HEALTH: RHEUMATOID ARTHRITIS (JOINT - INFLAMMATION - TREATMENT) Gout>>
What is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints. Rheumatoid arthritis (RA) can also cause inflammation of the tissue around the joints, as well as in other organs in the body. Autoimmune diseases are illnesses that occur when the body's tissues are mistakenly attacked by their own immune system. The immune system is a complex organization of cells and antibodies designed normally to "seek and destroy" invaders of the body, particularly infections. Patients with autoimmune diseases have antibodies in their blood that target their own body tissues, where they can be associated with inflammation. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease (that reduces the quality of overall health).
While rheumatoid arthritis is a chronic illness, meaning it can last for years, patients may experience long periods without symptoms. However, rheumatoid arthritis is typically a progressive illness that has the potential to cause joint destruction and functional disability in health.
A joint is where two bones meet to allow movement of body parts. Arthritis means joint inflammation. The joint inflammation of rheumatoid arthritis causes swelling, pain, stiffness, and redness in the joints. The inflammation of rheumatoid disease can also occur in tissues around the joints, such as the tendons, ligaments, and muscles.
In some patients with rheumatoid arthritis, chronic inflammation leads to the destruction of the cartilage, bone, and ligaments, causing deformity of the joints. Damage to the joints can occur early in the disease and be progressive health wise. Moreover, studies have shown that the progressive damage to the joints does not necessarily correlate with the degree of pain, stiffness, or swelling present in the joints.
Rheumatoid arthritis is a common rheumatic disease, affecting approximately 1.3 million people in the United States, according to current census data. The disease is three times more common in women as in men. It afflicts people of all races equally. The disease can begin at any age, but it most often starts after age 40 and before 60. In some families, multiple members can be affected, suggesting a genetic health basis for the disorder.
Health: Causes of Rheumatoid Arthritis (Joint - Inflammation)
The cause of rheumatoid arthritis is unknown. Even though infectious
agents such as viruses, bacteria, and fungi have long been suspected,
none has been proven as the cause. The cause of rheumatoid arthritis is
a very active area of worldwide research. It is believed that the
tendency to develop rheumatoid arthritis may be genetically inherited.
It is also suspected that certain infections or factors in the
environment might trigger the activation of the immune system in
susceptible individuals. This misdirected immune system then attacks
the body's own tissues. This leads to inflammation in the joints and
sometimes in various organs of the body, such as the lungs or eyes.
Rheumatoid arthritis occurs when white blood cells — whose usual job is to attack unwanted invaders, such as bacteria and viruses — move from your bloodstream into the membranes that surround your joints (synovium). The blood cells appear to play a role in causing the synovium to become inflamed. The inflammation causes the release of proteins that, over months or years, cause the synovium to thicken. The proteins can also damage the cartilage, bone, tendons and ligaments near your joint. Gradually, the joint loses its shape and alignment. Eventually, it may be destroyed.
Regardless of the exact trigger, the result is an immune system that is geared up to promote inflammation in the joints and occasionally other tissues of the body.Health: Risk Factors of Rheumatoid Arthritis (Joint - Inflammation)
Factors that may increase your risk of rheumatoid arthritis include:
- Sex. Women are more likely to develop rheumatoid arthritis than men are.
- Age. Rheumatoid arthritis occurs most commonly between the ages of 40 and 60. However, it can also occur in older adults and in children (juvenile rheumatoid arthritis).
- Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease. Doctors don't believe you can directly inherit rheumatoid arthritis. Instead, it's believed that you can inherit a predisposition to rheumatoid arthritis.
- Smoking. Smoking cigarettes increases your risk of rheumatoid arthritis. Quitting can reduce your health risk.
Also see: ARTHRITIS OSTEOARTHRITIS GOUT BURSITIS TENDONITIS
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Health: Symptoms of Rheumatoid Arthritis (Joint - Inflammation)
The symptoms of rheumatoid arthritis come and go, depending on the degree of tissue inflammation. When body tissues are inflamed, the disease is active. When tissue inflammation subsides, the disease is inactive (in remission). Remissions can occur spontaneously or with treatment and can last weeks, months, or years. During remissions, symptoms of the disease disappear, and patients generally feel well. When the disease becomes active again (relapse), symptoms return. The return of disease activity and symptoms is called a flare. The course of rheumatoid arthritis varies from patient to patient, and periods of flares and remissions are typical.
When the disease is active, symptoms can include fatigue, loss of energy, lack of appetite, low-grade fever, muscle and joint aches, and stiffness. Muscle and joint stiffness are usually most notable in the morning and after periods of inactivity. Arthritis is common during disease flares. Also during flares, joints frequently become red, swollen, painful, and tender. This occurs because the lining tissue of the joint (synovium) becomes inflamed, resulting in the production of excessive joint fluid (synovial fluid). The synovium also thickens with inflammation (synovitis).
