Rheumatoid arthritis is a chronic condition that causes inflammation of your joints, mostly in the hands, wrists, and knees. The inflammation can damage the tissue which leads to pain and loss of full function of the joints. It can also cause injury to other organs throughout your body.
What causes rheumatoid arthritis?
Rheumatoid arthritis is an autoimmune disease. This happens when your immune system starts to target your own cells instead of disease-causing organisms such as bacteria or viruses. In rheumatoid arthritis, they damage the tissue that surrounds the joint, known as synovium. This causes the synovium to become thicker and painful, making the joint red and hot. The inflammation causes damage to other areas of the joint such as the bone, cartilage, and tendons.
There is no one specific thing that causes rheumatoid arthritis. Some people have certain genes that make them more susceptible which become activated by environmental triggers. These can be a range of things such as stress or certain bacteria and viruses.
There are also certain risk factors that make you more likely to develop rheumatoid arthritis. It is more common in older age, most often starting in your sixties. Hormones also play a part, which means that women are two-to-three times more likely to have rheumatoid arthritis. It has also been shown that smoking and obesity both contribute to rheumatoid arthritis. The more extra weight that you have increases the risk more, so staying in shape is important to help prevent the onset of rheumatoid arthritis.
What are the symptoms?
The most common symptoms of rheumatoid arthritis are found in the joints, particularly small joints such as in the wrists, hands, and feet. As the disease progresses, larger joints become affected such as knees, elbows, ankles, and shoulders. Alongside the inflammation and pain, joints are often stiff in the morning or after inactivity. Multiple joints are affected, on both sides of your body. Symptoms are not always constant and you may have periods where the disease worsens, known as flares. Flares can last from a few days to months.
The joints are not the only part of your body affected by rheumatoid arthritis. Many organs can show different manifestations of the disease. Eyes may become dry, painful, and sensitive to light and your vision might be affected. Your skin can develop lumps over bony areas known as rheumatoid nodules. Damage to your heart and lungs can cause scarring and the number of blood cells that you have might start to decrease.
There are also symptoms that do not affect a specific organ. Weight loss, tiredness, and weakness are all common. You can also have an intermittent high temperature. A possible complication is feeling tingling or numbness in your fingers, a condition known as carpal tunnel syndrome.
Management
There is no cure for rheumatoid arthritis, however, the Pain Management Clinic current medications can help to reduce the progression of the disease to minimize damage to the tissue. This helps to reduce disability and helps you continue with daily activities as much as possible. There are two main types of medication for rheumatoid arthritis: disease-modifying anti-rheumatic drugs (DMARDs) and biological therapies. Medicines are also given to relieve the pain.
Disease-Modifying Anti-Rheumatic Drugs
DMARDs are the first treatment given when you are diagnosed with rheumatoid arthritis. They work by stopping the effects of chemicals that are released when your immune system targets your joints to minimize damage. The most common drug prescribed is called methotrexate, although there are others including hydroxychloroquine and sulfasalazine. These are taken as tablets and you will often take a combination of different DMARDs. These drugs take a few months to work fully, so you may not notice improvements immediately.
Whilst they are very good at reducing disease progression, they do have a series of side effects to be aware of. Common side effects include a loss of appetite and feeling sick, diarrhea and headaches. More serious side effects are less common, but it is important to have regular tests to check for them. Regular blood tests check your red blood cell levels and liver function. A chest x-ray is taken as you start the medication to have a baseline scan of your lungs. If a cough or feelings of shortness of breath develop, a further chest x-ray can be used to compare to the initial one to look for changes to your lung tissue. DMARDs work differently for each person, so if one combination of drugs is not working, your doctor may change them for a different set of tablets.
Biological Treatments
Biological treatments are newer medications that work by reducing how active your immune system is so that less damage is done to your tissues. Common biological treatments include infliximab and etanercept. They are given alongside DMARDs, particularly if DMARDs have not worked to slow the disease by themselves. They are given as an injection and also have some side effects. These include increasing your risk of infection and causing a feeling of sickness.
Pain Relief
Pain relieving-medication is not taken all of the time but is given during a flare when symptoms become worse. Your doctor may prescribe a pill that contains paracetamol and codeine (co-codamol). Non-steroidal anti-inflammatory drugs such as ibuprofen reduce pain and help decrease inflammation of the joints. Ibuprofen may increase the risk of a stomach bleed, so is often given alongside proton pump inhibitors (PPIs) which help protect the lining of your stomach. Whilst pain relief does not stop the progression of the disease, it helps to carry on daily activities as much as possible.
Lifestyle Changes
Alongside the medications, it is important to undertake certain lifestyle changes to help stop joints from getting damaged and deformed (changing shape). A physiotherapist will give exercises for certain joints to keep them flexible and reduce stiffness. An occupational therapist can also help to slightly alter how you carry out daily tasks to make them easier for you. This may mean changing simple activities such as picking up a book.
Regular physical activity is important to stay healthy and keep your joints supported. Walking, swimming and cycling are good ways to get activity into your daily routine. Your doctor can help by creating an exercise regime. Smoking also makes rheumatoid arthritis worse, so your doctor will advise that you cut down or stop smoking completely.
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Leva Clinic
Leva Clinic is the UK’s first fully registered online clinic for chronic pain management near me. Leva provides a personalized care package with a dedicated pain team including doctors, nurses, physiotherapists, and clinical psychologists. Leva clinic is currently offering a free eligibility phone call. For more information, go to www.levaclinic.com.
