When our joints ache, we often chalk it up to an old injury or osteoarthritis or rheumatoid arthritis — the wearing away of cartilage, which is common as people age, but aching joints could be even due to rheumatoid arthritis- the most severe, unremitting form of arthritis that continues for decades and causes debilitating joint damage.
What is rheumatoid arthritis?
Rheumatoid Arthritis (RA) is a chronic degenerative autoimmune inflammatory disease that occurs when the immune system attacks the tissues lining the joints treating it as a foreign body which results in pain, stiffness, redness, swelling, and warmth in joints. Over a period, the affected joints may get misaligned, deformed and damaged as the affected synovium destroys the cartilage and bone within joints. The tissue lining the joint becomes thick and wear downs the surrounding ligaments, cartilage, and bone as it spreads. Unlike other arthritis, rheumatoid arthritis occurs in a symmetrical pattern, which means that if the right knee is affected, then there are chances of the left knee to be affected as well.
RA often strikes the most important joints in the body, including joints in the:
What are the symptoms?
Unlike osteoarthritis, which is limited to the joints and can be treated with mild pain relievers or even exercise or can be resolved with joint replacement surgery. RA is a progressive disease that can damage the joints, tendons, and bones and affect the whole body, including vital organs such as the heart, lungs, and eyes.
The most prominent tip-off to RA is the presence of persistent swelling in multiple joints that don’t occur in other types of joint pain. Other classic symptoms of rheumatoid arthritis include joint pain that gets worse in the morning and gets better with movement, the presence of lumps or rheumatoid nodules below the skin and persistent fatigue. While some uncommon symptoms include fever, weight loss, anemia, and depression.
How to diagnose rheumatoid arthritis?
The rheumatologist will check your symptoms, medical history and will examine you accordingly. You may be asked for a blood test to be done. If the blood test reports show the presence of 60 to 70% of rheumatoid factor (an abnormal antibody, a protein that attacks healthy tissues), then there is 80% chance of you getting RA or other inflammatory diseases.
Other blood indicators that may indicate the presence and level of inflammation in the body, include:
- Erythrocyte sedimentation rate (ESR)
- Tumor necrosis factor-alpha
- C-reactive protein (CRP) levels
Rheumatologists would also examine x-rays, ultrasounds, and magnetic resonance imaging scans of the joints to determine if rheumatoid arthritis is the cause of erosion.
No single test confirms if a person has rheumatoid arthritis. Instead, your rheumatologist would recommend a combination of tests to make an accurate diagnosis. If you are diagnosed with rheumatoid arthritis, then you will have to work with your rheumatologist to create an effective treatment plan based on your current stage of Rheumatoid Arthritis.
What are the stages of rheumatoid arthritis?
Rheumatoid arthritis often develops as a progressive disease, which means that the condition will become more aggressive over time. However, this isn’t always the case as rheumatoid arthritis can also appear in other types of progressions as well.
- Monocyclic progression (also called remissive) is an episode of Rheumatoid Arthritis with symptoms that last only 2-5 years. Monocyclic progression is the result of early diagnosis and immediate treatment to ensure that the symptoms do not return.
- Polycyclic progression (also called intermittent) is the constant recurrence of rheumatoid arthritis symptoms and flares but in fluctuating stages. With polycyclic progression, patients can go long periods of time without experiencing any symptoms at all, but flares usually return.
How to treat rheumatoid arthritis?
It’s essential to treat rheumatoid arthritis as soon as possible, because the medication may slow down the disease progression. But, delaying treatment will, on average, lead to more joint damage and loss of joint function.
Medications do not reverse damage or improve strength, dexterity, or stamina of the damaged joints. They also do not address other aspects of health such as depression or the impact of excess weight; they just help to bring down the degeneration of joints.
- NSAIDs (Nonsteroidal anti-inflammatory drug)
- Standard DMARDs(Disease-modifying antirheumatic drug)
- Biologic DMARDs
Though medications and a modified exercise program are the mainstays of RA treatment, some complementary approaches have shown promise in expanding the options. That include:
- Weight loss management
- Occupational therapy
- Physical therapy
- Heat or cold therapy
- Magnet therapy
- Yoga and tai chi
- Diet supplements( such as glucosamine, and chondroitin)
- An anti-inflammatory diet (example: Fish oil, olive oil, fruit, and vegetables)
If the medications and self-management methods do not help you to alleviate the symptoms, then your rheumatologist would recommend surgical procedures to resolve arthritis, which includes:
- Arthroplasty: The articular surface of a musculoskeletal joint is replaced, remodeled, or realigned by surgical methods
- Arthrodesis: This procedure also called Joint Fusion is recommended when it’s difficult to replace the joints. The joint is removed and the bones are fused together with a bone graft
- Synovectomy: In case of severe rheumatoid arthritis, synovectomy is recommended where the inflamed synovial membrane surrounding the joint is removed
- Joint replacement: When RA turns severe and results in loss of mobility, then the doctor would suggest for joint replacement surgery where the joint is replaced with an artificial joint
If you have noticed any signs and symptoms of rheumatoid arthritis, then immediately consult a rheumatologist to treat rheumatoid arthritis more effectively.
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