How To Treat Rheumatoid Arthritis

Overview

Rheumatoid arthritis ( RA ) is a long-lasting autoimmune disorder that primarily affects joints. Unlike the wear-and-tear damage of osteoarthritis, it typically results in warm, swollen, and painful joints, that can eventually result in bone erosion and deformity. Pain and stiffness often worsen the following rest. Most commonly, the wrist and hands are involved. In some people, the condition can also damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. This may result in a low red blood cell count, inflammation around the lungs, and inflammation around the heart. Fever and low energy may also be present. Often, symptoms come on gradually over weeks to months.
An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attack's your own body's tissues. While the cause of rheumatoid arthritis is not clear, it is believed to involve a combination of genetic and environmental factors.
Rheumatoid arthritis affects between 0.5 and 1 % adults in the developed world, women's are affected 2.5 times as frequently as men. The first recognized a description of RA was made in 1800 by Dr. Augustin Jacob Landré-Beauvais ( 1772-1840 ). The term rheumatoid arthritis is based on the Greek for the watery and inflamed joints.

Symptoms and Causes

Symptoms

Symptoms of rheumatoid arthritis may include:

• Fatigue: You may feel unusually fatigued well before any other symptoms become obvious. Fatigued can precede the onset of other symptoms by weeks or months. It may come and go for a week to week and day to day. Fatigued is sometimes accompanied by a general feeling of ill health or even depression.
• Joint stiffness: Stiffness in one or more of the joints is a common early sign of RA. This can occur at any time of the day, whether you are active or not. Typically, stiffness begins in the joints of the hands. It usually comes on slowly, although it can come on suddenly and affect multiple joints over the course of one or two days.

As the disease progresses, symptoms often spread to the wrist, knees, ankles, elbows, hips, and shoulders. In most cases, symptoms occur in the same joint on both sides of your body. Most of the people who have RA also experience signs and symptoms that don't involve the joints. Rheumatoid arthritis can affect many non-joint structures, including.

• Lungs
• Eyes
• Kidneys
• Heart
• Salivary glands
• Blood vessels
• Bone marrow
• Nerve tissues
• Skin

Causes

Rheumatoid arthritis is an autoimmune disorder, it occurs when your immune system attacks the synovium - the lining of 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 join together weaken and stretch. Gradually, the joint loses its shape and alignment. 

 Risk factors

The etiology, or cause, of rheumatoid arthritis, is still unknown. Many cases are believed to result from an interaction between genetic factors and environmental exposures. Factors that may increase your risk of rheumatoid arthritis include:

• Age and sex: The incidence of RA is two to three times higher in women than men. The onset of RA, in both men and women, is highest among those in their sixties.
• Genetics: Rheumatoid arthritis can occur at any age but if a member of your family has rheumatoid arthritis, you may have an increased risk of the disease.
• Modifiable: Several modifiable risk factors for RA have been studied including reproductive hormonal exposures, dietary factors, tobacco use, and microbial exposures.

Management

There is no cure for RA, but treatment can improve symptoms and slow the progress of the disease. Disease modifying treatment has the best results when it is started early and aggressively. The goal of treatment is to reduce pain, decrease inflammation, and improve person's overall functioning. The optimal treatment of RA requires a comprehensive program that combines medical, social, and emotional support for a patient. It is essential that the patient and patient's family be educated about the nature and course of the disease. Treatment options may include:

• Medications: Normal health can be achieved by using two classes of medications, analgesics such as NSAIDs, and disease-modifying antirheumatic drugs ( DMARDs ).
• Lifestyle: Gentle exercise can help strengthen the muscles around your joints, and it can help fight fatigue you might feel. Occupational therapy has a positive role to play in improving functional ability of persons with rheumatoid arthritis.
• Relax: Find ways to cope with pain by reducing pain in your life. Techniques such as guided imagery, distraction, and muscle relaxation can all be used to control pain.
• Intramuscular Gold: Gold is very effective in the treatment of rheumatoid arthritis when it is given intramuscularly. Effects are achieved within 4 to 6 months or after administration of 1g of gold. Golds compounds are rarely used know due to their numerous side effects and monitoring requirements.
• Surgery: In early phases of the disease, an arthroscopic or open synovectomy may be performed. It consists of the removal of the inflamed synovia, while in chronic conditions joint replacement may require.