Rheumatoid arthritis

Rheumatoid arthritis (RA) is one of the most common types of chronic inflammatory autoimmune arthritis. Symptoms include severe inflammation of the joints, particularly in the fingers and toes, which, if left untreated, can result in serious damage and a potential disability.

Causes and Risk Factors of Rheumatoid Arthritis
Symptoms of Rheumatoid Arthritis
Diagnosis of Rheumatoid Arthritis  
Treatment of Rheumatoid Arthritis
Prevention and Patient Care  
  The definite causes of rheumatoid arthritis is currently unclear. However, it’s certain that the disorder does belong to the autoimmune diseases family, which are a group of conditions caused by an abnormal immune system attacking the body’s own tissue, resulting in chronic inflammation.
 
Rheumatoid arthritis is most commonly found in two distinct age groups: 20-30 year-olds and 50-60 year-olds. In the younger group, rheumatoid arthritis is more common in women, whereas in the older group, both sexes are affected equally.

Symptoms of Rheumatoid Arthritis

Patients suffer pain in their joints, particularly in smaller joints such as the fingers and toes. It is less common in larger joints such as the knees or the hips. The pain of rheumatoid arthritis differs from the pain from joint exhaustion, and is often experienced when the joints are at rest. For example, pain in the middle of the night, after waking up in the morning, or while resting. The pain usually lasts for an extended period of time, and while pain medication may relieve some of the symptoms, it does not fully control it.
 
If rheumatoid arthritis is left untreated, or is not treated properly, it can cause permanent damage and disability.


Diagnosis of Rheumatoid Arthritis

The doctor diagnoses rheumatoid arthritis through obtaining the patient’s detailed history, physical examination, blood tests, and X-rays. The doctor will determine whether the joints are inflamed by checking for swelling, tenderness, redness, and warmth, as well as assessing whether there is any reduction in joint mobility.
 
The common investigations are performed to confirm diagnosis and evaluate the RA condition, including RA factor, anti-CCP, liver function, kidney function, inflammation markers (ESR, CRP), and joint X-ray.
 

Treatment of Rheumatoid Arthritis

The goal of treatment is to stop inflammation and prevent the progression of damage and complications. This can be achieved through:
  • Medication – Medications, taken orally, subcutaneously, and intravenous, are specifically designed to stop inflammation, stop the spread of arthritis, and treat the other symptoms of the condition. This may include immunosuppressant medications and analgesics.
  • Surgery – This can be effective in instances where the joints have already been considerably damaged by arthritis. Surgery to repair or replace the joint is efficient in improving the overall mobility and function of the joint, reducing pain, and avoiding further disability.
  • Physiotherapy – This can improve the strength and flexibility of the joints.
Rheumatoid arthritis cannot be completely cured. And even though the symptoms may not be present for a period of time, they may still return. For this reason, most patients must take medications regularly to control the disease. Therefore, having regular follow-ups with the doctor is also important.
 

Prevention and Patient Care

Currently, there is no definite way to prevent rheumatoid arthritis, as the exact cause of this condition is unknown. However, one thing that can be done is to have a thorough check-up as soon as any persistent, unusual pain is felt in the joints. This is to protect against extreme inflammation and prevent any serious long-term damage. Patients who receive treatment for rheumatoid arthritis in the early stages have a much better chance of stopping the disease’s progression and are less likely to suffer permanent damage.

Patients can also improve their symptoms by:
  • Having regular visits with a rheumatoid arthritis specialist (rheumatologist) – for treatment follow-ups, as well as to monitor any possible side-effects of medications. 
  • Exercising the joints to improve flexibility and function, under the guidance of the doctor or physiotherapist.
  • Avoiding any behaviors or actions which could cause damage to the joints, such as lifting heavy objects, jumping, squatting, sitting cross-legged, or sitting on the ground in general.
  • Controlling your bodyweight / not becoming overweight, in order avoid putting additional stress on the ankles or knees.
  • Consuming foods which contain sufficient amounts of calcium and vitamin D to nourish tissue and bones; and cutting back on fatty foods and red meat which can affect inflammation levels.
  • When experiencing pain, aside from taking pain medication, use a cold compress on the affected area for 20 minutes, 3 or 4 times per day.
 
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