Rheumatoid arthritis is a chronic inflammatory disorder affecting your joints. It’s classed as an autoimmune disease, where the immune system mistakenly attacks the body’s own tissues, forming an autoimmune protein known as rheumatoid factor.
It is characterised by joint pain, swollen joints, stiffness, and inflammation that occur in more than one joint.
Rheumatoid or inflammatory arthritis affects primarily the tissue lining of your joints, but the disease progresses to affect blood vessels and other organs as well
Under normal conditions, the capsule around the joints keeps the bones in their place and therefore provides stability. When joint inflammation occurs, extra fluid accumulates inside the capsule. This causes the capsule to bulge out and also stretches it. Due to the attack of the immune system on the capsule and subsequent joint inflammation, the capsule is weakened and the joint becomes unstable and causes pain upon movement.
In this article, you will find accurate information about rheumatoid arthritis, its causes, symptoms, and treatment plans if you suffer from this condition.
When Does Rheumatoid Arthritis Occur?
Rheumatoid arthritis can occur at any age but is particularly common in old age. Rheumatoid or inflammatory arthritis diagnosed at age of 70 is known as late-onset RA. This is because of age-related degenerative changes that take place in the bones and the tissues causing subsequent weakening.
Rheumatoid arthritis below the age of 16 is known as juvenile rheumatoid arthritis. Women are at increased risk of developing rheumatoid arthritis, because of osteoporosis and other bone-related changes that occur as a result of decreased oestrogen following the menopause. Both late-onset and juvenile-onset rheumatoid arthritis have the same symptoms.
Causes of Rheumatoid Arthritis
The exact cause of rheumatoid arthritis is yet to be determined, but it’s thought to be a combination of genetic and environmental factors.
Rheumatoid arthritis typically occurs after a previous bacterial or viral infection. During an infection, the immune system works to eliminate the infectious agent, and some of the immune system’s cells may start working against the body’s self-tissues therefore causing joint damage.
Normally our immune system can distinguish between the body’s own cells and foreign cells. The immune system has the ability to act against and destroy only the foreign cells, but due to some genetic conditions, the immune system fails to make that distinction and produces rheumatoid factor.
Stress and other environmental factors can also spur on the rheumatoid factor. For people under significant stress, the inflammation in the affected joints becomes worse and it acts as a trigger for disease flare-ups.
Obesity can also contribute to developing RA. In obese people, metabolic processes are altered and it contributes to the weakening of many systems of your body. Rheumatoid arthritis affects the functioning of the immune system and causes significant diseases including this autoimmune disease. This makes living with rheumatoid arthritis more difficult.
How Rheumatoid Arthritis Affects Your Body
The symptoms of rheumatoid arthritis vary among different people as it affects more than one joint. In some instances, the joint symptoms develop gradually, affecting the joint function. However, in others, the RA symptoms show a rapid progression. Some of the RA symptoms are listed below.
In many cases, there comes a time when the patient presents with rheumatoid arthritis symptoms. This period is called flares. Alternatively, there is a period when the disease shows no symptoms called remission.
There is pain, stiffness, and swelling in various small joints of the body, especially in the hands. The stiffness and swelling occur due to the inflammatory reaction at the same joints. Due to the release of inflammatory mediators, several reactions take place at the site including redness. The RA patients complain of chronic pain and feel very uncomfortable.
The range of movements is reduced in the affected joints. This is due to joint stiffness that decreases the joint function and is seen especially in the morning or after a long period of sitting. The patient complains of weakness and fatigue due to stiff joints.
Almost all chronic inflammatory conditions are characterized by fever. The inflammatory process releases many chemical substances that affect various metabolic reactions and systems. This raises the core body temperature causing fever.
In some cases, patients present with a localized swelling called rheumatoid nodules. They are fleshy lumps formed under the skin of the affected joint. These rheumatoid nodules usually do not cause pain, however, they may become painful joints.
People with rheumatoid arthritis may also experience anaemia because of red blood cell deficiency. Rheumatoid arthritis affects blood vessels leading to their damage and it results in destruction of RBCs leading to their deficiency.
Early Rheumatoid arthritis RA affects the small joints and later on, the chronic disease affects other joints in the body as well including the hip joint, knee joint, and shoulder joint. The disease can progress to the blood vessels leading to vasculitis and coronary artery disease or lungs causing interstitial lung disease.
