Information on Rheumatoid Arthritis

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1 Information on Rheumatoid Arthritis Table of Contents About Rheumatoid Arthritis 1 Definition 1 Signs and symptoms 1 Causes 1 Risk factors 1 Test and diagnosis 2 Treatment options 2 Lifestyle 3 References 3 Important Information 4 Disclaimer 4 Copyright Policy 4 i

2 About Rheumatoid Arthritis Definition Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing swelling which can result in joint deformity. Rheumatoid arthritis usually affects the small joints in your hands and feet, and occurs when your immune system mistakenly attacks your own body s tissues. Signs and symptoms Rheumatoid arthritis symptoms can range from mild to severe. Some signs and symptoms include joint pain, swelling, morning stiffness which lasts for hours, joints that are tender to the touch, firm bumps of tissue under the skin (rheumatoid nodules), fatigue and fever. In rheumatoid arthritis, the smaller joints, specifically joints in the wrists, hands, ankles and feet, are usually affected first. The problem may progress to affect other parts such as the shoulders, elbows, knees, hips, jaw and neck. Symptoms of rheumatoid arthritis tend occur in a symmetrical pattern the same joints on both sides of your body. Joint damage caused by rheumatoid arthritis can be debilitating. Daily activities take more energy to accomplish and with time, it may even be impossible to do them totally. Causes Rheumatoid arthritis occurs when the body s immune system attacks the synovium the lining of the membranes that surround the joints, causing inflammation. This inflammation causes irritation and the wearing down of cartilage and bone. The tendons and ligaments which hold the joint together weaken and gradually, the joint loses its shape and alignment. Risk factors Some rheumatoid arthritis risk factors are listed as follows. Age. Rheumatoid arthritis can occur at any age, but it most commonly begins between the ages of 40 and 60. Gender. Women are more likely to develop rheumatoid arthritis. Family history. People who have family members with rheumatoid arthritis may have an increased risk of the disease. One does not directly inherit rheumatoid arthritis but rather, he or she can inherit a predisposition to rheumatoid arthritis. Smoking. Smokers are more likely to develop rheumatoid arthritis. 1

3 Test and diagnosis If rheumatoid arthritis is suspected, some of the following tests may be conducted, in addition to a physical exam. However, rheumatoid arthritis can be difficult to diagnose in its early stages because its early signs and symptoms are similar to those of many other diseases. It is also important to note that no one test or physical finding confirms the diagnosis. Imaging such as X-rays to help track the progression of rheumatoid arthritis over time. Laboratory tests such as blood tests to look for erythrocyte sedimentation rate (ESR, or sed rate), rheumatoid factor and anti-cyclic citrullinated peptide (anti-ccp) antibodies. Treatment options There is no cure for rheumatoid arthritis although there are treatments to help reduce inflammation or slow down joint damage. Physical therapy. Therapists can help in many different ways, including advising on ways and suggesting assistive devices to do everyday tasks without putting extra stress on the joints. Medication. Many drugs used to treat rheumatoid arthritis have potentially serious side effects. Doctors typically prescribe medications with the fewest side effects first. Stronger drugs may be prescribed if disease progresses. Nonsteroidal anti-inflammatory drugs (NSAIDs.) NSAIDs such as ibuprofen and naproxen may help relieve both pain and inflammation. However, long-term use of NSAIDs can cause stomach irritation, cardiovascular problems, and liver and kidney damage. Corticosteroids or steroids. Reduces inflammation and suppresses the immune system. They can be taken orally or be injected directly into the painful joint. Side effects include upset stomach, gastrointestinal leeding, hypertension, thinning of the bones and cataracts. Disease-modifying antirheumatic drugs (DMARDs). DMARDs slow or stop your immune system from attacking your joints and is often used to treat rheumatoid arthritis and autoimmune causes of arthritis. Examples include methotrexate and hydroxychloroquine. Side effects vary but may include liver damage, bone marrow suppression and severe lung infections. Immunosuppressants. These medications suppress or prevent immune response, which is out of control in rheumatoid arthritis. Immunosuppressants can increase risk of infection. TNF-alpha inhibitors. TNF-alpha inhibitors can help reduce pain, morning stiffness, and tender or swollen joints usually within one or two weeks after the start of treatment. Side effects may include injection site reactions, infusion reactions, heart failure, demyelinating diseases and infections. Surgery. Surgery may be considered if more-conservative measures are no longer effective in preventing or slowing joint damage. Joint replacement. This is a surgery to remove damaged joint surfaces and replace them with plastic and metal prostheses. This surgery is more commonly done for hip and knee joints although replacements shoulder, elbow, finger or ankle joint replacements are also possible. There is a small risk of infection and bleeding with the surgery. With normal use and activity, the new replacement can wear 2

