Symptoms and Treatments

what is Rheumatoid Arthritis?

Rheumatoid arthritis or RA is an autoimmune disorder that leads to chronic or long standing inflammation afflicting and possibly damaging the joints and surrounding tissues.

Description

It is an autoimmune disorder because the body’s immune system mistakenly attacks the joints and tissues as if they were foreign matter. The inflammation is a direct consequence of this attack. While the condition is chronic lasting for years, patients have been known to enjoy long periods without the symptom.  But the disease is progressive with the potential to destroy the joints causing ambulatory and functional disability of the hands and limbs.

Causes and Risk Factors of Rheumatoid Arthritis

RA is a common rheumatic ailment affecting nearly 1.3 million in the US.  Men are three times more predisposed to it than women and the ailment usually starts after age 40 and before 60.

The causative factors leading to RA are generally unknown.  While infectious bacteria, virus and fungi have been suspected, none has been shown to have direct links. Environmental factors are also suspected but genetic inheritance show a more promising link.  Some families exhibit multiple RA afflictions among its members suggesting genetic roots. But it remains to this day as one active area for laboratory and clinical tests.

Symptoms of Rheumatoid Arthritis

RA symptoms come and go without treatment. But once the joint tissues are inflamed, the disease is active and can go into remission spontaneously or with treatment over a few weeks. People can go for months without the symptoms but when it relapses, it is called a flare.  Periods of remissions and flares vary between individuals.  The usual symptoms include

• Fatigue and loss of energy
• Loss of appetite
• Muscle and joint aches and stiffening
• Low grade fevers
• Reddened, swollen, tender and painful joints

The tenderness and pain experienced often comes symmetrically, meaning both sides of the body. Simple tasks like turning door knobs or opening jars can be a nightmare of pain.  Sometimes, the pain involves only a joint on one side of the body and mimics the symptoms of gout or simple joint infection.

Because of its chronic (long lasting) nature, RA has been known to result in joint deformities if not outright destruction as it erodes cartilages and weaken bones and the tissues around the joints effectively losing the function associated with the joint

Diagnosis of Rheumatoid Arthritis

Diagnosing RA involves eliminating bacterial infection common in gout patients and the doctor can perform arthrocentesis where the fluids in the joint get extracted with a syringe for lab analysis. Then there’s blood test and X-rays.

A blood test can reveal abnormal antibodies often found in the blood of people with RA but this is incomplete as only 80% of RA sufferers have blood containing the “rheumatoid factor.”  Another blood test used as a crude measure is the sedimentary rate test where the rate with which red blood cells settle to the bottom of a test tube can measure the joint inflammation.  A faster rate indicates RA,

The most telling diagnoses are X-rays to show the swelling of joint tissues as well as bone erosions typical in RA patients. The American College of Rheumatology has classified RA severity based on X-ray appearance of the joints.

• Stage 1:  No damage though signs of bone thinning are apparent
• Stage 2:  Slight cartilage damage with atrophy of surrounding muscles but no joint abnormality
• Stage 3: Evidence of cartilage and bone damage and deformity with extensive muscle atrophy
• Stage 4:  Sever osteoporosis around the joint with sever muscle atrophy and abnormality as well as  permanent fixation or ankylosis.

Treatment of Rheumatoid Arthritis

There is no known cure for RA and the RA treatments available are there to relieve and reduce RA symptoms and prevent joint destruction and muscular atrophy around the joints.  Early medical treatment can help arrest the chronic situation with longer periods without the symptoms. Occasionally, cortisone medications are resorted to as injectibles into the joint during an arthrocentesis session to rapidly relieve the painful joint inflammation and reduce RA symptoms.

Optimal management of the disease involves a mix of joint-strengthening exercises, sufficient rest and symptom alleviation thru prescribed or OTC drugs.  The treatment is customized to the need of the sufferer including allowances for treatment of other ailments, if any.

Two classes of treatment are often employed using either fast acting drugs for fast relief and reduction of joint pain and inflammation, and slow acting drugs to improve chances of remission and forestall joint destruction but are not anti-inflammatory. The former are usually aspirin and cortisone-based while the latter are your methotrexate and Hydroxychloroquine based drugs.