RHEUMATOID ARTHRITIS EXPLAINED

RHEUMATOID ARTHRITIS EXPLAINED

Joints creak and painful? That Could Be Rheumatoid Arthritis


Rheumatoid Arthritis Definition

We have all heard the jokes and watched the tropes on tv, with age comes the creaking knee joints and body aches. But not all aches can simply be explained by age; they could be symptoms of something more chronic and debilitating such as rheumatoid arthritis.

A chronic autoimmune condition that attacks the joints, rheumatoid arthritis can cause mild to severe pain and the disease may also damage your whole body. First, your own body attacks the lining of the joints, the synovium, causing them to swell. Then, the painful swelling of the joints can lead to bone and cartilage erosion. Moreover, the ligaments and the tendons that connect the joint will eventually weaken and eventually, the joints will become deformed.

More often than not, if your right hand is affected by RA as the disease is also commonly called, then your left hand may also be affected. It is this peculiarity that differentiates RA from other types of arthritic diseases such as gout or osteoarthritis (OA).

The inflammation that is associated with RA is also the primary reason why the disease can affect other parts of the body. Nearly 40% of those diagnosed with this joint disease will have other areas of their body affected as well. The non-joint areas that can be affected by rheumatoid arthritis can include:

● Eyes
● Skin
● Heart
● Kidneys
● Lungs
● Nerve Tissue
● Blood vessels
● Bone Marrow
● Salivary glands

RA signs and symptoms manifest periodically in what we call as flares. These exacerbations of symptoms can also disappear temporarily in what is termed as a remission. However, as a chronic disease, the patient will have to learn to deal with the flares and the remissions and manage how they impact one’s life.

TREATMENT OVERVIEW

Knowing what to look out for is important for early diagnosis. And if we catch on to an early RA diagnosis, treatments will work better. Read the new medications treating symptoms to the different RA types, and the home remedies that can help alleviate pain. The article also explains more about the importance of diets and other alternatives to traditional treatment of rheumatoid arthritis. However, the current treatments only manage the symptoms; there are, as of yet, no known cure for rheumatoid arthritis.

SYMPTOMS

Rheumatoid arthritis symptoms can be mild to severely debilitating. Sometimes, the symptoms only manifest in a joint but it can also be pervasive affecting the whole body including the internal organs.

For the symptoms in the joints, RA will cause:

● Pain
● Stiff joints
● Swollen joints
● Loss of Function and weakness
● Deformation of the joints

DIAGNOSING RHEUMATOID ARTHRITIS

It will take time to have a confirmed diagnosis of rheumatoid arthritis. To be frank, a physician’s clinical examination of your symptoms will just be the beginning. To eliminate the other types of arthritis, multiple lab tests will be conducted to verify the clinical diagnosis.

The Physical Exam

First, your doctor will initially conduct a physical examination of the affected area or joints. The signs that your healthcare provider will look for are:

● Redness or swelling of joints
● Tenderness and fever in the affected joints
● Reflex and muscle tests
● Range and limit of motion and joint functionality

Usually, your physician will refer you to a specialist, doctors who specifically treat your disease, and are called rheumatologists. As of now, there are no tests available to verify an RA-diagnosis. Some of the medical tests will check for antibodies or the levels of acute-phase reactants in your blood. Acute phase reactants are substances in our blood which increase when inflammation is present in our body.

You might also have to undergo what we call imaging tests, which include X-rays, ultrasounds, or an MRI. These imaging tests can show the extent of joint damage and the severity of its effects on the joint lining. As nearly 40% with RA will also have other areas affected by the disease, monitoring and a comprehensive evaluation of the body will also be conducted.

What Blood Tests to Take for Rheumatoid Arthritis

To confirm an RA diagnosis, your physician or your rheumatologist will ask you to have several blood tests taken. Some of the blood tests used to diagnose RA are:

ANTI CITRULLINATED PROTEIN ANTIBODY TEST (anti-CCP)

A blood test that checks for an antibody that has been linked to rheumatoid arthritis, the anti-CPP is usually present in most people who have RA and is a specific test for the disease. However, some people who have RA will test negative for the test and that is why most doctors will ask you to take several kinds of blood tests to cross-check the diagnosis.

RHEUMATOID FACTOR TEST

The RF test will look for the rheumatoid factor protein and high levels will usually indicate a positive diagnosis, especially for rheumatoid arthritis.  The RF blood test is used commonly to check for autoimmune diseases.

