Rheumatoid arthritis is one of the most disabling types of arthritis, and it affects at least 1.3 million Americans. Of that 1.3 million, 75 percent are women. Although it can be a very disabling disease, new treatments have greatly improved the quality of life for individuals with rheumatoid arthritis. For treatment, people generally see a rheumatologist who specializes in rheumatic diseases. Seeing a rheumatologist is actually very important for people with rheumatoid arthritis because it is a chronic disease that needs to be managed by a specialist.
Knowing that rheumatoid arthritis, RA, affects 1.3 million people in the US, you may be wondering what causes it. Since RA belongs to a group of diseases known as autoimmune diseases, the exact cause is not known. In an autoimmune disease, the immune system mistakenly attacks healthy tissue, which creates inflammation and damage. For RA, the inflammation occurs in the tissue that lines the joints called the synovium. This inflammation leads to cartilage damage, which means that the tissues that cushion the joints and bones get worn down. This process of inflammation and damage that occurs in autoimmune diseases can be very debilitating, and it causes a range of symptoms.
The classic symptoms of RA include pain, morning stiffness, joint swelling, and limited motion and function in joints. These symptoms are typically accompanied by loss of energy, low-grade fevers, loss of appetite, and dry eyes and mouth. Also, people sometimes find firm lumps called rheumatoid nodules underneath the skin on the elbows and hands. Any joint in the body can be affected by RA; however, the hands and feet are usually affected the most. With all of these symptoms, you would think that RA would be easy to diagnose. Yet, some of these symptoms can be subtle, making diagnosis difficult at times.
Catching RA in its early stages is tricky because the symptoms can be non-specific, but it is important to catch it as early as possible so joint damage can be stopped. To diagnose RA, a rheumatologist will perform a physical exam checking for warmth and swelling in the joints. He/ she will also check for joint immobility. In addition to performing a physical exam, the rheumatologist will also order blood tests to check for anemia, a rheumatoid factor, antibodies to specific proteins, and an elevated erythrocyte sedimentation rate, which indicates joint inflammation. Sometimes, patients will also have to have an MRI, ultrasound, or X-ray to check for the severity of joint damage. Obviously, there are a lot of tests that can be done to assess if a patient has RA, and if the rheumatologist does diagnose RA a specific treatment plan will be put in place.
While there is no cure for RA, there are treatments available to keep the disease from progressing and to decrease symptoms. As a way to limit joint damage, RA patients have to take medications known as disease-modifying antirheumatic drugs, DMARDs. These medications will relieve the symptoms and slow the progression. They include Methotrexate, Plaquenil, and gold, all of which are very powerful and have some serious side effects. That being said, they can be quite helpful. In serious cases of RA, doctors will prescribe biologic agents, such as Orencia, Humira, and Enbrel, which target the parts of the immune system that lead to joint pain and damage. In addition to these medications, RA patients will also take anti-inflammatory medications to help with the pain. Clearly, medicine can play a major role in treating RA; however, exercise can also help.
Because RA is a painful disease, being active can seem impossible. Yet, inactivity can cause increased stiffness and put people at risk for Type II diabetes, cardiovascular disease, and osteoporosis. Clearly, movement is important. People with RA usually benefit from physical therapy, which can include water therapy where exercises are performed in a pool to take stress off the joints. While having the guidance of a physical therapist when beginning an exercise program can help, people can also get physical activity on their own by going to their local pool, doing yoga, or doing tai chi. Each of these types of exercises has been shown to be beneficial for people with RA. It is just a matter of a person figuring out which one fits them best.
In addition to conventional treatments, you should be aware that there are also alternative treatments for RA, some of which can be very beneficial. Supplementing with fish oil is one alternative treatment that has been helpful for many people. Although fish oil doesn’t stop joint damage, it does decrease pain and tenderness, making people much less likely to need anti-inflammatory medication. Acupuncture is another treatment that can decrease pain levels for RA patients. Another alternative treatment some people look to is dietary changes, which are helpful for some. In particular, some people have found removing nightshade vegetables like potatoes, tomatoes, peppers, and eggplants decreases joint pain. While there is no one approach that helps all people, these alternative treatments are worth trying as they can make a difference in the quality of life if they help.
One of the major symptoms of RA is joint pain, which means the lifestyle of someone with RA will be affected. Things that are easy for people who don’t have RA can be very challenging for people with RA, especially if grip strength, walking pace, and range of motion are greatly affected. This means that it might take someone with RA longer to do something or they may need help. Also, resting can be important when RA symptoms flare. All this being said, having RA doesn’t have to mean that a person can’t enjoy life. It just means that it might be necessary to alter one’s lifestyle.
Rheumatoid arthritis is an arthritic condition that needs specialized medical care. With proper care and treatment, RA can be well controlled and people can live fairly normal lives. Understanding all of these things about RA can help both people with RA and their family and friends manage the various symptoms of the disease with success. Do you know anyone who has rheumatoid arthritis?
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