Overview:
Rheumatoid arthritis is a chronic inflammatory disease that could affect more than just your joints.
In some individuals, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart, and blood vessels.
An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body’s cells.
Contrary to the wear-and-tear harm of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that may eventually result in bone erosion and joint deformity.
The inflammation associated with rheumatoid arthritis is what can damage other areas of the human body also.
While new types of medications have improved treatment options dramatically, acute rheumatoid arthritis can still cause disabilities.
Symptoms:
Joint stiffness is generally worse in the mornings and after inactivity
Early rheumatoid arthritis will affect your muscles particularly the joints which attach your fingers to your hands and your toes to your feet.
As the disease progresses, symptoms often spread into the torso, knees, ankles, elbows, hips, and shoulders.
In most cases, symptoms occur in the very same joints on each side of the human body.
Approximately 40% of the people who suffer from rheumatoid arthritis also experience symptoms and signs that don’t involve the joints.
Rheumatoid arthritis may affect lots of nonjoint structures, including:
Eyes
Lungs
Heart
Blood vessels
Rheumatoid arthritis signs and symptoms may vary in severity and might even come and go.
Periods of increased disease activity, called flares, alternate with periods of relative remission — when the swelling and pain fade or disappear.
Over time, rheumatoid arthritis may cause joints to deform and shift out of place.
Make an appointment with your doctor if you’ve got persistent swelling and discomfort in your joints.
Causes:
Rheumatoid arthritis occurs when your immune system attacks the synovium — the liner of the membranes that surround your joints.
The consequent redness thickens the synovium, which may finally destroy the cartilage and bone within the joint.
The tendons and ligaments which hold the joint together weaken and extend.
Doctors do not know what starts this procedure, although a genetic component seems probable.
Although your genes don’t really cause rheumatoid arthritis, they can make you more susceptible to environmental factors like infection with certain viruses and bacteria which can trigger the illness.
Risk Factor:
Your sexual activity. Girls are more prone than men to develop rheumatoid arthritis.
Age. Rheumatoid arthritis may occur at any age, but it most commonly starts in middle age.
Family history. If a member of your family has rheumatoid arthritis, you may have a heightened chance of the illness.
Smoking. Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly in the event that you’ve got a genetic predisposition for developing the illness.
Smoking also appears to be associated with greater disease severity.
Environmental exposures. Although poorly known, some exposures such as asbestos or silica may increase the chance of developing rheumatoid arthritis.
Emergency workers exposed to dust from the collapse of the World Trade Center are at a higher risk of autoimmune diseases like rheumatoid arthritis.
Obesity. People especially women age 55 and younger who are overweight or obese appear to be at a somewhat higher risk of developing rheumatoid arthritis.
Complications:
Rheumatoid arthritis raises your risk of developing:
Osteoporosis. Rheumatoid arthritis itself, together with some drugs used for treating rheumatoid arthritis, can raise your risk of osteoporosis — a condition that weakens your bones and makes them more susceptible to fracture.
These company lumps of veins most commonly shape around pressure factors, such as the elbows.
However, these nodules can form anywhere in the body, such as the lungs.
Dry eyes and mouth. Individuals who have rheumatoid arthritis are way more likely to experience Sjogren’s syndrome, a disease that reduces the amount of moisture in your eyes and mouth.
Infections. The disease itself and lots of the drugs used to combat rheumatoid arthritis can impair the immune system, resulting in increased infections.
Abnormal body composition. The proportion of fat to lean mass is frequently higher in those who have rheumatoid arthritis, even in people that have a normal body mass index (BMI).
Carpal tunnel syndrome. If rheumatoid arthritis impacts your wrists, then the inflammation may compress the nerve that serves nearly all of your hands and fingers.
Heart issues. Rheumatoid arthritis can increase your risk of hardened and blocked arteries, as well as inflammation of the sac that encloses your heart.
Celiac disease. Individuals with rheumatoid arthritis have an increased risk of scarring and inflammation of the lung tissues, which can result in progressive shortness of breath.
Lymphoma. Rheumatoid arthritis increases the risk of lymphoma, a set of blood vessels that develop in the lymph nodes.
Diagnosis:
Rheumatoid arthritis can be difficult to diagnose in its early stages due to early signs and symptoms that mimic those of many different diseases.
There’s no one blood test or physical discovering to validate the diagnosis.
During the physical exam, your doctor will check your muscles for swelling, redness, and warmth.
He or she may also check your reflexes and muscle strength.
Blood Tests:
Individuals with rheumatoid arthritis frequently have an elevated erythrocyte sedimentation rate (ESR, or sed rate) or C-reactive protein (CRP), which might indicate the existence of an inflammatory process in the body.
Additional common blood tests search for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies.
Imaging tests
Your doctor may recommend X-rays to help track the development of rheumatoid arthritis on your joints over time.
MRI and ultrasound evaluations can assist your physician judge the intensity of the disease on your system.
Treatment:
There’s no cure for rheumatoid arthritis.
But clinical trials suggest that remission of symptoms is much more likely when treatment starts early with drugs known as disease-modifying antirheumatic drugs (DMARDs).
Medications:
The kinds of drugs recommended by your doctor will depend on the intensity of your symptoms and how long you have had rheumatoid arthritis.
NSAIDs. Nonsteroidal anti-inflammatory medications (NSAIDs) can relieve pain and reduce inflammation.
Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve).
Side effects can include stomach irritation, heart issues, and kidney impairment.
Steroids. Corticosteroid drugs, such as prednisone, reduce pain and inflammation and slow joint damage.
Side effects can include thinning of bones, weight gain, and diabetes.
