Rheumatoid Arthritis

What is Rheumatoid Arthritis?

Rheumatoid arthritis is an autoimmune disorder that occurs when the immune system mistakenly attacks the body's tissues. While it mainly erodes your joints, it is a systemic disease that can manifest throughout your body. With the potential to affect other parts of the body such as the skin, lungs, and heart, this condition can range from mild to severe.

An important distinction is that rheumatoid arthritis is completely different from osteoarthritis. The latter type of arthritis results from wear and tear of the joints. In contrast, rheumatoid arthritis is a chronic disease where your immune system attacks and damages your joints. 

As an ongoing condition that progresses throughout life, treatment is critical to prevent worsening and maintain a good quality of life.

Pathophysiology and Risk Factors

Doctors do not know what causes your immune system to attack your joints. However, they believe there are a few factors that may contribute to developing rheumatoid arthritis. These include:

  • Gender - Women are more likely to develop this condition than men due to hormonal differences.
  • Family History - There is likely a genetic component to rheumatoid arthritis.
  • Alcohol and tobacco use - People who use these substances in excess have higher levels of inflammatory cytokines than people who don't drink or use tobacco (or use them in moderation). These cytokines can increase immune system activity.
  • Excess weight - Fat tissue releases cytokines that can increase immune activity.

Signs and Symptoms

The main symptoms of rheumatoid arthritis are joint stiffness, pain, and swelling that lasts six weeks or more. Symptoms are usually most noticeable in the morning. They are particularly indicative of rheumatoid arthritis if they last for more than half an hour after getting up.

Stages of Rheumatoid Arthritis 

There are four stages of rheumatoid arthritis that correspond to symptom severity. Stage one is the mildest, and stage four is the most serious. It's important to remember that not every person with rheumatoid arthritis will experience each stage. Progression is usually very gradual.

Stage 1

This is the earliest stage of rheumatoid arthritis. It usually involves joint pain, stiffness, and swelling. In addition, the inner tissues of the affected joints swell, which may present as tenderness to the touch.

Stage 2

In this stage, inflammation in the synovium, the joint lining, causes damage to the cartilage of the joint. This can result in a reduced range in motion as well as ongoing pain and swelling. 

Stage 3 

This stage includes severe damage that extends the bone. Due to bone erosion, the affected joints lose their smooth surfaces, which causes pain and a loss of function. Often there is an associated decrease in mobility as well as joint deformity.

Stage 4

This is the final stage of rheumatoid arthritis, and there are usually systemic symptoms at this point. These can include changes in the heart, lungs, and other organs' functions. Mobility may be severely compromised, and there are usually multiple noticeable joint deformities. Pain and swelling may reach debilitating levels.

If you are experiencing any of the above symptoms, check-in with one of our online doctors now to find out how to start living more comfortably.

Diagnosis

Because of the progressive nature of this disease, early diagnosis is essential to prevent permanent joint damage and preserve a good quality of life. Unfortunately, because its symptoms are similar to other diseases, this chronic condition can take some time to diagnose.

Your doctor will likely begin by performing a medical exam and checking the appearance and flexibility of your joint. They may also check your reflexes along with muscle strength. 

Blood tests are a standard tool for diagnosis as they can indicate inflammation in your body caused by rheumatoid arthritis. In addition, imaging like X-rays, magnetic resonance imaging (MRI), and ultrasounds can help visualize joint health.

Treatment

In comparison to other forms of arthritis, rheumatoid arthritis is very challenging to treat. This is because of the involvement of the immune system. There is no cure for rheumatoid arthritis but, luckily, there are several medications that may help slow its progression. It is also easiest to treat early-stage rheumatoid arthritis as it tends to be more responsive to therapy. 

While you can do things to improve your overall health, like maintaining a well-balanced diet and exercising, treatment of rheumatoid arthritis requires prescription medication. Your doctor can recommend a regimen that helps bring your immune system back in check to prevent joint damage. This can also reduce pain and inflammation.

In addition to medication, physical therapy can help combat stiff joints, maintain flexibility, and preserve range of motion. In some cases where severe joint damage has occurred, joint replacement surgery can be an option. Many times, your doctor may refer you to a rheumatologist for specialized treatment and care.

Prognosis

Rheumatoid arthritis is a chronic, systemic condition. This disease progresses gradually, but its effects over time can be quite pronounced. Without appropriate treatment, the disease and its complications may reduce lifespan by 10 - 15 years. Some of the most common concomitant health issues patients with rheumatoid arthritis may develop are:

  • Osteoporosis - The joint damage caused by rheumatoid arthritis and the potential side effects of some medications used in its treatment increases your risk of developing osteoporosis.
  • Infections of rheumatoid nodules - Nodules often develop at joints due to long-standing inflammation. These can become infected. 
  • Carpal Tunnel Syndrome - If arthritis occurs in the wrist, there is an increased risk of developing Carpal Tunnel Syndrome. This causes wrist and hand numbness, tingling, and weakness.
  • Lymphoma - Cancer of the lymphatic system can occur as a result of widespread, long-term inflammation. It is also a potential, though rare, side effect of some rheumatoid arthritis medications.
  • Other complications can involve the skin, eyes, nerve tissue, and other body systems.

Rheumatoid arthritis is a lifelong condition. Your prognosis depends on many factors such as disease severity at diagnosis, adherence, and response to treatment, and lifestyle. Many people can enjoy a good quality of life and minimal limitations with appropriate therapy. If you live with rheumatoid arthritis and would like to learn more about managing your condition, speak with one of our online doctors now!

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