(RA; Rheumatoid Arthritis)
What is Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an autoimmune disease. It causes pain, swelling, stiffness and loss of function in the joints. In general, RA affects the same joint on both sides of the body. It occurs mainly in:
Causes of Rheumatoid Arthritis
RA is caused by a combination of genetic and environmental factors that trigger an abnormal immune response.
Genetic factors: some genes that play a role in the immune system are associated with the onset of RA.
- Defects in the immune system can cause continuous inflammation.
- Environmental factors: some infectious agents, such as certain viruses or bacteria, can increase the susceptibility to manifest AR.
- Other factors: some evidence suggests that hormonal factors may promote the development of RA in combination with genetic factors and environmental exposure.
Risk factors of Rheumatoid Arthritis
These risk factors increase your chances of developing RA. Tell your doctor if you have any of the following risk factors:
- Family members with AR
- Sex: female
- Ethnic background: Pima indigenous tribe
- Excessive smoking or smoking for a prolonged period
Symptoms of Rheumatoid Arthritis
When RA begins, symptoms may include:
Articular pain and stiffness that is:
- Most prominent in the morning
- It lasts at least half an hour
- Red, hot, or swollen joints
- Joint deformity
- Light fever, tiredness
- Loss of appetite
- Small lumps or nodules under the skin
As the RA progresses, it can cause complications in:
- Nervous system
- Blood vessels
It is also related to early cardiovascular disease and death.
Diagnosis of Rheumatoid Arthritis
There is not a single test to determine AR. The doctor will ask about your symptoms and medical history. It will examine joints, skin, reflexes and muscle strength.
- Level of rheumatoid factor (FR) in the blood
- Erythrosedimentation rate (VES) of blood: to measure inflammation in the body
- C-reactive protein: an indicator of active inflammation in the blood
- White blood cell count
- X-rays of the affected joints (especially dual-energy x-ray absorptiometry) -a test that uses radiation to capture images of structures inside the body, especially the bones
Treatment of Rheumatoid Arthritis
There is no cure for RA. The objectives of the treatment are:
- Ease the pain
- Reduce inflammation
- Slow down joint damage
- Improve functional capacity
Medicines for Rheumatoid Arthritis
Disease modifying antirheumatics (DMARDS): to slow down the course of the disease. These medications are used early in the development of the disease to prevent long-term damage:
- Methotrexate (eg, Rheumatrex)
- Hydroxychloroquine (eg, Plaquenil)
- Sulfasalazine (eg, Azulfidine)
- Leflunomide (eg, Arava)
- Cyclosporine (eg, Neoral)
- Penicillamine (eg, Cuprimine)
- Gold (eg, Ridaura): can also be given as injections
- Minocycline (eg, Minocin)
- Immunosuppressants (only used when other DMARDs are not effective):
- Azathioprine (eg, Imuran)
Cyclophosphamide (eg, Cytoxan): rarely administered
Chlorambucil (eg, Leukeran): rarely administered
Biological response modifiers: drugs that interfere with the autoimmune response associated with RA:
- Etanercept (eg, Enbrel)
- Infliximab (eg, Remicade)
- Adalimumab (eg, Humira)
- Abatacept (eg, Orencia)
- Rituximab (eg, Rituxan)
- Complementary medicines:
- Paracetamol (eg, Tylenol)
- Non-steroidal anti-inflammatory drugs (NSAIDs) that include ibuprofen and naproxen
Steroids for Rheumatoid Arthritis
Low-dose corticosteroids (eg, prednisone) are often administered first. They may be reduced gradually when other medications begin to act. Avoid long-term steroid administration. Injections of corticosteroids in inflamed joints can also be used.
Rest and exercise for Rheumatoid Arthritis
Rest reduces active inflammation of the joints and pain. In addition, it reduces fatigue. Exercise is important to maintain muscle strength and flexibility. In addition, it preserves the mobility of the joints.
Joint care for Rheumatoid Arthritis
Splints placed in painful joints can reduce pain and swelling. The devices that help with the activities of daily life can also reduce the effort of the joints. These devices include:
- Extenders with closure
- Long-handled shoes
- Tools specially designed for the kitchen
Stress reduction for Rheumatoid Arthritis
Reducing stress can ease the difficulties of living with a chronic and painful illness. Participation in an exercise program or a support group are two strategies you can use to reduce stress. Cognitive behavioral therapy, a form of talk therapy, and meditation may also be beneficial for pain relief and to improve the ability to cope with RA. * ¹
Surgery for Rheumatoid Arthritis
Joint replacement and tendon reconstruction help relieve serious joint damage.
Control of lifestyle for Rheumatoid Arthritis
- They can relieve stiffness and weakness as well as reduce inflammation:
- Maintain a balance between rest and exercise.
- Try to perform a gentle strengthening workout.
- Participate in aerobic exercises (eg, hiking, swimming, dancing).
- Avoid high impact exercise.
- If you smoke, stop it .
- Control the weight.
- Participate in a physiotherapy program.
Prevention of Rheumatoid Arthritis
There are no general guidelines for preventing RA.