Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease. Your immune system attacks certain parts of the body, especially the joints. It is a chronic systemic disease characterized by inflammatory changes in joints and related structures that result in crippling deformities.

Rheumatoid arthritis (RA) affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with RA can damage other parts of the body as well.

The specific cause is unknown. But it is generally believed that the pathological changes in the joints are related to an antigen-antibody reaction that is poorly understood. (Antibodies are part of the body's defense system. Antibodies attach to proteins which they recognize to be foreign. The foreign proteins and chemicals that antibodies attach to are called antigens.)

RA and diabetes are different diseases. Having one may make it more likely to have the other. Nearly half of American adults who have diabetes will also have arthritis.

Risk factors for RA:

• Women are more likely than men to develop RA
• RA can occur at any age, but it most commonly begins at age 40-60
• Family history of RA
• If you have a genetic predisposition for RA, smoking increases your risk
• Diabetes

While new types of medications have improved options, severe RA can still cause physical deformities. RA tends to affect the smaller joints first, particularly the joints in your fingers and toes. It often spreads to the wrist, knees, ankles, elbows, hips and even your shoulders.

Signs and symptoms may include:

• Achy joints
• Redness
• Minor fever
• Unintentional weight loss
• Fatigue
• Joint stiffness that is usually worse in the morning and after inactivity
• Pain
• Formation of nodules (Nodules are solid, elevated areas of tissue or fluid inside or under the skin. Nodules are not normally benign and often painless)

There is no specific therapy. If the condition is severe and painful, bedrest may be required for a short time.

All other pain relief strategies are secondary to controlling inflammation. DMARD (diease modifying anti-rheumatic drugs) are drugs designed to work to suppress the body's overactive immune system response, to prevent joint damage and slow the progression of the disease. They are usually prescribed shortly after a diagnosis in order to prevent as much joint damage as possible. Be careful when DMARD'S are prescribed because they may have a lot of side effects. Always read the pamphlet about the drug your taking. Digestive issues, such as nausea and diarrhea are a few of the most common side effects. Always tell your doctor if you are having any problems when taking these drugs.

Treatments are usually given to relieve pain. There are many drugs that can help so you need to see your doctor or rheumatologist to see what they recommend. For acute pain they may prescribe Aspirin and Ibuprofen as well as celecoxib. They may treat joint pain but research has shown they don't prevent joint damage.

Although some say a certain diet will help, but these "special diets" aren't backed by the medical community. But there is some evidence that omega-3 fatty acids can reduce inflammation and possible loss of joint pain may result from it. Omega-3 can be found in cold-water fish and in fish oil supplements. It could reduce the amount of pain medication needed.

Possible complications of RA:

• Osteoporosis
• Sjogren - very dry eyes and mouth
• RA medications given to combat the disease, can impair the immune system, leading to increased infections.
• When RA affects the wrists, the inflammation can compress the nerve that serves most of your hand and fingers - leading to what is known as carpal tunnel syndrome (Pressure on the median nerve causing pain over the wrists and fingers. This can lead to numbness, tingling, or weakness in the hand or fingers. It can also lead to atrophy of the hand and finger muscles.)
• RA can increase your risks of hardened and blocked arteries, as well as inflammation of the sac that encloses the heart
• People with RA have a greater risk of inflammation and scarring of the lung tissue leading to shortness of breath.

Suggestions that may help:

• Maintain a healthy weight
• Get a light massage to help reduce muscle and joint pain
• Low-impact exercise can actually help - walking, swimming, (especially water aerobics) cycling, yoga - When it comes to exercise ralk to your medical care provider about it first
• Orthoses - mechanical aids of some type
• Some people find acupuncture helps

If you are experiencing more pain than before, or if the pain is interfering with your ability to get things done, don't hesitate to let your health care provider know.