Rheumatoid Arthritis

1. RheumatoidArthritis • Rheumatoid arthritis (RA) is an inflammatory arthritis in which joints of the hands and feet, are inflamed, which results in joint pains, swelling and frequent destruction of joints. Small joints of the limbs become painful and have stiffness which persists for about 60 minutes on awakening andafterinactivity.Duetoweakness,feveranddamagetootherorgansmayalsooccur.RAaffects bothsidesofthebody.Forexample,ifajointisaffectedinonearmorlegthenasimilarjointofthe otherarmorleg willbe affectedtoo. ThisisoneofthewaysRAisidentifiedbythedoctors from otherformsofarthritislikeOsteoarthritis(OA). • Rheumatoidarthritisdevelopsinabout1%inthewholeworld’spopulation.Womenareaffected • 2 times more than men. It appears in the age group between 35 to 50years. A similar disease in childrenmayoccurwhichisknownasJuvenileidiopathicarthritis. • The cause of Rheumatoid arthritis is not known, it is considered as an autoimmune disease. The componentsoftheimmunesystemattackthesofttissuesandwillalsoattacktheconnectivetissue inotherpartsofthebodysuchasbloodvesselsandlungs.Duetothis,graduallythebone,cartilage and the ligaments of the joints wear away causing deformity. Many unknown factors like viral infectionsandsmokingplayavitalrole. • TreatmentsworkbestwhenRAisidentifiedatanearlystage,soit’ssignificanttolearnthesigns. • ReadontoacquireallyouwanttoknowaboutRA,fromkindsandindications,tohomeremedies, diets, and othertreatments. • Symptoms: • PeoplewhohaveRAmayexperiencethesesymptoms: • Joint pain, fatigue, Joint tenderness, Joint swelling, redness in joints, Joint stiffness, Loss of joint function,limping,jointdeformity,bothsidesofthejointsaffected,Anemia,Fever,Depression. • Somemayfeeltiredandweakbyafternoon.RAmayalsocauselossofappetitewithweightloss. • ThesignsandsymptomsofRAmayvaryfrompersontoperson.IntenseRAsymptomsareknown asflare-ups,andinactiveperiods.Othertimeswhensymptomsarelessisknownasremission. • Diagnosis: • The3testswhichdoctorsfollowtodiagnoseRA: • Bloodtests • X-rays • Examination of fluidjoints

2. It is difficult to diagnose RA at early stages. There is no single test or physical finding to confirm the diagnoses. Your doctor will do a physical check-up of your joints for swelling, rednessandwarmth.Doctorwillalsotestyourreflexesandstrengthinmuscles. Bloodtest:ThebloodtestsaredonetofindthebloodlevelsofrheumatoidfactorandAnti–CCP antibodiesorC-reactiveprotein(CRP),ESRorboth. Rheumatoid factortest: RF is a group of antibodies that attack the affected persons own tissues instead of attacking the harmful bacteria or viruses. If Rheumatoid factor in the blood is high then it means the autoimmunesystemisactingup.TheRFtestismostlyassociatedwithRAbutisn’tlimitedtothat disease. Anti–CyclicCitrullinatedproteinantibodytest(anti-CCP): Thistestisdonetofindoutanti-CCPantibodiesintheblood.Citrullineisproducednaturallyinthe bodyaspartofthemetabolismoftheaminoacidarginine.Citrullinechangestheproteinstructure and may trigger the immune response, by producing the auto antibodies against joint proteins. Antinuclear antibodytest: Thistestisdonetofindouttheamountandpatternofantibodiesinthebloodthatworksagainst yourownbody(autoimmunereaction). Erythrocyte sedimentation rate(ESR): TheESRishighinpeoplewhohaveactiverheumatoidarthritis.Thistestisdonetoknowthelevel of inflammation and measures the speed of red blood cells settling to the bottom of a test tube containing blood sample. Normally red blood cells settle relatively slow, if they settle faster than normalratethenitindicatestheinflammationinthebody. C-reactive proteintest: CRPisabloodtesttochecktheamountofproteincalledC-reactiveproteinintheblood.Thishelps in measuring the general levels of inflammation in the body. Many infections and long term diseases will cause high level of CRP. This CRP test cannot identify the root cause or the location oftheinflammation.Othertestsarerequiredtounderstandtheactualcause. Treatment for Rheumatoidarthritis: Thetreatmentsthataresuggestedbythedoctordependsontheseverityofthesymptomsandthe durationofRA.Theprocedureoftreatmentwilldifferfrompersontoperson. The main aim for your doctor is to stop inflammation and relive from the symptoms, reduce further damage of joint and organ, improvise thephysical function and reduce long term

3. complications.Toachievealltheseyouwouldbesuggestedtotakemedicationsandalsolifestyle changesarerequired.Ifthesedonothelpthensurgerywouldbesuggested. • Measures to betaken: • Drugs:BytakingtheDMARDs(diseasemodifyingantirheumaticdrug)willslowtheprogression of the disease and it will also help reducing some symptoms. These drugs are started as soon as RA isdiagnosed. • Exercising: • Simple exercises can benefit for relieving pain and stiffness. These exercises and stretches will help mainly during a flare. Exercising will improve the joint mobility and flexibility, reduces painful symptoms. The best exercises are stretching, walking, yoga, Pilates, swimming, cycling, hand exercises,gardening. • Isrestisthebestway: • Inflamedjointsrequiremorerestduringflare-ups.Frequentrestperiodsmayhelprelievepain.A • short period of bed rest with good sleep will help to diminish inflammation in its most active painful stage. You can try splints and braces as a support when you rest. You can use canes and crutchestokeepupmobility. • Therapies: • Youcanalsofollowfewnondrugtherapiessuchasmassages,tractionanddeepheattreatments( helps in muscle functioning, reduces stiffness and muscle spasm), self help devices such as gripperswillhelpyourhandwhenyouneedtosqueezeforcefully,applyingicepackswillreduce pain. • Manage life withRA. • Preventiontips: • Rheumatoid arthritis is an autoimmune disease. The root cause of this is unknown it isvery • difficult to escape from RA. You can only lessen the symptoms and try to prevent it by making lifestylechanges. • Findoutmorehomeremediesandtherapiestobringdownthepain. • Tryacupuncture • Adietchangeisimportant. • Exercise • Stressmanagement

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