid arthritis symptoms include:

1. Severe pain or aching in multiple joints
2. Swelling and tenderness in multiple joints
3. Experiencing stiffness in multiple joints
4. Losing weight and experiencing weakness
5. Similar joint pains on both hands and knees
6. Stiffness in the joints flares up in the mornings and after inactivity
7. Low-grade fever, fatigue and tiredness

Some people show signs of rheumatoid arthritis in body parts that don’t involve any joints. Such part includes skin, kidneys, eyes, blood vessels, salivary glands, lungs, heart, bone marrow, nerve tissue etc.

Rheumatoid arthritis is an autoimmune disorder where the body’s immune system attacks its own healthy cells. It is currently unknown what causes this, but researchers have identified many factors which can increase the risk of developing rheumatoid arthritis.

Some of them are:

1. Rheumatoid arthritis can strike any person, but the risk of getting it significantly increases as we get older. The peak age for getting RA is generally around sixty.
2. A woman is more likely to develop rheumatoid arthritis, as 75% of RA patients are women.
3. If someone in our family has RA, then we may be at a higher risk of getting the disease. Certain genes we’re born with may put us more at risk of developing RA.
4. Multiple scientific studies show how cigarette smoking is linked to the development of rheumatoid arthritis and can even worsen the condition.
5. Research has shown that obese people have a higher chance of developing RA. The more overweight the person, the greater their risk of developing RA.

The following methods are commonly used for a rheumatoid arthritis diagnosis.

Physical exam

The doctor will examine our joints and look for any signs of swelling or redness. They may also test muscle strength and reflexes.

Blood tests

Rheumatoid arthritis leads to an increase in the levels of erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP). If the blood test shows positive for these elevations, then it can be diagnosed as rheumatoid arthritis.

Imaging tests

The doctor may want to order an X-ray to see the development of rheumatoid arthritis in our joints. MRI and ultrasound scans are also available and can help the doctor measure how severe the disease is in our system.

RA treatment aims to reduce inflammation and pain and help do the things that matter in daily lives. Some common treatments for rheumatoid arthritis include:

Medications

The doctor will prescribe the type of medications for rheumatoid arthritis that is most appropriate for our symptoms and the duration of the disease.

Non-steroidal anti-inflammatory drugs or NSAIDs

These drugs reduce pain and inflammation. Common over-the-counter pain relief drugs are ibuprofen and naproxen sodium. 

Some common side effects of NSAIDs are heart problems, damage to the kidney and irritation of the stomach.

Steroids 

Steroid medications can provide relief to people with joint pain in a short amount of time. However, they come with side effects such as thinning bones, diabetes and weight gain. 

Doctors often prescribe these types of drugs for short term relief, but they may not be the best long-term solution.

Conventional DMARDs

DMARDs can help hamper in the development of rheumatoid and protect the joints from getting damaged permanently.

Therapy

Therapy for rheumatoid arthritis has drastically improved in the past 30 years. Our physical or occupational therapist will prescribe exercises that will assist in improving the flexibility of the joints and also suggest new ways to do tasks that don’t put much strain on our joints.

The therapist may also recommend certain assistive devices such as cane wraps and splints to reduce joint pain.

Surgery

In some cases, when medication and therapy fail, surgery is needed. It can help restore our ability to use our joints, relieve some of the pain and improve our movements. Surgeries include synovectomy, joint fusion, tendon repair etc.

Although there is no guarantee we will avoid developing rheumatoid arthritis due to factors such as age, sex and family history, there are still a few significant things that may help decrease the risk of developing RA:

1. Quit smoking
2. Reduce weight
3. Exercise daily

Rheumatoid arthritis is a common form of autoimmune arthritis that can cause inflammation in various parts of the body, which leads to pain, swelling, and deformity.

 RA affects more women (around 75%) than men. There are currently no definite known causes for the development of rheumatoid arthritis, and also there is no permanent cure for this condition. Treatment includes medication, therapy and surgery. 

The multidisciplinary care team at the CK Birla Hospital provides expert care regarding rheumatoid arthritis. To learn more about this issue, visit the CK Birla Hospital or book an appointment with Dr. Rajiv Ranjan Kumar.