What is rheumatoid arthritis?
Rheumatoid Arthritis (RA)
is a common disorder, which causes inflammation, pain and stiffness
in the joints.
RA can be chronic (lasting) or it may flare up and then go into
remission (long periods without any symptoms).
RA
typically affects the small joints, such as the hands, wrists, elbows
and feet. However, RA can affect any joint and can be the most disabling
type of arthritis. RA is usually symmetrical - if a joint is affected
on one side of the body the other side is also affected. Occasionally,
RA can cause inflammation in other body organs such as the heart
and lungs.
Anyone of any age can get RA, however, it is more
common in women and people aged between 30 and 50. In Great Britain, approximately
3 people in 100 are affected by RA .
What causes rheumatoid arthritis?
RA is a complicated disease and like many other forms
of arthritis, the actual cause of RA is not known. However, scientists
suspect that it might be triggered by an infection (viral or bacterial)
but there is presently no proof to support this case.
It is known
that RA is an autoimmune disease, which means the body's immune
system reacts to something abnormal in the body and tries to
remove it. In RA the immune system attacks the
layers of healthy tissue that line the joint (known as the
synovium).
The synovium
produces a thick lubricating fluid called synovial fluid. This fluid
acts like an oil, which lubricates the joint allowing free movement.
In RA the
synovium becomes much thicker and may produce larger amounts of
fluid, causing the joint to become painful, stiff and inflamed.
If left untreated the joint can become permanently damaged, resulting
in deformity.
What are the symptoms of rheumatoid arthritis?
Symptoms of RA can vary a great deal from person to
person. For some people symptoms of RA will develop slowly, sufferers may begin to notice that a few joints, such as the fingers are uncomfortable or they may swell. For others the disease may develop rapidly with the sufferer experiencing swelling and pain in a lot of joints.
As mentioned earlier symptoms of RA
may come and go, when RA is active you may experience any of the following
symptoms:
- Swelling and redness in more than one joint.
- Stiffness around the joints, that lasts for
more than a hour.
- Constant or recurring pain in joints.
- Fever.
- Loss of appetite.
- Fatigue.
- Depression.
- Anaemia
Most people with RA will experience some damage in various joints. Once these joints have become damaged from the inflammation they will not heal easily, this is why the majority of treatments are aimed at reducing inflammation.
As RA progresses you may suffer the loss of a joint function.
You may also develop firm lumps under the skin called rheumatoid
nodules. These are usually found around the elbows though they can
be found anywhere. On very rare occasions, people with RA can develop
inflammation of other body organs, such as :
- The eyes and mouth - causing a dry mouth
and dry eyes.
- The lining of the heart - known as pericarditis,
causing chest pain when lying down
- The lining of the lungs - known as pleuritis, which can cause
chest pain and coughing.
Symptoms of RA tend to be worse in the morning and
sometimes in cold, damp weather.
Am I at risk of getting rheumatoid
arthritis?
Anyone of any age can get rheumatoid
arthritis, however, you are more at risk if you
are a woman or if there
is a history of RA in your family.
Can I do anything to prevent getting rheumatoid
arthritis?
Though there is nothing you can do to
prevent getting RA you should maintain a healthy diet and
ensure you get regular exercise, this will help prevent weight gain
and joint stiffness.
Is there anything I can do to
prevent rheumatoid arthritis flare ups and how will the disease progress?
When RA symptoms flare up they can have
an obvious cause, such as illness, physical activity that your not
used to or because of emotional problems. However, there is not
usually a reason why RA has flared up.
RA varies greatly in each person, some
people will have progressive RA but others will only have mild RA,
with few symptoms and little or no joint damage. Though RA can be
a very serious disease most people when treated properly will have
few symptoms and will be able to lead a normal life.
How is rheumatoid arthritis
diagnosed?
Your doctor will suspect RA from your
symptoms and medical history. In many cases RA may also be diagnosed
from a physical examination of the joints, especially if it's a
large joint that is affected. Your doctor will also look for the
presence of rheumatoid nodules. You will usually need to have a
blood test to confirm what type of arthritis you are suffering with,
as rheumatoid arthritis needs to be quickly diagnosed. An x-ray
of the affected area will usually confirm the diagnosis.
How is rheumatoid arthritis
treated?
There is no cure for most types
of arthritis, however, there is a large range of treatments available
to help you live a normal life. Some people may only require a simple,
daily exercise program to help ease the pain and improve movement
in the affected joint. Exercise helps strengthen the muscles around
the joint as well as helping you maintain a healthy weight. The
best forms of exercise if you have RA are swimming, cycling or walking.
Your doctor or a physiotherapist will advise you on the type of exercise you should be doing.
If you are finding the joints very
painful, there are many drugs available to relieve pain and reduce
inflammation around the joint. These drugs fall into three categories:
- Analgesics (pain killers) such as paracetamol
which help relieve pain. These are available over the counter
at chemists.
- Non-steroidal anti-inflammatory drugs (NSAIDs),
such as ibuprofen and aspirin, which are available over the counter
at chemists. There are also many stronger NSAID'S which can be
prescribed by your doctor. These drugs normally start working
within a few hours, they reduce inflammation and so reduce pain.
However, if taken over a long period they may cause stomach problems.
- Steroids, usually cortisone can be taken
either in tablet form or via an injection directly into the affected
joint for immediate relief. Steroids can have side effects if
taken long term so they are usually only prescribed to control
severe arthritis.
With
RA your doctor may also prescribe disease-modifying anti-rheumatic
drugs (DMARDs) to slow down the progress of the disease and reduce
inflammation. These drugs act on the immune system rather than the
symptroms of the disease. DMARDs are taken for long periods, usually
many years or even for the rest of your life. However, they can
have side effects so your doctor will keep a regular check on you,
this might include regular blood and urine tests.
Your doctor may also recommend you use
a walking stick, splints or a brace to support and protect the affected
joint.
If arthritis is severe you may
require surgery to replace the affected joint, nowadays hip and knee replacements
are a very common operation.
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