There are some risk factors that make the individual prone to the development of this condition. Some of the important risk factors are:
- Family history: You are at increased risk of developing RA if you have a positive family history of this condition.
- Obesity: You are more likely to develop RA if you are overweight. Therefore, keep a check on your weight if you want to avoid this condition.
- Sex: Women are more likely to develop rheumatoid arthritis than men.
- Smoking: Tobacco smoking significantly increases the chances of developing RA. Cigarette smoke contains chemicals that can damage many systems of the body including the immune system and it can cause chronic disease.
- Age: Rheumatoid arthritis is more common in the elderly than in young people, since the degenerative changes that take place with age.
Diagnosis of rheumatoid arthritis
The correct diagnosis of rheumatoid arthritis RA is difficult because RA symptoms overlap with other similar conditions and also there is not any particular type of blood test to diagnose RA. Your general practitioner will do a physical examination of the small joints to determine the degree of mobility of the joints, stiffness, and inflammation to assess the situation. Early diagnosis prevents the progression of disease.
Although the blood tests cannot specifically confirm the diagnosis, different blood tests can make the rheumatoid arthritis diagnosed in most cases. The main blood tests for this purpose are:
Erythrocyte sedimentation rate (ESR)
This blood test helps to assess the level of inflammation in the body. It measures how rapidly your red blood cells stick together and fall to the bottom of the test tube within an hour.
C-reactive protein (CRP)
It measures the amount of protein your liver makes during inflammation in the body. Result of this C reactive protein test varies from person to person and from lab to lab, but usually, the normal value is below 1.0.
Complete blood count
The test is used to assess the general status of your health, but it is also used to find other possible causes of your symptoms. It also helps to diagnose anaemia, because of deficiency of red blood cells in people with rheumatoid arthritis.
These blood tests provide help for the proper diagnosis of rheumatoid arthritis. In addition to these, there are other tests such as X-ray, ultrasound, and MRI of your joint to provide a more detailed picture of the joint.
Treatment of Rheumatoid Arthritis
Living with rheumatoid arthritis can be very challenging. To treat rheumatoid arthritis, the main goal is to reduce inflammation and swelling in the joint, relieve symptoms, reduce joint pain, stop or slow down the process of joint damage and improve the degree of mobility of the joint. Early treatment and support can reduce the degree of joint tenderness and limit the impact of the condition.
There are three main strategies to treat rheumatoid arthritis:
- Physical therapy
Medications to treat rheumatoid arthritis RA and relieve pain are:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Disease modifying antirheumatic drugs (DMARDs)
Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen reduce joint pain. These medications also reduce inflammation by reducing the synthesis of prostaglandin that mediate pain by stimulating sensory nerve endings. These drugs are effective in reducing joint symptoms and reducing pain.
Disease modifying antirheumatic drugs include methotrexate and sulfasalazine. Methotrexate is the drug of choice for treating rheumatoid arthritis often with other DMARD or short-course steroids. DMARDs modify the immune system and therefore, slow down the progression of this autoimmune disease and reduce inflammation. These block the action of rheumatoid factor which is the immune protein attacking the joints.
Steroids such as prednisone can either be used orally or as an injection into the joint or into the muscle for treating rheumatoid arthritis. They reduce pain instantly, reduce inflammation and swelling, and provide resolution of inflammation, so are effective in treating arthritis.
Physiotherapy and Surgery
A physical or occupational therapist performs various movements on the joints and prescribes certain exercises that will improve the condition and reduce pain. The occupational therapist will perform a physical examination to determine the severity of condition and degree of joint damage. Physiotherapy is also a part of the rehabilitation process after the recovery.
Sometimes the medication and occupational therapy do not improve the condition, in which case the only option to treat RA is the surgery of the joint.
Living with rheumatoid arthritis is painful and you should try your best to prevent it especially if you are of old age and overweight. Here in this article, we have explained to you various causes, symptoms, and factors that increase the risk of developing this condition. Rheumatoid arthritis affects your daily routine and interferes with the normal functioning of your body. Consuming a good diet is one of the best ways by which you can prevent this condition.
If you experience any of the symptoms of rheumatoid arthritis, then instead of ignoring it, you should consult your orthopedic doctor to get the rheumatoid arthritis treated. People with rheumatoid arthritis can easily get depressed. So, you should go to a rheumatoid arthritis support network, get in touch with an arthritis foundation or join a free rheumatoid arthritis community. In people with rheumatoid arthritis, if adequate treatment is not ensured then the condition can worsen over time.