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RA is an autoimmune disease that causes chronic inflammation of the joints as well as the tissues around them. The body’s own immune system attacks the synovial membrane (the tissue that lines, protects and lubricates joints), causing inflammation. As a result, chemicals are released into the joint, leading to further damage of the bone, cartilage, tendon and ligament. RA can affect the whole body including the lining of the lung and heart, tear and salivary gland, and blood vessels. RA commonly affects small joints of the hands, wrists, feet and ankles. The joints on both sides of the body are usually involved at the same time. Other joints that may be affected include the elbows, shoulder, hips, knees, neck and jaw.
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RA affects women three times more often than men. The disease can start at any age but occurs most frequently between ages 20 to 50. RA is not hereditary but persons with an inherited gene for RA may have more of a tendency to develop the disease.
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The cause of RA is unknown.
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Symptoms may start abruptly or subtly and vary in severity from person to person.
They may also come and go.
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Stiff joints especially after awakening or prolonged inactivity
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Red, swollen, tender and painful joints
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Fatigue
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Low-grade fever
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Loss of appetite
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Anemia
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Rheumatoid nodules – lumps under the skin of the elbows, fingers or other parts of the body
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Dry eyes and dry mouth
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Chest pain with deep breathing or coughing
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A complete medical history, symptom history, physical exam, joint examination, X-rays and certain blood tests enable your physician to diagnose the disease. The presence of an antibody in the blood, called “rheumatoid factor”, is detected in 80% of the people with RA.
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Currently, there is no known cure for RA. Treatment aims to reduce joint pain and inflammation, improve joint function and prevent joint deterioration.
1) Activity and Rest
Regular exercise keeps joint flexible and muscles strong. Listen to your body and learn to adjust your activities accordingly. Balance activity with rest. Therapeutic exercises include range-of-motion and strengthening exercises. Consult your doctor, physical or occupational therapist for specific instructions.
2) Heat and Cold Applications
Heat reduces pain and relaxes intense and painful muscles while cold applications temporarily dull and numb pain.
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Take a 15 mins. hot shower or bath
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Soak joints in warm water
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Use hot or cold packs or a bag of frozen vegetables (wrapped in towels)
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Use electric heating pads or heat lamps for 15 to 20 mins. at a time
Don’t use heat or cold treatments if you have poor circulation or poor skin sensation
3) Medications
a. Medications that provide fast relief of symptoms (pain, swelling and inflammation):
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Non-steroidal anti-inflammatory drugs (NSAIDs)
Aspirin and ibuprofen are examples of over the counter NSAIDs. Prescription NSAIDs are more potent but cause more stomach problems.
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COX-2 inhibitors
A new class of NSAIDs that suppresses the enzyme involved in inflammation. They tend to be less irritating to the stomach.
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Corticosteroids
Prescribed for short-term use to relieve acute symptoms. May be given by mouth or injected directly into the tissues and joints.Acetaminophen
b. Medications that slow down disease progression:
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Disease-modifying anti-rheumatic drugs (DMRDs)
These drugs usually take weeks or months to be effective and may have potentially serious side effects such as liver, kidney or bone marrow damage, and increased risk of infection. Included in this category is a group of powerful drugs called
Immunosuppressants. These drugs are reserved for persons with severe and aggressive RA. They work at suppressing the body’s immune system.
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Biological response modifiers (BRMs)
A new class of drugs that blocks the protein that causes inflammation.
4) Surgery
In some cases where there is severe joint deformity, surgery may be necessary.
5) Diet
Eat a balanced diet and keep your weight under control. There is no scientific evidence at this time to suggest that any particular food causes or cures RA. Fish oil supplements, which contain omega-3 fatty acids, have been shown to provide relief for some RA patients. Always consult your physician before using any products with health claims.
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Learn to protect your joints and perform daily activities in ways that are least stressful on your joints.
1) Use large joints and strongest muscles to do a task.
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To push open a door, use your hip instead of your hand
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To open a jar, use the palm of your hand instead of your fingers
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To hold a bag, use your arm or shoulder instead of your fingers
.2) Spread your weight over several joints
3) Do not twist or use your joints forcefully.
4) Use self-help devices such as a cane, walker, jar gripper, toilet seat raisers,
lightweight plastic dishes, and long-handled reachers to help with day-to-day activities. To learn more about the latest treatments for Rheumatoid Arthritis, contact:
The Arthritis Foundation
1-800-283-7800
www.arthritis.org
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