Rheumatoid arthritis (RA) refers to the chronic inflammation of the joints of a person due to autoimmune disorder (the immune system attacks the normal tissues of your own body mistakenly).
This condition not only damages your joints but also other organs like heart, blood vessels, skin, lungs and eyes of a person.
However this type of arthritis is different from osteoarthritis as it damages the lining of the joints leading painful inflammation which cause deformation and erosion of bone and joints over the time.
Rheumatoid arthritis is a common disease that can lead people to physical disability and drastically affect their lives. Many newer treatment options and medications have been introduced into the market to treat this chronic disorder.
Different sign of rheumatoid arthritis are as follows:
- Swollen joints
- Tenderness on joints
- Joint become stiff and get worse if an individual remains inactive
- Loss of appetite
- Fatigue and fever
In the early stages, rheumatoid arthritis affects the smaller joints especially the joints attaching the fingers to hands and toes to feet. With the progression of RA, the symptoms extend to other joints such as hips, elbow, shoulders, knees, wrists, and ankles on both sides of the body.
Some other part of the body where the symptoms may occur other than the joints include skin, nerve tissues, blood vessels, eyes, bone marrow, lungs, kidney, salivary glands, and heart.
The severity of these symptoms vary from person to person and the time at which they might appear also varies. Some triggers like exertion or over activity may exacerbate these symptoms and cause a relapse. In severe cases, the joints of a person deform to such an extent that they are displaced.[i]
As to what causes this disorder, here are the two main components found to be the culprits of this disease. The main factor that has been associated with causing RA is the overactive immune system of a person. Autoimmune condition refers to the situation where the immune system, instead of attacking the foreign bodies, start to attack the joints itself leading inflammation and later deformation of joints.
Some studies have also linked RA to another component that the genetic system. Apparently the genes can probably make your body react to some environmental agents including bacteria or viruses thus triggering the disease.
Rheumatoid arthritis diagnosis
The diagnosis of RA is a time taking process and requires a series of lab tests and clinical exams to confirm that a person has it. Your doctor will need to use different tools for making a diagnosis for RA.
The first step in the diagnosis is to check all the symptoms that you are experiencing and then taking your medical history. After that a physical examination is done for your joints to check how they are working. Following this will be observed in this exam:
- Checking if the joints are swollen or red
- Checking how your joints are functioning
- Determining the range of mobility of your joints
- Determine if the joints are tender or warm
- Evaluating your muscle strength and your reflex
If RA is suspected in an individual he will be referred to a rheumatologist who specializes in this field. There are several tests that need to be run to confirm RA. Your blood may be screened for the presence of certain antibodies or phase reactants that become increase due to inflammation of joints. The elevation of these substances points towards the presence of rheumatoid arthritis and to further confirm it imaging tests will be performed that include MRI, Ultrasound or X-ray. These tests not only indicate the joint damage but also show the severity of the damage.
The blood tests that your doctor may suggest you are as follows:
Rheumatoid factor test
This test is used to check the presence of a protein referred to as rheumatoid factor (RF). The elevation of this factor in the blood is associated to RA as they increase the risk of autoimmune disorder.
Anticitrullinated protein antibody test
Anti-CCP test is done to determine the presence of RA associated antibody. Although this antibody is not present in everyone having RA tests but this test can give some idea about the disease. Furthermore anti-CCP test is more specific than RF test.
Antinuclear antibody test
Another test for confirming RA is this test in which we determine if the immune system is making antibodies.
Erythrocyte sedimentation rate
An ESR test can help in determining the level of inflammation in the joints of your body.
C-reactive protein test
CRP indicates a severe inflammation or infection in the body and that is why it may be associated with RA.
Treatments for RA help to manage the pain and control the inflammatory response which can in many cases result in remission. Decreasing the inflammation can also help to prevent further joint and organ damage.
Treatments for RA include medication and lifestyle modifications including gentle exercise, yoga as well as some dietary alterations. The medications used for RA are stated below:
Nonsteroidal Anti-Inflammatory Drugs – including iboprufen, dicloefenac sodium and naproxen sodium act by inhibiting the prostaglandin synthesis and reduce pain and inflammation.
Corticosteroids – these medications also decrease the inflammation in joints and decrease the pain.
Acetaminophen – this drug is also used to alleviate pain in the patients.
Disease-modifying antirheumatic drugs – DMARDs are anti-rheumatic drugs that block the response of body’s immune system and slows down the disease progression.
Biologics – these medications target the inflammatory response rather than the immune response of the body. These are usually used in individuals not responding to DMARDs.
Janus kinase inhibitors – is another category of DMARDs which help in inhibiting certain immune responses. JAK inhibitors are used for prevention of inflammation as well as stopping joint damage.
Some lifestyle modifications and home remedies can also help you in improving your quality of living with rheumatoid arthritis. Some of these include:
Exercising – some gentle exercises can be helpful in improving the mobility of your joints. Yoga can also enhance your flexibility and remove bone stiffness.
Rest – Proper rest is really important when you have RA. This can reduce the chance of disease remission and also help to decrease pain and inflammation.
Use of hot or cold compresses – applying cold or hot compresses to the joints can decrease the pain and may help to lower down the inflammation and risk of muscle spasms.
Assistive devices – Braces and other assistive devices can lower the load on your joints while walking and thus strengthen your joints and decreases inflammation.[ii]