What is rheumatoid arthritis?
Rheumatoid arthritis is a chronic inflammatory condition which can affect the joints as well as other parts of the body.
The condition is an autoimmune disorder which triggers an attack of the body against its own organs, such as the eyes, lungs, heart, skin and blood vessels.
Affecting the lining of your joints, rheumatoid arthritis causes painful swelling that over time, can result in joint deformity and erosion of bone.
It is the inflammatory nature of the condition which allows it to damage other body parts besides the joints. There are treatment options and ways of managing rheumatoid arthritis but severe cases can still be debilitating.
Common signs and symptoms
People suffering from rheumatoid arthritis may experience:
- Joint swelling and tenderness – this can include the joint feeling hot to the touch
- Joint stiffness – which is usually at its worst on waking and after periods of inactivity
- Tiredness, fever and loss of appetite
- Changes in the joints of the hands and feet – rheumatoid arthritis usually begins in this area
Whilst symptoms tend to start in the hands and feet, over time they spread to the wrists, knees, ankles, elbows, hips and shoulders. It is normal to find that symptoms are affecting both sides of the body in the same place.
As mentioned, rheumathoid arthritis can affect structures outside of the joints too. About 40% of sufferers will find this to be the case. Other organs affected include the:
- Salivary glands
- Nerve tissue
- Bone marrow
- Blood vessels
Rheumatoid arthritis signs and symptoms can flare up from time to time and range in severity. Flare ups can alternative with periods of improved symptoms when the swelling and pain decreases. However, as time progresses, rheumatoid arthritis can cause joint deformity and even joint movement.
Common causes of rheumatoid arthritis
Rheumatoid arthritis is caused by your immune system attacking the synovium — the lining of the membranes that protect your joints. Inflammation causes a thickening in the synovium and this leads to a breakdown of the cartilage and bone within the joint. The tendons and ligaments around the joint are also affected, and their weakening causes instability in the joint.
The certain cause of rheumatoid arthritis is not known, but it is thought that genetics play a part, making people more susceptible to the environmental factors that may trigger the disease.
You may be at higher risk of developing the condition based on:
- Women are more prone.
- It tends to begin in middle age and get progressively worse.
- Family history.If a member of your family has rheumatoid arthritis, you may be more likely to develop.
- Cigarette smoking increases your risk of developing rheumatoid arthritis and may be linked to greater disease severity.
- Environmental exposures.It is thought that some exposures such as asbestos or silica may cause rheumatoid arthritis to develop.
- Women under the age of 55 who are overweight or obese appear to be at higher risk.
Rheumatoid arthritis has also been linked to another of other conditions such as lung disease, heart problems and osteoporosis (to name a few).
Diagnosing rheumatoid arthritis
In the early stages, rheumatoid arthritis can be difficult to diagnose. This is due to the fact that many of the symptoms are similar to those of other conditions. Unfortunately there is not a specific test that can diagnosis the condition.
As part of an initial examination, your doctor will look for swelling, redness and warmth around the joints. They may also want to look at your reflexes and muscle strength.
Although there is not a specific blood test that can identify rheumatoid arthritis, people who have the condition tend to have an elevated erythrocyte sedimentation rate (ESR, or sed rate) or C-reactive protein (CRP). These findings may point to inflammation in the body. Other common blood tests check for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies.
X-rays can be useful in observing the condition of your joints over time while magnetic resonance imaging (MRI) and ultrasound tests can help to ascertain the severity of the condition.
Treating rheumatoid arthritis
Unfortunately, there is no cure for rheumatoid arthritis. However, there are plenty of options available to help reduce the disease’s progression and improve your life quality.
There are certain medications that may be suitable for managing and treating the symptoms of rheumatoid arthritis:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen – these can reduce pain and inflammation.
- Steroids – corticosteroids medications, such as prednisone, help to reduce inflammation and pain and slow joint damage. However, they can result in unwanted side effects so long term use is not recommended.
- DMARDs, like methotrexate – these drugs help to slow progression and prevent other tissues from becoming damaged.
- Biological agents – these agents can help to lessen the response of the immune system in rheumatoid arthritis, reducing the effects of the condition. However, it can put users at risk of other health issues.
Therapy can be helpful in keeping your joints flexible and reducing the impacts of daily activities on your body. An occupational therapist can show you ways of adapting your lifestyle to lessen the impact of the condition. There are also certain devices which can be recommended to aid you in day to day tasks around the house.
If after medication your condition has not improved, your doctor may suggest a surgical procedure to repair your joint damage, restoring your body movement and reducing pain.
Some of the most common procedures are:
- Joint fusion – where fusion of a joint can help to increase stability when joint replacement is not an option.
- Tendon repair – an option when a tendon has ruptured or become damaged.
- Synovectomy – a procedure that involves removing the inflamed lining from the joint.
- Total joint replacement – the removal of a damaged joint to replace it with an artificial structure.
After surgery, it is important to follow the rehabilitation plan and advice provided to you by your doctor and therapists.
Physiotherapy can be a crucial part of recovery, allowing you to regain strength and function in your healing joints. Occupational therapy can assist you in adapting to life with the condition, helping to prevent further stresses on the body.
Regular follow up visits should be attended in line with the recommendation of your doctor. Depending on the type of surgery you have had, your recovery could take weeks or months.