Medicine and Health related Information

What is Rheumatoid Arthritis?

Rheumatoid Arthritis is a form of chronic arthritis which typically affects the same joints of the two sides of the human body like hands and feet. The symptoms keep coming and going at different times. Rheumatoid arthritis is one of the more common types of arthritis.

RHEMATOID ARTHRITIS SYMPTOMS and DIAGNOSIS

Rheumatoid arthritis is diagnosed if a patient has four of the seven symptoms described below. They are as follows:

1.      Stiffness of the joints in the morning lasting at least for one hour for a period of 6 weeks or more

2.      Arthritis of three or more joints.

3.      Arthritis of hand joints.

4.      Symmetrical arthritis i.e., involving arthritis of the same joints on both sides of the body.

5.      Finding of RF in the serum of the patient.

6.      Presence of rheumatoid nodules in the patient which is observed by a physician.

7.      Radiological changes of the hand and wrist.

The onset of the disease is heralded by symptoms such as fatigue, weight loss, muscle ache or myalgia, early morning stiffness of the joints, arthalgia or joint pain, swelling of the joint or sometimes fever.

RHEUMATOID ARTHRITIS CAUSES

Many theories have been put forward to find the cause of rheumatoid arthritis disease.

1.      INFECTION- One of the most reasonable theory suggests that rheumatoid arthritis is due to some kind of infection or by some tiny germs called viruses which are yet unknown. Viruses can find their way into the joints and trigger off inflammation.

2.      AUMTO IMMUNE RESPONSE- It is based on a theory called ‘Auto immune’ theory. It states that rheumatoid arthritis happens when the immune system is mistakenly seems to turn against the body. In general antibodies are produced against the invading antigens to protect the body and if these antibodies are directed against parts of the persons own body cells they are called auto-antibodies and the disease is termed auto immune.

3.      GENETIC FACTOR- Rheumatoid arthritis can also be inherited from ones own parents or grand parents.

FURTHER DEVELOPMENT OF RHEUMATOID ARTHRITIS

In most of the cases rheumatoid arthritis starts spreading gradually for several weeks with persistent pain and stiffness in one or more joints. The hands and feet are affected first usually and this stiffness is worse especially during early morning hours and wears off during the day. Slowly the arthritis may spread to others joints of the body like elbow join, shoulder joint, hip joint, knees and ankles. Sometimes even the joints in the jaw and spine, especially the neck can be affected. A hoarse voice in the joints of larynx which is voice box of the body may indicate arthritis rarely. At some point the tendon sheaths frequently become inflamed which adds to the pain and swelling. Sometimes the fingers in hands and toes in the feet bend and deform in which case it becomes difficult to straighten that part.

Remember rheumatoid arthritis is not only a disease of the joints but of the whole body. The affected person feels tired, weak and feverish. The weakness worsens when the muscles near the painful joint start getting smaller. Organs like lungs, heart, eyes and digestive system may also get involved in later stages.

RHEUMATOID ARTHRITIS TREATMENT

The treatment of rheumatoid arthritis consists of adequate rest, individually tailored exercise and physiotherapy, joint protection and suitable medication to control symptoms. If so warranted by the situation surgical procedures may require as an inevitable part of rehabilitation to reduce the inflammatory symptoms and to produce routine activities.

Median nerve decompression at the wrist, arthrodesis of wrist or ankles, synovectomy of the wrist and knee, repair of ruptured tendons, hip, knee and other joint replacement are useful operations in rheumatoid arthritis.

The main objective of the drug therapy is to get relieve from the pain, reduce inflammation, prevent deformities and to keep the joints functioning as effectively as possible.

Depending upon intensity of the symptoms and signs the patient can administer salicylates, NSAID (non-steroidal anti-inflammatory drugs), DMARDS (disease modifying anti-inflammatory drugs) such as gold salts, D-penicillamine, antimalarials and immunosuppressive agents on the advice of a physician. Antidepressants, antibiotics, iron tablets, muscle relaxants are can also be prescribed by the doctor depending on the intensity of symptoms.

The patients who do not respond to other medications are treated by systemic corticosteroid therapy. Injection of a steroid medicine to the affected joints with persistent inflammation is done by orthopedic surgeon in patients who do not respond to other medicines.

About one third of the rheumatoid arthritis patients have miled illness with a high rate of spontaneous remission, whereas another third of the patients progress slowly with minor functional disability while the remaining patients have a significantly aggressive disease with only limited periods of partial or complete remission.

Surgical help for arthritis is considered in the last resort except for infective arthritis. Mostly drugs and rehabilitation can take care of the rheumatoid arthritis.