Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body’s tissues.
Rheumatoid arthritis occurs when your immune system attacks the synovium — the lining of the membranes that surround your joints.
The resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment.
The cause of RA is not known. There is evidence that autoimmune conditions run in families. For instance, certain genes that you are born with may make you more likely to get RA.
Signs and Symptoms
With Rheumatoid Arthritis, there are times when symptoms get worse, known as flares, and times when symptoms get better, known as remission.
Signs and symptoms of Rheumatoid Arthritis include:
- Pain or aching in more than one joint
- Stiffness in more than one joint
- Tenderness and swelling in more than one joint
- The same symptoms on both sides of the body (such as in both hands or both knees)
- Weight loss
- Fatigue or tiredness
Rheumatoid Arthritis is diagnosed at our clinic in Dubai by examining blood test results, physical examination of the joints and reviewing x-ray or ultrasound images. There is no one test to diagnose RA. Blood tests are run to look for antibodies in the blood that can been seen in RA. Antibodies are small proteins in the bloodstream that help fight against foreign substances called antigens. Sometimes these antibodies are found in people without RA. This is called a false positive result. Blood tests are also run to look for high levels of inflammation. The symptoms of RA can be very mild making the diagnosis more difficult. Some viral infections can cause symptoms that can be mistaken for RA. A rheumatologist is a physician with the skill and knowledge to reach a correct diagnosis of RA and to recommend a treatment plan.
Abnormal blood tests commonly seen in RA include:
- Anemia (a low red blood cell count)
- Rheumatoid factor (an antibody, or blood protein, found in about 80% of patients with RA in time, but in as few as 30% at the start of arthritis)
- Antibodies to cyclic citrullinated peptides (pieces of proteins), or anti-CCP for short (found in 60 – 70% of patients with RA)
- Elevated erythrocyte sedimentation rate (a blood test that, in most patients with RA, confirms the amount of inflammation in the joints)
X-rays can help in detecting RA, but may be normal in early arthritis. Even if normal, initial X-rays may be useful later to show if the disease is progressing. MRI and ultrasound scanning can be done to help confirm or judge the severity of RA.
RA is a chronic arthritis. Generally the symptoms will need to be present for more than three months to consider this diagnosis. However there are patients who are diagnosed sooner.
There is no cure for rheumatoid arthritis. But clinical studies indicate that remission of symptoms is more likely when treatment begins early with medications known as disease-modifying anti-rheumatic drugs (DMARDs).
The types of medications recommended by your doctor will depend on the severity of your symptoms and how long you’ve had rheumatoid arthritis.
- NSAIDs. Non-steroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation.
- Steroids. Corticosteroid medications, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, weight gain and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication.
- Disease-modifying anti-rheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage.
- Biologic agents. Also known as biologic response modifiers, this newer class of DMARDs includes abatacept.
These drugs can target parts of the immune system that trigger inflammation that causes joint and tissue damage. These types of drugs also increase the risk of infections
Your doctor at Westminster Ortho Med clinic, Dubai may refer you to a physical therapist who can teach you exercises to help keep your joints flexible. The therapist may also suggest new ways to do daily tasks, which will be easier on your joints. For example, you may want to pick up an object using your forearms.
Assistive devices can make it easier to avoid stressing your painful joints. For instance, a kitchen knife equipped with a hand grip helps protect your finger and wrist joints. Certain tools, such as buttonhooks, can make it easier to get dressed. Catalogs and medical supply stores are good places to look for ideas.
If medications fail to prevent or slow joint damage, you and your doctor may consider surgery to repair damaged joints.
Rheumatoid arthritis surgery may involve one or more of the following procedures:
- Synovectomy. Surgery to remove the inflamed lining of the joint (synovium) can be performed on knees, elbows, wrists, fingers and hips.
- Tendon repair. Inflammation and joint damage may cause tendons around your joint to loosen or rupture. Your surgeon may be able to repair the tendons around your joint.
- Joint fusion. Surgically fusing a joint may be recommended to stabilize or realign a joint and for pain relief when a joint replacement isn’t an option.
- Total joint replacement. During joint replacement surgery, your surgeon removes the damaged parts of your joint and inserts a prosthesis made of metal and plastic.
Living with rheumatoid arthritis
It is important to be physically active most of the time, but to sometimes scale back activities when the disease flares. In general, rest is helpful when a joint is inflamed, or when you feel tired. At these times, do gentle range-of-motion exercises, such as stretching. This will keep the joint flexible.
When you feel better, RA patients are encouraged to do low-impact aerobic exercises, such as walking, and exercises to boost muscle strength. This will improve your overall health and lower the pressure on your joints. A physical therapist, Hadel Radwan OR Anil Daniel at westminster Clinic, Dubai can help you find which types of activities are best for you, and at what level or pace you should do them.
Finding that you have a chronic illness is a life-changing event. It can cause worry and sometimes feelings of isolation or depression. Thanks to greatly improved treatments, these feelings tend to decrease with time as energy improves, and pain and stiffness decrease. Discuss these normal feelings with your health care providers. They can provide helpful information and resources.
Rheumatoid Arthritis Diet
Your healthcare provider or dietitian may recommend an anti-inflammatory diet to help with your symptoms. This type of diet includes foods that have lots of omega-3 fatty acids.
Foods high in omega-3 fatty acids include:
- Fatty fish like salmon, tuna, herring, and mackerel
- Chia seeds
- Flax seeds
Antioxidants, such as vitamins A, C, and E, and selenium, may also help reduce inflammation. Foods high in antioxidants include:
- Berries, such as blueberries, cranberries, goji berries, and strawberries
- Dark chocolate
- Kidney beans
Eating lots of fiber is also important. According to the researchers, fiber may help reduce inflammatory responses which may decrease C-reactive protein levels. Choose whole grain foods, fresh vegetables, and fresh fruit. Strawberries may be particularly beneficial.
Foods containing flavonoids can also help to counter inflammation in the body. They include:
- Soy products, such as tofu and miso
- Green tea
What you don’t eat is just as important as what you do eat. Make sure to avoid trigger foods. These include processed carbohydrates and saturated or trans-fats. Avoiding trigger foods and choosing the right foods in trying to follow an anti-inflammatory diet may help you manage your Rheumatoid Arthritis.
Should you require additional information or would like to make an appointment with our Consultant Orthopedic Surgeon Dr. Ishrat Khan , Pain Consultant Dr. Tarek Sultan OR Physical Therapists, Anil Daniel, OR Hadel Radwan please call us or e-mail us at email@example.com
- Center for diseases control and prevention (CDC)
- American college of rheumatology
Disclaimer: All contents on this site are for general information and in no circumstances information be substituted for professional advice from the relevant healthcare professional, Writer does not take responsibility of any damage done by the misuse or use of the information.