Rheumatoid Arthritis is a chronic disease of the immune system. It is an autoimmune disease where your body’s immune cells attack the lining of the joints, known as synovium. The causes for this condition are attributed to genetic factors and environmental triggers.
An inflammatory process characterises Rheumatoid Arthritis in the synovium throughout your body. Your immune system is designed to fight bacteria and other foreign invaders that may cause harm to your body. In Rheumatoid Arthritis, the immune system mistakes the cells of the synovium as a foreign invader and begins attacking this lining of the joints.
The synovium produces a fluid that helps the joint move smoothly. But as the cells of the immune system attack it, there is inflammation in these cells, leading to the eventual destruction of the cartilage and bone elements of the joint.
As a result, one can experience pain, stiffness, and weakness, among other symptoms. The duration of these symptoms varies from one person to another. For some, the symptoms may be aggressive and progress rapidly. For others, it may take several years. There might also be instances where patients experience a period of time with symptoms (flare) and some with no symptoms (regression).
What are the symptoms of Rheumatoid Arthritis?
The intensity of symptoms experienced varies over the different stages of Rheumatoid Arthritis. In the early stages, the symptoms include,
- Joint stiffness lasts for extended periods, such as half an hour.
- Experience stiffness in the same joints on both sides of the body.
- Unexplained pain, swelling and tenderness in smaller joints or multiple joints simultaneously.
- Fatigue and weakness.
- Symptoms and discomfort that last longer than six weeks.
How is Rheumatoid Arthritis diagnosed?
In the earlier stages, the symptoms of Rheumatoid Arthritis may be similar to other types of arthritis. No singular, gold standard test determines the diagnosis of Rheumatoid Arthritis. Hence, the examination for diagnosing consists of a combination of physical and blood tests.
● Physical examination
The doctor or physician checks the joints for swelling or tenderness. The range of motion is also checked across different joints.
During the physical examination, you may be asked about symptoms and your medical and family history for any genetic influences and instances of Rheumatoid Arthritis in relatives.
● Blood examination
Post the physical examination, blood tests are conducted to identify any forms of inflammation and autoantibodies that may indicate Rheumatoid Arthritis. The blood tests may include,
- Rheumatoid factor (RF) test and CCP antibody test (anti-cyclic citrullinated peptide)–. You can take a CCP Antibody test to distinguish it from other types of Arthritis. CCP antibody test is more specific and has less false positives in comparison to RF
- Erythrocyte sedimentation rate and C reactive protein – higher levels of these tests may indicate the condition. These are non-specific markers of inflammation
- Antinuclear antibodies – a positive or negative test helps with diagnosis.
- Complete blood count (CBC) — is recommended when the doctor finds low red blood cells, an indicator of Rheumatoid Arthritis.
● Imaging Tests
In combination with blood tests, imaging tests reveal the diagnosis and progression of the disease such that the doctor can monitor and provide treatment accordingly. The imaging tests recommended include,
- X-rays showcase the amount of joint damage.
- Ultrasound and Magnetic Resonance Imaging (MRI) to provide more details on the condition of the joints.
These tests can show if the ends of the bones are slowly eroding over time due to inflammation. Imaging tests are also used between treatments to check the progress and results of medications and treatment.
How is Rheumatoid Arthritis treated?
There is no specific cure for the disease, but early investigations, diagnosis and medications can help keep symptoms under control. The inflammation can be reduced or stopped, and doctors can prescribe medications to relieve symptoms’ remission. Treatment in Rheumatoid Arthritis usually involves medication such as disease-modifying anti-rheumatic drugs.
- Steroids — Corticosteroids such as Prednisone help reduce inflammation and pain and slow joint damage.
- Conventional DMARDs — are intended to slow the progression of rheumatoid arthritis and save the joints from permanent damage. They are used along with biologic response modifiers, such as methotrexate.
- Targeted synthetic DMARDs — these are used when conventional and biological response modifiers do not work.
- Over-the-counter NSAIDs — Non-steroidal Anti-Inflammatory Drugs can relieve pain and reduce inflammation during treatment.
The doctor may refer you to a physical or occupational therapist to engage in exercises that can help keep the joint flexible. These modifications are also suggested to one’s daily activities to make them more manageable. For instance, helpful equipment and assistive devices can help you get dressed, get a better grip on holding objects, and so on.
Surgery is often the last resort for rheumatoid arthritis when the medications fail to prevent or slow joint damage. The types of surgery that can reduce pain and improve function include,
- Tendon repair — targeted to repair the tendons around the joint that have been loosened or ruptured due to inflammation.
- Total joint replacement — the damaged parts of the joints are replaced by prosthetic parts.
- Synovectomy — aimed to remove the synovium, the inflamed lining of the joints, to reduce pain and improve flexibility.
- Joint fusion — only in cases where replacement is impossible, joint fusion is conducted to relieve pain and stabilise or realign a joint.
Discussing the pros and cons of surgery before undertaking the procedure is crucial. Ensure that you are informed of all procedures before and after surgery.
Other forms of self-care to manage Rheumatoid Arthritis
While medications and treatment are essential, you can also contribute to your recovery by managing diet and lifestyle choices to control rheumatoid arthritis. Eating healthier, being involved in daily movement such as light walking, proper rest, and using heat treatments to relieve joint pain can help. A diet with Rheumatoid Arthritis may include supplements such as omega-3 fish oil and eliminating habits such as smoking, intake of junk food, and so on.
Such habits can contribute to preventing and reversing the effects of rheumatoid arthritis in the long run. Consulting the doctor and therapists on recovery methods and cultivating a positive support system and environment are complementary in the recovery process from Rheumatoid arthritis.