Rheumatoid arthritis is a chronic autoimmune disease that affects joints, causing pain and stiffness, and requires a comprehensive approach to management and treatment.
Rajni* is a 55-year-old first-generation American Indian citizen living in Seattle. Recently, she began experiencing pain, swelling, and stiffness in both wrists, particularly noticeable in the mornings and after periods of inactivity. Along with these symptoms, she has felt unusually fatigued and has lost her appetite. After consulting her primary care provider and undergoing several tests, she was diagnosed with rheumatoid arthritis, a condition she had not previously heard of. Seeking guidance on how to cope with this diagnosis, she reached out for assistance.
Rheumatoid arthritis (RA) is a long-lasting autoimmune disease characterized by the immune system mistakenly attacking the joints. Dr. Manoj Sharma explains that there are four stages of this disease. In the first stage, patients experience pain, swelling, and stiffness in the lining of the joints, which is what Rajni is currently facing.
The second stage involves damage to the cartilage, the flexible connective tissue surrounding the joints. In the third stage, the bones surrounding the joints may also suffer damage. Finally, in the fourth stage, while inflammation may subside, joint movement becomes problematic, leading to deformities. RA affects approximately 0.5 to 1% of the adult population and is more prevalent in women. It is important to note that rheumatoid arthritis is distinct from osteoarthritis, which typically results from joint overuse.
Diagnosis of rheumatoid arthritis involves checking for specific antibodies, such as rheumatoid factor and anti-cyclic citrullinated peptide antibody, which are often present in patients. Blood tests may also reveal elevated levels of erythrocyte sedimentation rate and C-reactive protein. In advanced stages, imaging studies can help assess the extent of joint damage.
The exact cause of rheumatoid arthritis remains unknown. However, several risk factors have been identified, including family history, smoking, obesity, stress, poor oral hygiene, and exposure to environmental pollutants. While RA cannot be entirely prevented, adopting certain lifestyle changes can be beneficial. These include avoiding smoking, engaging in regular exercise, maintaining a healthy weight, practicing good oral hygiene, and following an anti-inflammatory diet rich in fruits, vegetables, and nuts while limiting processed foods and sugars.
Fortunately, treatment options for rheumatoid arthritis have significantly improved over the years. Dr. Sharma notes that first-line treatments often include non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids to reduce inflammation. Second-line treatments may involve disease-modifying anti-rheumatic drugs (DMARDs). Newer therapies, such as Janus kinase (JAK) inhibitors and biologics, are also changing the landscape of RA treatment. Patients are encouraged to discuss all potential treatment options with their healthcare providers. Additionally, physical and occupational therapy play crucial roles in managing the condition, and surgery may be considered in advanced cases.
Complications associated with rheumatoid arthritis can extend beyond joint pain. The condition can hinder physical activity, leading to weight gain and increasing the risk of elevated cholesterol levels, high blood pressure, diabetes, and heart disease. RA can also affect other parts of the body, including the eyes, causing dryness and sensitivity, and may lead to lung issues and damage to blood vessels.
In addition to medical treatment, Dr. Sharma emphasizes the importance of balancing rest and exercise. Low-impact activities, such as water-based exercises or yoga, can be particularly beneficial. Patients should take care of their affected joints, and under the guidance of an occupational therapist, they may use splints or assistive devices to alleviate pain and reduce strain on the joints.
Monitoring symptoms and maintaining a log to share with healthcare providers is essential. Managing stress is also crucial for individuals with rheumatoid arthritis. There are various stress management techniques available to help reduce anxiety and improve overall well-being.
For those seeking additional information, Dr. Sharma recommends several resources, including the Arthritis Foundation, Cleveland Clinic, and Mayo Clinic websites, which provide comprehensive insights into rheumatoid arthritis management and treatment options. Books on stress management and yoga for arthritis can also offer valuable guidance.
If you have questions or need further assistance, you can reach out to Dr. Manoj Sharma at editor@indiacurrents.com.
Source: Original article