Rheumatoid Arthritis Overview

Rheumatoid arthritis (RA), a condition that is more than twice as common in women then men, is a chronic condition that causes joint pain, stiffness, swelling, aching, and throbbing.

More then 19 million people suffer from some form of arthritis, which if left untreated, can become a debilitating disease making everyday activities such as getting in and out of a chair to opening a bottle of water difficult and painful.

Rheumatoid Arthritis Symptoms

Symptoms of Rheumatoid Arthritis may come and go at first but will increasingly get worse over time. Arthritis flare ups generally affect smaller joints such as your hands, ankles, wrists, and feet but as the condition progresses it can effect larger joints such as your hips, neck, knees, elbows, shoulders, and jaw.

Common Symptoms from Rheumatoid Arthritis may include:

• Joint pain
• Joint swelling
• Red and puffy hands
• Rheumatoid Nodules (small firm bumps under the skin)
• Fatigue and tiredness
• Fever
• Weight loss

The inflammation that rheumatoid arthritis causes in the joints can become quite painful over time so it’s important to see your doctor as soon as possible if any of these symptoms appear so you can be diagnosed and start the treatment process. The symptoms will get worse and can seriously affect the quality of life without treatment.

What Causes Rheumatoid Arthritis

RA is an autoimmune disease where the immune system doesn’t function properly and causes the condition. When white blood cells surround your joints (synovium) they release proteins that over time build up and cause swelling of the synovium. The proteins can also damage the cartilage, bone, tendons and ligaments near your joint and over time create permanent damage.

Why this happens is yet to be completely understood. Many researchers believe that genetics and hereditary play a large role as well as environmental factors and various viral and bacterial infections.

Rheumatoid Arthritis Tests and Diagnosis

Diagnosis is a fairly simple procedure consisting of a simple physical exam, questions about your symptoms, possible blood work, and X rays.

• Physical Exam You will be given a simple exam where you may move in different situations to indicate when the pain is being caused to give a general idea of the affected joints, ligaments, and bones.

• Blood tests. People with rheumatoid arthritis have an elevated erythrocyte sedimentation rate (ESR, or sed rate), which indicates the presence of an inflammatory process in the body. This can indicate, but doesn’t necessarily mean you rheumatoid arthritis is the cause of your symptoms. Other blood work might be done as well, to rule out infections as a cause of the symptoms.
• X-Rays might be taken to see if there is any damage to the bone and joints, and may be taken over time to keep track of the progression of the conditions effect on the body.

Your doctor may also ask about your family history in relation to the condition. As well as physical factors such as work history and past injuries.

Rheumatoid Arthritis Treatments Medications an Drugs

There is no cure for rheumatoid arthritis but there are treatment options available to limit the pain caused and slow down joint damage.

• Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce inflamation in the joints and help relieve pain. Some over the counter NSAIDs include ibuprofen such as Advil and Motrin and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription if warranted.

• Steroids drugs such as prednisone and methylprednisolone are corticosteroid medications that reduce inflammation and slow permanent joint damage. They should be used for short term treatment because of the serious side effects including thinning of bones, cataracts, weight gain, and even diabetes.
• Disease-modifying anti-rheumatic drugs such as hydroxychloroquine (Plaquenil), the gold compound auranofin (Ridaura), sulfasalazine (Azulfidine), minocycline (Dynacin, Minocin) and methotrexate (Rheumatrex) are used to slow down the condition in hopes to lessen permanent damage to the bones.
• TNF-alpha inhibitors are cell proteins that reduce inflammation to help with pain.
• Anakinra is an interleukin-1 (IL-1) receptor antagonist. Anakinra blocks the biologic activity of naturally occurring IL-1, including inflammation and cartilage degradation associated with rheumatoid arthritis. Anakinra is not considered a Disease-modifying antirheumatic drug (DMARD) but rather a Biological Response Modifier (BRM) because its able to selectively target the pathologic element of the disease.
• Abatacept (Orencia) is a fusion protein composed of an immunoglobulin fused to the extracellular domain of CTLA-4, a molecule capable of binding B7. Abatacept is a selective costimulation modulator as it inhibits the costimulation of T cells. It is used for the treatment of rheumatoid arthritis in the case of inadequate response to anti-TNF-alpha therapy.
• Rituximab (Rituxan) are used to reduce the number of B cells in your body that cause inflammation. It can be useful in the short term as well as the long term.
• Total joint replacement (arthroplasty) is a surgery where they remove and replace some or all of the affected joint where necessary.

Home Remedies for Arthritis

• Epsom Salt, which is high in magnesium has been said to help with the pain associated with forms of arthritis.
• Weight Keeping a decent level of weight helps keep the strain off of the muscles and joints.
• Low impact exercises help keep the joints limber and may reduce future pain and complications.
• Stay away from caffeine products.
• Plant oils that contain gamma-linolenic acid (omega-6 fatty acids) have been said to help with pain and stiffness.

These remedies are not all recommended and you should consult your doctor before starting a new dietary regiment or exercise strategy.

Podcast-CDC Taking About Arthritis