ANTINUCLEAR ANTIBODY TEST

This is a panel of tests to check for antibodies. However, the general nature of the test will not specifically single out RA as our immune system produces various antibodies for different kinds of diseases and types of autoimmune disorders including RA.

C-REACTIVE PROTEIN TEST

When our body is undergoing severe inflammation or a serious infection, the liver will produce the C-reactive protein. High levels of this protein in the kidney is a marker linked with RA.

ERYTHROCYTE SEDIMENTATION RATE

Rarely used alone to diagnose an autoimmune disorder, the ESR test will check for inflammation and the degree of inflammation. The test will check for the degree of red blood cells (RBC) clumping which is an indication of inflammation. However, the test cannot indicate the causes of the inflammation, just its presence.

TREATING RHEUMATOID ARTHRITIS

Like most chronic autoimmune disorders, there is no definitive cure for rheumatoid arthritis. We can, however, we can manage even the most debilitating symptoms and help people who have RA.

The most basic approach in treating RA is managing the pain, which is the most common complaint and then slowing the deterioration of the joints. Nowadays, an RA treatment plan is developed by both the healthcare provider and the patient and is usually tailored towards the needs and symptoms of the patient.

Advances in medications and treatments can make the treatment process easier. We have also improved our medical strategies to ensure a good quality of life for those with RA, especially those with severe cases. Rheumatologists and RA patients have teamed out together in the Treat to Target Rheumatoid Arthritis which incorporates lifestyle changes and alternative pain treatments.

Using the treating-to-targeting treatment philosophy, patients have been able to effectively manage their symptoms and increased the rates of remission, those periods where arthritic symptoms are absent. Among the strategies being used in the treatment plan include:

● Setting monthly assessments and monitoring for treating and eventually managing RA pain

● Setting testing and treatment goals geared towards minimizing symptoms and eventually increasing remission rates

● Prompt response and change rates for medications if the treatment does not show progress

By targeting the inflammation caused by rheumatoid arthritis, pain and other symptoms can be effectively managed. Moreover, the long-term plan is to stop the further deterioration of the joints and other organs affected by the disease.

A target-to-treat plan will most likely include:

● Medication

● Home remedies and alternative treatment of symptoms

● Changes in the diet

● Exercises specifically developed for RA treatment

Your physician will develop a treatment plan that is specifically built around your goals and the realities of the disease. Most rheumatoid arthritis treatments are geared towards maintaining a productive and active lifestyle and holistic well-being for the patient.

MEDICATIONS

Your healthcare provider will prescribe several medications to treat your rheumatoid arthritis. Some of the prescriptions are geared toward managing the pain while some may be to reduce the degree of inflammation caused by the disease. Some of the new medications out on the market increase the rates of remission and reduces the damage in the joint linings.

The medications developed to reduce RA flares and inflammation will include:

● Acetaminophen

● Corticosteroids

● Nonsteroidal anti-inflammatory drugs (NSAIDs)

The medications that are taken to control the progress of the disease and damage to the joints and organs include:

● DMARDS (Disease-modifying antirheumatic drugs). These medications suppress the immune system and slow down its response. The downside of DMARDs is the probability of impairing your immunity. However, the benefit of slowing down or preventing the progress of RA outweighs the risk, especially for those with severe rheumatoid arthritis.

● JAK inhibitors (Janus kinase inhibitors). A new class of DMARDs that selectively targets specific autoimmune symptoms. These inhibitors work by suppressing and preventing inflammation and further damage to the joints. The drug is usually prescribed when the patient fails to positively respond to other medications.

● Biologics are a new class of DMARDs that are more streamlined in responding to inflammation that causes rheumatoid arthritis. Biologics do not suppress the whole autoimmune system and are usually prescribed when earlier DMARDs do not work.

HOME AND ALTERNATIVE REMEDIES

Rheumatoid arthritis can be a very debilitating disease, but with changes in lifestyle and a sound treatment plan, it can be managed. An early diagnosis can help mitigate further deterioration and with a proactive mindset, you can improve your quality of life.

Sleep and rest

Sleep is the body’s natural healing mode. Getting enough sleep and with a proper sleeping routine, your body will produce hormones that are meant to repair cells and tissues. Get enough sleep when you have a flareup to lessen fatigue and inflammation. Sleeping is also a natural painkiller.

Rest when you have flare-ups and adopt a more active lifestyle when your RA is in remission.

Do not forget to exercise

Physical activity helps both the mind and the body. Low-impact exercises specifically developed for disorders like rheumatoid arthritis can increase the range of motion and overall-all mobility. Moving about can also strengthen your body which will improve your muscular integrity and can relieve the pain and pressure on your joints.

