Rheumatoid Arthritis: Pain, Treatment and Causes
By Med-Fit Content Team . Last Updated Thursday, 27th July 2023
What is Rheumatoid Arthritis
This type of arthritis is a chronic inflammatory disorder, extending its impact beyond just the joints, affecting various body systems like the skin, eyes, lungs, heart, and blood vessels. This autoimmune condition arises when the immune system mistakenly attacks the body's own tissues, leading to painful joint swelling, bone erosion, and deformities, unlike osteoarthritis caused by wear-and-tear damage.
The inflammation associated with rheumatoid arthritis not only affects the joints but also poses risks to other parts of the body. Although advancements in medications have significantly improved treatment options, severe cases can still result in physical disabilities.
This condition brings about pain, swelling, and stiffness in the joints as the immune system's confusion prompts it to attack healthy tissues.
Approximately 400,000 adults aged 16 and over in the UK are affected by rheumatoid arthritis, and it can impact people of all ages. Due to its potential to worsen rapidly, early diagnosis and intensive treatment play a crucial role. Starting treatment early increases the likelihood of its effectiveness.
Understanding the development of rheumatoid arthritis requires insight into the workings of a normal joint. Rheumatoid arthritis (RA) is a systemic autoimmune disease, characterized by chronic inflammation, which affects joints with varying severity among patients.
Risk factors include age, gender, genetics, and environmental exposure, such as cigarette smoking, air pollutants, and certain occupational factors.
Complications that may arise include permanent joint damage necessitating arthroplasty, rheumatoid vasculitis, and Felty syndrome, which may require splenectomy if left unaddressed.
Unfortunately, there is currently no cure for RA, and treatment goals focus on pain reduction and halting or slowing further damage. A variety of past and present treatment modalities have been used to address the complexities associated with rheumatoid arthritis.
What causes Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a complex autoimmune disease that arises when the body's immune system, which is designed to protect against infections and diseases, mistakenly attacks its own healthy tissues, particularly the joints. This immune response can also extend to various other organs, leading to medical problems affecting the heart, lungs, nerves, eyes, and skin.
While the exact triggers of this immune system malfunction are not fully understood, there is evidence pointing towards a genetic component that increases the likelihood of reacting to environmental factors. These factors may include infections caused by certain viruses and bacteria, which could potentially serve as triggers for the onset of the disease.
RA can lead to inflammation in and around the joints, causing damage to the skeletal system. Moreover, it has the potential to affect other organs like the heart and lungs. Researchers believe that heredity might play a role in the development of RA, though the specific causes remain unknown.
This autoimmune disorder is not limited to a particular age group, as it most commonly appears in individuals aged 30 to 50 but can occur at any age. Additionally, it is more prevalent in women compared to men.
Ways to Treat & Self Care for Rheumatoid Arthritis
Promoting overall wellness and managing rheumatoid arthritis involves adopting various strategies:
- Healthy Eating: A well-balanced, nutritious diet that includes all essential food groups helps maintain a healthy weight and supports overall well-being.
- Daily Movement: Incorporate physical activity into your daily routine, even when you don't have time for a full exercise session. Utilize stairs instead of elevators, park farther away to encourage walking, or opt for longer routes to stay active throughout the day.
- Balancing Activity with Rest: During a flare-up, it's crucial to find a balance between staying physically active and allowing your body to rest. While staying active helps manage inflammation and fatigue, adequate rest is essential to alleviate pain and swelling in affected joints.
- Hot and Cold Treatments: Apply heat pads or enjoy warm baths to soothe stiff joints and tired muscles. For acute pain and swollen joints, cold treatments can help numb painful areas and reduce inflammation.
- Stress Reduction and Complementary Therapies: Engage in relaxation techniques such as meditation, deep breathing, or visualizing pleasant images to alleviate stress and shift focus away from pain. Massage can also help reduce pain, relax muscles, and ease stress. Acupuncture or acupressure may offer pain relief benefits for some individuals.
- Supplements: Curcumin/turmeric and omega-3 fish oil supplements have shown potential in easing rheumatoid arthritis pain and morning stiffness. However, consult your doctor before taking any supplements to discuss potential side effects and interactions with other medications.
- Tens Machines: Tens machines are non-invasive treatments that assist with pain relief and have gained popularity in arthritis management. These machines come in wired or wireless options, with multiple channels available to target larger areas for pain relief.
Incorporating these various strategies can contribute to a more holistic approach to managing rheumatoid arthritis and improving overall well-being. As always, it's essential to consult with healthcare professionals for personalized guidance and treatment recommendations based on individual needs and health conditions.
How is it diagnosed?
Diagnosing rheumatoid arthritis (RA) during its early stages can be challenging due to mild symptoms and the absence of visible signs in X-rays or blood tests. Healthcare providers employ several diagnostic tools, including medical history, physical examination, laboratory tests, and imaging studies.
