What is Rheumatoid Arthritis ?

According to N.I.C.E about 400,000 adults aged 16 and over are affected by Rheumatoid arthritis. Prevalence of disease is more in women than men. RA can occur at any age but it is more common after age 45.

What is Rheumatoid Arthritis?

Rheumatoid arthritis is an autoimmune and chronic inflammatory disease in which our immune system attack tissues of the body that causes inflammation and damage of healthy tissue. It mainly affects the joints of hand, wrist and knee.

In Rheumatoid arthritis or RA, the lining of joint called Synovium become inflamed due to antibodies produced immune system. Hence joint become swollen, painful and stiff.

What are the signs and symptoms of RA?

Rheumatoid arthritis usually affects hands, wrists and the knee joint. It can affect more than one joint on the body.

The main symptoms of Rheumatoid arthritis are:

 Pain in more than one joint
 Swelling in or around one joint
 Stiffness in the joints. Usually more in the morning and after inactivity

 Tenderness in joint
 Joint deformities

Other general symptoms, a patient can suffer are:

 Low grade fever
 Body fatigue or ache
 Loss of appetite
 Generalised body weakness

 Loss of ability to work

Other systems involvement in RA

Rheumatoid arthritis is an autoimmune disease besides joints, antibodies can attack other healthy tissue of the body system. About 40% of individuals have signs and symptoms of other body organs, these are:

 Heart
 Lungs
 Skin
 Kidney
 Blood vessels
 Nervous system

 Eyes

 Bone marrow

What causes Rheumatoid Arthritis?

Our immune system protects the body from foreign invaders like bacteria, viruses and fungi. In RA the immune system mistakenly attacks the healthy tissues of joints and cause damage to the structure lining of the joint. Antibodies are formed against the synovial cells that attack and chemicals are then released. These chemicals damage the cartilage, bones and tendons.

What are the risk factors for RA?

 Gender: Females are three times more at risk of developing this condition than their male counterparts.

 Age: Although RA affects at any age but after 45 it is very common inflammatory disease of joints

 Family History: If your family member has RA then there is more risk of developing RA. Genetics has role in this condition

 Smoking: Research tells us that people who smoke are at more risk of developing rheumatoid arthritis.

 Obesity: Being overweight or obese is a risk factor for RA.

 Diet: Consuming foods that contains high sugar, red meat and iron does pose a  risk for developing Rheumatoid arthritis.

What are Complications of RA?

Patients suffering from Rheumatoid arthritis can develop other health complications, these are:

 Carpal tunnel syndrome
 Pulmonary fibrosis
 Eye diseases like dryness of eyes and inflammation

 Heart complications
 Inflammation of blood vessels
 Lymphoma
 Pneumonia
 Joint erosion
 Kidney failure
 Skin nodule
 Gastrointestinal bleeding

How is RA Diagnosed?

A health care professional completes a medical history and does a full physical examination for signs and symptoms of Rheumatoid arthritis. Your doctor will conduct a clinical evaluation of your joints and notice any joint swelling, stiffness, Tenderness around any joint, responses and reflexes on joints and muscles.

They will then recommend some blood tests to confirm the diagnosis of Rheumatoid arthritis

  RA Factor Test: This test checks the protein released, it helps in diagnosing of the condition.

  Anti-CCP test: This test check the antibody produced in RA. Its is more specific and sensitive than the factor test.

 ANA Test: Anti-nuclear antibody (ANA) test, reveals the antibodies against nucleus of healthy cells. ANA test can be positive in other autoimmune diseases.

 ESR Test: Erythrocyte sedimentation rate (ESR) Test helps to identify the inflammatory response in the body. It is important test for chronic and acute conditions.

 CRP Test: C- reactive protein is acute phase reactant that is released from liver during any inflammatory reaction inside the body.

 Complete blood count:
CBC is blood baseline test that helps to diagnose any disease. It reveals the details of every type of cells including Red blood cells, White blood cells and Platelets.

 Imaging study: Your doctor may recommend X-rays, Ultrasound and MRI investigations to evaluate any changes in joint structure.

How Rheumatoid arthritis treated?

There is no cure for Rheumatoid arthritis but treatment options are available to control symptoms and prevent more damage.

Your health care professional may prescribe 3 ways to treat RA:

1. Medications

2. Physical therapy

3. Surgery

1-Medications: Pain Killers:

Oral analgesics like NSAIDS ( Naproxen, Meloxicam, Etoricoxib) are effective in reducing inflammation and relief from pain.

Acetaminophen and Tramadol can also be administered for pain relief in RA

DMARDs( Disease modifying anti-rheumatic drugs):

DMARDs Therapy works by stopping the antibodies produced by immune system and control the disease process. there are conventional DMARDs and new class Biologic agents.

 Conventional DMARDs:
These are Azathioprine , Hydroxychloroquine, Gold injections, Methotrexate, Leflunamide, Sulfasalazine

 Biologic Agents:
Biologic agents are effective when conventional DMARDs are not responding. They target the inflammatory response of the immune system. There are some important Biologic agents:
Infliximab, Etanercept, Rituximab, Sarilumab, Adalimumab, Tofacitinib, Abatacept and Tocilizumab

2- Physical Therapy:

Your health care provider may recommend exercises that help to increase the range of motion of the affected joint. Low impact exercises and muscle strengthening exercises can decrease the pressure on joints and relieve from symptoms.

Regular exercise can help to prevent the effects of Rheumatoid arthritis.

Our OrthoPro - Electric Hand Massager is a brilliant creation designed to help relieve pain, increase hand strength and reduce feelings of stress and anxiety. The hand  massager provides a 15 minute tender massage along with heat therapy that helps relieve painful, sore, numb, cold hands by stimulating blood circulation. 

Scientific research shows that people undergoing regular hand massage can experience reduced feelings of stress and uneasiness. Hand massage can supplement the treatments for Carpal Tunnel Syndrome, Rheumatoid Arthritis, Neuropathy, Hand Joint Pain and other painful hand and finger conditions.

3- Surgery:

In some cases of RA,  surgical procedure is opted to reduce the symptoms of:

 Inflamed tissue(Synovium of joint)

 Carpal tunnel release surgery
 Tendon repair surgery - release of tendon
 Toe strengthening procedure

 Joint replacement surgery

The Bottom Line:

Although there is no permanent cure of Rheumatoid arthritis, early diagnosis and treatment can decrease the inflammation and damage caused by the immune system. Consult your health care professional at early signs and symptoms. Proper compliance with treatment, followed by exercise can help with relief from painful hands and joints and reduce the swelling, stiffness and deformity of the joint, for you to live a quality and pain free life.