Yoga can also be an alternative physical activity and can help improve your overall wellness.

Compresses can help

Old-fashioned cold and heat treatments can help alleviate the symptoms of RA. Using a cold compress to relieve pain and reduce the swelling in your joints can also help reduce muscle spasms that usually accompany a flare-up.

A hot pack can also reduce stiffness as well as taking warm baths or showers. Alternate your cold and hot water treatments for maximum effectiveness.

Using assistive devices

Assistive devices such as splints, canes, and braces are geared toward decreasing pressure on the joints and increasing your mobility. However, these assisted devices are used for specific purposes and always consult your physician before using one.

Crutches and canes can increase your mobility, especially during a flare-up.

Braces and splints work by reducing inflammation on your joints. Holding your arm or hand in a resting position can reduce the pressure and the pain of the inflammation.

You might also consider installing handrails and grab bars in selected areas of your house such as the bathroom to not only help you when you are having a flare-up but to also prevent injury and accidents.

DIET

Modifying your diet to manage your rheumatoid arthritis is always part of a comprehensive treatment plan. Most dietitians can help you draw up a diet that minimizes inflammation by avoiding certain foods. You should also be eating more food with substances that can improve your health such as antioxidants and omega-3 fatty acids that can suppress inflammation.

Foods that contain anti-inflammatory omega-3 fatty acids:

● Flax seeds

● Walnuts

● Chia seeds

● Fatty fish (tuna, mackerel, salmon, and herring)

Vitamins A, C, and E and the mineral selenium are rich in antioxidants which are anti-inflammatory and can help slow down the damage to your joints and cells.

Foods rich in antioxidants:

● Dark chocolate

● Kidney beans

● Berries (blueberries, strawberries, cranberries, etc.)

● Spinach

● Artichokes

● Pecans

Fiber-rich foods can help reduce the body’s immune response and reduce swelling. Fiber has been linked by some research into a decrease of C-reactive proteins.

● Fresh vegetables especially the leafy type

● Whole grains

● Fresh fruits especially strawberries

Flavonoids are plant nutrients that can help your metabolism and counter swelling caused by RA. They also have antioxidant effects.

● Berries

● Soy products such as miso and tofu

● Matcha

● Grapes

● Berries

Avoid RA-trigger foods

Some foods contain chemicals that can trigger a rheumatoid arthritis flare-up. Most dietitians will recommend that you give up processed foods as much as possible especially processed carbohydrates and foods rich in trans and saturated fats.

Eating right includes eating the foods that can promote your well-being and avoiding the ones that will exacerbate your flare-ups. It may take time getting used to especially as culturally we have associated certain foods with comfort, but wellness is a path and a process.

THE DIFFERENT TYPES OF RHEUMATOID ARTHRITIS

As much as there are different types of arthritis, there are also several sub-types of RA, and knowing the specific type can both help and your physician increases the effectiveness of your treatment plan.

Juvenile Idiopathic Arthritis

An RA disorder that afflicts young people, 17 years old and younger. Formerly known as juvenile rheumatoid arthritis, JIA has the same kind of symptoms as other RA types. However, because those who have JIA are still in the developing stage, physical development can be affected. The eyes can also become inflamed because of the disease.

Seropositive RA

The most common RA type which has also been linked to genetics. Those who test positive for the rheumatoid factor blood test are categorized under this type. The RF test checks for the antibodies that attack the body’s joint linings.

Seronegative RA

People who test negative for both the anti-CCP and RF blood tests are called seronegative. However, as RA runs its course, the person will eventually become seropositive as the body starts developing antibodies indicative of the disorder.

SEROPOSITIVE RA

The most common among the rheumatoid arthritis types, seropositive RA generally has more severe symptoms than the other types. If a blood relative has seropositive RA, then a family member is also most likely to develop the disease compared to someone who has not.

SYMPTOMS

● Pain and inflammation in the joints

● Morning cramps or stiffness longer than 30 minutes

● Pain and inflammation in symmetrical areas such as both left and the right little finger has swollen joints

● Fever

● Rheumatoid nodules (firm lumps under the skin and are found near the affected joints)

● Weight loss

● Chronic fatigue

Seropositive RA can also cause inflammation in the following areas:

● Heart

● Lungs

● Kidneys

● Nerves

● Eyes

● Blood Vessels

● Salivary glands

● Skin

WHAT CAUSES RA

Like most autoimmune disorders, the exact cause of rheumatoid arthritis is unknown. However, some risk factors can increase a person’s predisposition to develop the disease:

● Gender - Females are more likely to develop rheumatoid arthritis than males.