Medical History: Your doctor will inquire about your symptoms, their onset, and how they have progressed over time. Additionally, they may ask about any limitations in daily activities, your medical history, family history of similar symptoms or rheumatoid arthritis, and the medications you are taking. This information aids in making an accurate diagnosis and understanding the impact of the disease on your life.
Physical Examination: The doctor will conduct a physical exam that involves inspecting your joints, observing your movements while walking and performing daily tasks, checking for any skin rashes or nodules, and listening to your chest for signs of lung inflammation.
Laboratory Tests: Several blood tests are commonly used to aid in diagnosing rheumatoid arthritis:
- Rheumatoid factor (RF) test: This checks for the presence of RF antibodies, which many people with rheumatoid arthritis may have in their blood. However, not all RA patients test positive for RF, and some individuals may have RF but never develop the disease. Therefore, this test is considered along with other evaluations to diagnose RA.
- Anti-cyclic citrullinated peptide antibody (anti-CCP) test: This checks for anti-CCP antibodies that often appear in individuals with rheumatoid arthritis. The presence of anti-CCP, along with RF results, can help confirm an RA diagnosis and, in some cases, detect the disease even before symptoms manifest.
- Complete blood count (CBC): This test helps diagnose anemia, which is common in people with RA.
- Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP): These tests measure inflammation levels and help monitor disease activity and treatment response.
- Other blood tests: Doctors may also conduct additional tests to assess kidney function, electrolytes, liver function, thyroid function, muscle markers, autoimmune markers, and infection indicators to evaluate overall health and consider other potential diagnoses related to RA.
Imaging Tests: To assess joint damage, doctors may use imaging tests such as X-rays, MRI, and ultrasound:
- X-rays can help check for RA, although they might not show abnormalities in the early stages before joint damage occurs. They are often used to monitor disease progression and rule out other causes of joint pain.
- MRI and ultrasound are useful for diagnosing rheumatoid arthritis in its early stages and evaluating the extent of joint damage and disease severity.
Other imaging tests like CT scans, PET scans, bone scans, and DEXA may also be considered in certain cases of rheumatoid arthritis. By utilizing these various diagnostic approaches, healthcare providers can accurately identify RA and differentiate it from other joint conditions.
What are the symptoms?
Rheumatoid arthritis (RA) presents a range of symptoms, and in its early stages, redness and swelling in the joints may not be immediately evident. However, individuals may experience tenderness and pain as significant indicators.
Here are the key clues to identify RA:
- Joint pain, tenderness, swelling, or stiffness that persists for a duration of six weeks or longer.
- Morning stiffness lasting for 30 minutes or more.
- Involvement of multiple joints.
- Typically, small joints such as wrists and certain joints in the hands and feet are the first to be affected.
- Symmetrical presentation, with the same joints on both sides of the body being impacted.
- Many individuals with RA experience fatigue, and some may have a low-grade fever.
- RA symptoms can fluctuate, with periods of increased inflammation and other symptoms known as "flares." Flares can last for varying lengths, ranging from days to months.
Aside from these primary symptoms, other manifestations might include tiredness, lack of energy, reduced appetite, unintended weight loss, sweating, dry eyes due to inflammation, and occasional chest pain resulting from inflammation.
Additionally, a few people may develop painless fleshy lumps called rheumatoid nodules around affected joints.
How will it affect me?
The impact of rheumatoid arthritis varies from person to person, making it challenging to predict the exact course of the condition for each individual.
For those diagnosed with rheumatoid arthritis who smoke, quitting smoking is highly recommended. Smoking can worsen the symptoms of rheumatoid arthritis compared to non-smokers and may weaken the effectiveness of medications.
Physical activity plays a crucial role in managing the symptoms and overall health of individuals with rheumatoid arthritis.
To assess the progression of arthritis and determine the best treatment approach, your doctor will utilize blood tests and x-rays.
The outlook for people with rheumatoid arthritis is continuously improving with the availability of new and more effective treatments. By adhering to prescribed medications and making necessary lifestyle changes, it is possible to lead a fulfilling and active life despite the condition.
Rheumatoid arthritis can also affect other parts of the body, such as:
- Eyes: Symptoms include dryness, pain, inflammation, redness, sensitivity to light, and visual difficulties.
- Mouth: Dryness, gum inflammation, irritation, or infection may occur.
- Skin: Rheumatoid nodules, which are small lumps beneath the skin over bony areas.
- Lungs: Inflammation and scarring can lead to shortness of breath and lung disease.
- Blood vessels: Inflammation of blood vessels may cause nerve, skin, and organ damage.
- Blood: A lower than normal number of red blood cells.
- Heart: Inflammation can lead to damage to the heart muscle and surrounding areas.
Painful joints may also hinder regular exercise, leading to weight gain. Being overweight can increase the likelihood of developing high cholesterol, diabetes, heart disease, and high blood pressure in people with rheumatoid arthritis.