4 Lifestyle or even loosen and become painful. With appropriate activity modification, they can however last for many years. Synovectomy. This is the removal of inflamed joint tissue. Rheumatoid arthritis causes the synovium (joint capsule's lining) to swell, especially in the wrists, hands and fingers. Removing the synovium may slow joint deterioration. Joint fusion. This procedure, also known as arthrodesis, is more often used for smaller joints, such as those in the wrist, ankle and fingers. It removes the ends of the two bones in the joint and then locks those ends together until they heal into one rigid unit. The fused joint is more stable and can then bear weight without pain, but has no flexibility. This option may be considered for those suffering severe joint pain but unable to undergo joint replacement surgery. Making some adjustments to your lifestyle may help you better cope with rheumatoid arthritis. Rest. Rest the joint for 12 to 24 hours if pain or inflammation occurs. People with arthritis may also suffer from muscle weakness and tire more easily. Try taking a 10-minute break every hour or a rest or short nap when you re tired. Exercise. Regular exercise with doctor s approval may help fight fatigue and strengthen muscles surrounding the joints, improving joint stability. Focus on gentle exercises such as walking and swimming. Avoid exercising tender, injured or swollen joints and stop the exercises if new joint pain is felt. Maintain positive attitude. The pain and disability associated with rheumatoid arthritis can be frustrating and depressing. Talking about your feelings may may help to alleviate such pain. References i. Rheumatoid arthritis. American College of Rheumatology. diseases_and_conditions/ra.asp?aud=pat. Accessed Aug. 25, ii. iii. iv. O'Dell JR. Rheumatoid arthritis. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; B _ Accessed Aug. 25, Handout on health: Rheumatoid arthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Accessed Aug. 25, Hunder GG. Mayo Clinic Straight Talk on Arthritis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; v. Rheumatoid arthritis and complementary and alternative medicine. National Center for Complementary and Alternative Medicine. Accessed Aug. 26,

5 Important Information Disclaimer This Internet site and its services, including the information above, may contain general information relating to various medical conditions and their treatment. Such information is provided for informational purposes only and is not meant to be a substitute for advice provided by a physician or other qualified health care professional. Patients should not use the information contained herein for diagnosing a health or fitness problem or disease. Patients should always consult with a physician or other health care professional for medical advice or information about diagnosis and treatment. Do not delay seeking or disregard medical advice based on information above. While the content providers make efforts to update the content on the site, some information may be out of date and therefore the information should not be used to diagnose, treat, cure or prevent any disease without the supervision of a medical doctor. Copyright Policy The entire contents of this Internet site are subject to copyright protection. Copyright 2010 TERRACLOUDS PRIVATE LIMITED. The contents of TERRACLOUDS Internet sites may not be copied other than for noncommercial individual reference with all copyright or other proprietary notices retained, and thereafter may not be recopied, reproduced or otherwise redistributed. Except as expressly provided above, you may not otherwise copy, display, download, distribute, modify, reproduce, republish or retransmit any information, text or documents contained in this Web site or any portion thereof in any electronic medium or in hard copy, or create any derivative work based on such images, text or documents, without the express written consent of TERRACLOUDS. Nothing contained herein shall be construed as conferring by implication, estoppel or otherwise any license or right under any patent or trademark of TERRACLOUDS, or any third party. 4

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