Rheumatoid Arthritis

Overview

Rheumatoid Arthritis (RA) is a chronic autoimmune disorder that can severely affect one's joints. It particularly develops in the tissue lining the joints, leading to pain, bone erosion and in severe cases, joint deformity. The condition is not limited to the joints but also negatively impacts and damages other body systems including one's eyes, skin, lungs, blood vessels and even the heart.

It occurs when the immune system of the body mistakes certain body tissues as a threat and attacks them. There is no specific cause of rheumatoid arthritis that can be pinpointed. However, new developments in treatment methods have resulted in the betterment of diagnosed individuals at a faster rate. Yet, the complication of physical disabilities remains in the absence of prompt treatment.

What is Rheumatoid Arthritis?

Rheumatoid arthritis is an autoimmune disease which affects the joints of an individual's body. It is a chronic disorder and treatment procedures can only help manage the symptoms and not eliminate the condition. Diagnosed individuals may experience inflammation and pain in different parts of their bodies, including the wrists, feet, toes, fingers, etc.

Extreme levels of inflammation can cause damage to the ‘shock absorbers’, known as cartilages in one’s joints. This may trigger the fusion of the finger joints (a phenomenon initiated by the affected joints to protect themselves against the pain and irritation). Eventually, it can result in joint deformity and/or bone erosion.

There are certain cells in the immune system which aid the fusion process of the joints. The substance, thus, produced in the joints may spread and cause symptoms throughout the host body, including the skin, eyes, lungs and heart, among others.

Types of Rheumatoid Arthritis

There are 3 types of rheumatoid arthritis recognised clinically, based on the antibodies present in the affected individuals’ bodies. The types of RA are listed below:

Seropositive Rheumatoid Arthritis

One needs to be diagnosed with seropositive rheumatoid arthritis if they test positive for the rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (ACPA). People diagnosed with this type of RA are likely to experience more severe symptoms, faster disease progression, more complications, more bone erosion and less noticeable response to treatments.

Seronegative Rheumatoid Arthritis

People who test negative for the RF and ACPA antibodies may have seronegative rheumatoid arthritis. It is a milder form of the disorder, causing lesser symptoms. This condition responds more effectively to treatment.

Juvenile Idiopathic Arthritis (Juvenile Rheumatoid Arthritis)

This is the most common type of arthritis occurring in children below the age of 16 years. Symptoms are similar to those of RA, but this type has recently been distinguished as a category of its own.

Symptoms of Rheumatoid Arthritis

Symptoms of rheumatoid arthritis may vary in appearance from person to person. They may develop over several years or progress rapidly. Sometimes, symptoms may go into remission and at other times, they may flare up.

Some common symptoms of RA include swelling, stiffness, pain or tenderness in joints; stiffness resulting from sitting up straight for a long period or after waking up in the mornings; and pain in the pairs of joints on both sides of the body. Other than that, affected individuals often develop fevers, feel weaker than usual and also get fatigued easily from a little physical activity.

Causes of Rheumatoid Arthritis

Specific causes of rheumatoid arthritis have not been determined. However, research reveals that a combined effect of hormones, genetics and the general environment may lead to the condition. In an environment characterised by smoke; hormonal changes due to varying emotional or physical stress levels, among others, may lead to the immune system malfunctioning and affecting the joints.

Specific genetic variations have been held responsible for causing RA. For example, people who have variations in the HLA genes (human leukocyte antigen) are more prone to the condition. Some non-genetic causative factors include sex and the general health of a person. Women are 2 to 3 times more likely to get rheumatoid arthritis. Individuals who may be obese are at a higher risk of developing RA.

Rheumatoid Arthritis Diagnosis and Tests

A rheumatologist will conduct a physical exam first. They shall then ask for the patient’s medical history and symptoms. Accordingly, they will recommend the necessary imaging and blood tests. The blood test will look for antibodies in the body to specify the type of RA and inflammation. The antibodies may include the existence of erythrocyte sedimentation rate which reveals inflammation of the joints; CRP (C-reactive protein), rheumatoid factor and cyclic citrullinated peptides.

As rheumatoid arthritis can cause one's bones to erode or wear down, imaging tests need to be conducted to check for the state of the bones. These tests include MR eyes, ultrasounds and X-rays. Further, one's doctor may watch over the affected individual for some time before definitively diagnosing them with RA.

Rheumatoid Arthritis Management and Treatment

There is no cure for rheumatoid arthritis. However, symptoms can be managed efficiently and sent into remission quicker if the treatment process is undertaken at an earlier stage. The medications involved in the procedure are known as disease-modifying antirheumatic drugs or DMARDs.

A rheumatologist will prescribe drugs according to the severity of one's symptoms. For example, NSAIDs (to reduce inflammation and pain), steroids (to reduce pain and slow down joint damage), biologics with conventional DMARDs and targeted synthetic DMARDs may be prescribed.

The doctor may recommend physical or occupational therapy which will help keep the joints flexible and functional. If the medications fail, there are surgery options including synovectomy, tendon repair, total joint replacement and joint fusion.

Preventive Measures for Rheumatoid Arthritis

Certain lifestyle changes can reduce the chances of developing rheumatoid arthritis. For example, one can quit smoking, exercise regularly, control alcohol consumption, take care of their teeth, avoid external irritants possibly from polluted environments, manage stress effectively and undertake action as soon as possible upon diagnosis. Switching to a balanced diet will also help. So, avoid high salt content in said diet and include more fish and omega-3. Also, avoid sugar and carbonated beverages.

Myths and Facts Related to Rheumatoid Arthritis

Here are some misconceptions associated with rheumatoid arthritis and the facts that prove them wrong:

Myth 1: If I Have Rheumatoid Arthritis, I Should Always Rest and Avoid Physical Activities
Fact: A person with rheumatoid arthritis does not necessarily have to rest all the time. Instead, they should exercise regularly to relieve tension at the joints and increase flexibility. While rest is important, being completely inactive shall only be the case.

Myth 2: Rheumatoid Arthritis Only Happens to Older People
Fact: Rheumatoid arthritis is not limited to older people. A lot of people believe that it is a naturally occurring condition that happens with age. However, That’s a false conception. It can happen to people between the ages of 40 to 60 years, and also to certain teenagers and children.

Myth 3: Rheumatoid Arthritis and Osteoarthritis are the Same
Fact: Rheumatoid arthritis and osteoarthritis may showcase similar symptoms, both affecting the joints - however, the two are essentially different. They both require different treatment approaches. While RA is an autoimmune disease, osteoarthritis does not involve the body’s immunity system.