● Genetics - more people with a family history of arthritis develop RA compared to those with none

Onset triggers for rheumatoid arthritis

Specific factors can start the onset of RA, though people are more likely to start exhibiting RA symptoms when they reach middle age.

● Cigarette smoking

● Obesity

● Viral infections such as mononucleosis can trigger the onset of RA

● Exposure to bacteria usually associated with gum disease

● Bone trauma or injuries such as fracture, ligament damage or joint dislocation

HOW RHEUMATOID ARTHRITIS WILL AFFECT YOUR HANDS

The symptoms of RA in the hands can start as a slight burning sensation, usually occurring in the evening or night. Most people tend to ignore it, ascribing the feeling to tiredness or physical activity. It is only when the pain increases and spreads from the hands to the wrist will a person see a physician.

Early diagnosis of RA can greatly improve your chance of stopping the degenerative aspect of the disease. Other symptoms you should watch out for:

● Stiffness especially of the joints

● Feverish areas in the hands and fingers

● Redness

● Inflammation

If the disease remains untreated, cartilage and bone erosion may occur, and you might start noticing deformations in your hands especially around the joints. If the cartilage is completely affected and severe deterioration sets in, you will feel a grinding sensation particularly in the large joints of the fingers and hands.

Eventually, bone spurs or knobby growth in the affected joints. If they become severe enough, a person may slowly find it more difficult to use the affected hand.

As rheumatoid arthritis progresses, synovial cysts will usually develop in the small joints of the hands. Other parts of the body will also develop these fluid-filled growths: wrists, elbows, knees, and ankles.

Your physician can give you hand and finger exercises to retain function and range of motion, increase mobility, and stem the progress of rheumatoid arthritis in your hands. Developing a treatment plan with your health care provider can improve the management of your RA symptoms and stave off the disease.

VISIBLE EFFECTS OF RHEUMATOID ARTHRITIS

We have seen pictures or even for ourselves if we have a family member who has the condition, the visible effects of RA. As the disease usually affects the hands and feet, you will see and experience more than pain and swelling in these areas if the disorder remains untreated.

The unchecked inflammation of the joint lining will damage your ligaments and you will eventually find it harder to move and walk. You can use assisted devices, but early treatment is still the best course of action.

Hands and feet can also become deformed. For RA in the hands, your fingers and hands will curve seemingly like claws. The same can also happen with the toes, forming claw-like hooks that can either curl under or bend upward. Your feet can also have calluses, ulcerations, and bunions.

Rheumatoid nodules can also form under the skin, lumps that will grow around affected joints. These nodules can be as small as a pea or as big as a walnut and can even form in clusters.

DIFFERENTIATING BETWEEN OSTEOARTHRITIS AND RHEUMATOID ARTHRITIS

Osteoarthritis (OA) can also cause stiffness and pain in the joints and severe cases can impede mobility. However, people with OA do not develop serious inflammation that will cause redness in the joint area. Osteoarthritis is not caused by the body’s autoimmune system but rather by trauma and usually because of age and the wear and tear we usually associate with growing old.

This is the primary reason why most OA sufferers are senior adults. If they happen to younger adults, it is because of extreme activity associated with being an athlete or caused by an accident. RA is caused by an immune system gone haywire and is attacking itself.

THE ROLE OF GENETICS

You will not necessarily inherit rheumatoid arthritis the way cardiac diseases or diabetes can be hereditary. However, the disease does run in families which can be a mix of several factors involving genetics, the environment, or both.

If your family has a history of rheumatoid arthritis and you start noticing the onset of symptoms, consult your doctor and the best way of checking for a diagnosis. Though you will not inherit the disease, your risks of developing RA are greatly increased. Early treatment can help make stave off the progress of the disease.

CONSULTING YOUR PHYSICIAN

Rheumatoid arthritis may not have any cure for now and it is chronic and degenerative nature may make you fear a diagnosis. However, remain mindful that you can manage the flare-ups and extend the periods of symptom-free remissions with a proper treatment plan and commitment on your part. This is why it is especially important to consult your healthcare provider, so you can both develop a target-to-treat plan streamlined to your symptoms.

It is also usually important to prevent further damage to your joints and enact a medical course of action. Consult your doctor as soon as you notice any symptom or if you are a person at risk or have concerns about rheumatoid arthritis.

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