Doctors often prescribe a corticosteroid to relieve acute symptoms, with the aim of gradually tapering off the drug.
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, others), leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine).
Side effects vary but may include liver damage, bone marrow suppression, and acute lung ailments.
Biologic agents. These drugs can target parts of the immune system that cause inflammation that causes joint and tissue damage.
These kinds of drugs also increase the chance of infections. In people with rheumatoid arthritis, higher doses of tofacitinib may increase the risk of blood clots in the lungs.
Biologic DMARDs are usually most effective when paired with a nonbiologic DMARD, such as methotrexate.
Therapy:
Your doctor may send you to a physical or occupational therapist who can teach you exercises to keep your joints flexible.
The therapist can also suggest new ways to perform daily tasks, which are easier on your joints.
For instance, you may choose to pick up an object using your forearms.
Assistive devices can make it simpler to avoid stressing your joints that are painful.
For instance, a kitchen knife armed with a handgrip helps safeguard your wrist and finger joints.
Certain tools, like buttonhooks, can make it easier to get dressed. Catalogs and medical supply stores are great places to look for ideas.
Surgery:
If drugs fail to prevent or slow joint damage, you and your doctor may consider surgery to repair damaged joints.
Surgery may help restore your ability to use your joint. It can also reduce pain and enhance function.
Rheumatoid arthritis surgery may involve one or more of these processes:
Synovectomy. Surgery to remove the inflamed lining of the joint (synovium) may be performed on knees, elbows, wrists, fingers, and buttocks.
Tendon repair. Inflammation and joint damage can cause tendons around your joint to loosen or rupture. Your surgeon may be able to repair the tendons around your joint.
Joint combination. Surgically fusing a joint may be advisable to either stabilize or realign a joint and also for pain relief when a joint replacement isn’t an alternative.
Total joint replacement. Throughout joint replacement surgery, your surgeon removes the damaged parts of your joint and inserts a prosthesis made of plastic and metal.
Surgery carries a risk of bleeding, pain, and infection. Examine the benefits and risks with your doctor.
Home Remedies:
You can take steps to take care of your own body when you’ve got rheumatoid arthritis.
These self-care measures, when used along with your rheumatoid arthritis medications, can help you manage your symptoms and signs:
Exercise frequently. Moderate exercise can help strengthen the muscles around your joints, and it can help combat fatigue you might believe. Check with your doctor before you begin exercising. If you’re just getting started, start by taking a stroll.
Apply cold or heat. Heat can help alleviate your pain and relax tense, painful muscles. Cold also has a numbing effect and may reduce swelling.
Relax. Figure out strategies to deal with pain by reducing stress in your life.
Techniques such as guided imagery, deep breathing, and muscle relaxation can all be used to control pain.
Alternative medicine:
Fish oil. Some preliminary studies have found that fish oil supplements may reduce rheumatoid arthritis pain and stiffness.
Negative effects can include nausea, belching, and a fishy taste in the mouth.
Fish oil can interfere with medications, so check with your doctor first.
Plant oils. The seeds of evening primrose, borage, and black currant contain a type of fatty acid that may help with rheumatoid arthritis pain and morning stiffness.
Side effects can include headache, diarrhea, and gas. Some plant oils may cause liver damage or interfere with drugs, so check with your physician first.
Tai chi. This motion therapy involves gentle exercises and stretches along with deep breathing.
Many people use tai chi to ease stress in their lives. Small studies have found that tai chi may enhance mood and quality of life in people with rheumatoid arthritis.
When directed by a knowledgeable instructor, tai chi is safe. But don’t do any moves that cause annoyance.
Coping and support:
The pain and disability associated with rheumatoid arthritis may affect an individual’s work and family life.
Depression and anxiety are common, as are feelings of helplessness and reduced self-esteem.
The level at that rheumatoid arthritis affects your daily activities depends in part on how well you cope with the disease.
Talk to your doctor or nurse about strategies for dealing. With time you will find out what strategies work best for you personally.
In the meantime, try to:
Take control. With your physician, make a plan for managing your arthritis. This can allow you to feel in control of your disease.
Know your limits. Rest when you are tired. Rheumatoid arthritis can make you prone to fatigue and muscular fatigue. A rest or short nap that doesn’t interfere with nighttime sleep may help.
Connect with others. Keep your household aware of how you’re feeling.
They might worry about you but might not feel comfortable asking about your pain.
Find a family member or friend you can talk to if you’re feeling particularly overwhelmed.
Additionally, connect with other men and women who have rheumatoid arthritis — whether through a support group in your area or on the internet.
Take some time for yourself. It’s easy to get active and not take time for yourself.
Find time to get what you like, while it’s time to compose a diary, go for a walk or listen to songs.
This can decrease stress.
Preparing for your appointment:
While you might first discuss your symptoms with your physician, they could consult with a physician who specializes in the treatment of arthritis and other inflammatory conditions (rheumatologist) for further evaluation.
What you can do
Compose a listing that includes:
Thorough descriptions of your symptoms
Info about medical issues you’ve had in the past
Information about the medical issues of your parents or siblings
All the drugs and dietary supplements you currently take and have obtained in the past for This Issue
Questions you would like to ask the Physician
What to expect from your Physician:
Your doctor may ask some of the following questions:
When did your symptoms begin?
Have your symptoms changed over time?
Which joints are affected?
Can any action make your symptoms worse or better?
Are your symptoms interfering with daily tasks?
Ask your friends and loved ones for support.
If you’re feeling anxious or depressed, consider joining a support group or seeking counseling. Believe in your ability to take control of the pain…
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