In rheumatoid arthritis, multiple joints are usually inflamed in a symmetrical pattern (both sides of the body affected). The small joints of both the hands and wrists are often involved. Simple tasks of daily living, such as turning door knobs and opening jars, can become difficult during flares. The small joints of the feet are also commonly involved. Occasionally, only one joint is inflamed. When only one joint is involved, the arthritis can mimic the joint inflammation caused by other forms of arthritis, such as gout or joint infection. Chronic inflammation can cause damage to body tissues, including cartilage and bone. This leads to a loss of cartilage and erosion and weakness of the bones as well as the muscles, resulting in joint deformity, destruction, and loss of function. Rarely, rheumatoid arthritis can even affect the joint that is responsible for the tightening of our vocal cords to change the tone of our voice, the cricoarytenoid joint. When this joint is inflamed, it can cause hoarseness of the voice.
Since rheumatoid arthritis is a systemic disease, its inflammation can affect organs and areas of the body other than the joints.Symptoms of rheumatoid arthritis may include:
- Joint pain
- Joint swelling NATURAL CURE FOR ARTHRITIS
- Joints that are tender to the touch
- Red and puffy hands
- Firm bumps of tissue under the skin on your arms (rheumatoid nodules)
- Loss of appetite
- Fatigue and weakness
- Morning stiffness that lasts at least 30 minutes
- Widespread muscle aches
- Fever
Eventually, joint pain appears. When the joint is not used for a while, it can become warm, tender, and stiff. When the lining of the joint becomes inflamed, it gives off more fluid and the joint becomes swollen. Joint pain is often felt on both sides of the body, and may affect the fingers, wrists, elbows, shoulders, hips, knees, ankles, toes, and neck.
Additional symptoms of rheumatoid arthritis include:
- Anemia due to failure of the bone marrow to produce enough new red blood cells
- Hand and feet deformities
- Swollen glands
- Paleness
- Skin redness or inflammation
- Numbness or tingling
- Low-grade fever
- Nodules under the skin (usually a sign of more severe disease)
- Lung inflammation (pleurisy)
- Limited range of motion
- Eye burning, itching, and discharge
Symptoms appear in smaller joints first
Rheumatoid arthritis usually causes problems in several joints at the
same time. Early rheumatoid arthritis tends to affect your smaller
joints first — the joints in your wrists, hands, ankles and feet. As
the disease progresses, your shoulders, elbows, knees, hips, jaw and
neck can also become involved.
Symptoms of a rheumatoid arthritis flare
Rheumatoid arthritis and symptoms may vary in severity and may
even come and go. Periods of increased disease activity — called
flare-ups or flares — alternate with periods of relative remission,
during which the swelling, pain, difficulty sleeping, and weakness fade
or disappear.
Health: Diagnosis of Rheumatoid Arthritis (Joint - Inflammation)
The first step in the diagnosis of rheumatoid arthritis is a meeting between the doctor and the
patient. The doctor reviews the history of symptoms, examines the joints for
inflammation and deformity, the skin for rheumatoid nodules, and other parts of
the body for inflammation. Certain blood and X-ray tests are often obtained.
The diagnosis will be based on the pattern of symptoms, the distribution of the
inflamed joints, and the blood and X-ray findings. Several visits may be
necessary before the doctor can be certain of the diagnosis. A doctor with
special training in arthritis and related diseases is called a rheumatologist.
The distribution of joint inflammation is important to the doctor in making a diagnosis. In rheumatoid arthritis, the small joints of the hands, wrists, feet, and knees are typically inflamed in a symmetrical distribution (affecting both sides of the body). When only one or two joints are inflamed, the diagnosis of rheumatoid arthritis becomes more difficult. The doctor may then perform other tests to exclude arthritis due to infection or gout. The detection of rheumatoid nodules (described above), most often around the elbows and fingers, can suggest the diagnosis.
Abnormal antibodies can be found in the blood of patients with rheumatoid arthritis. An antibody called "rheumatoid factor" can be found in 80% of patients.The American College of Rheumatology has developed a system for classifying rheumatoid arthritis that is primarily based upon the X-ray appearance of the joints. This system helps medical professionals classify the severity of your rheumatoid arthritis.
Stage I
- no damage seen on X-rays, although there may be signs of bone thinning
Stage II
- on X-ray, evidence of bone thinning around a joint with or without slight bone damage
- slight cartilage damage possible
- joint mobility may be limited; no joint deformities observed
- atrophy of adjacent muscle
- abnormalities of soft tissue around joint possible
Stage III
- on X-ray, evidence of cartilage and bone damage and bone thinning around the joint
- joint deformity without permanent stiffening or fixation of the joint
- extensive muscle atrophy
- abnormalities of soft tissue around joint possible
Stage IV
- on X-ray, evidence of cartilage and bone damage and osteoporosis around joint
- joint deformity with permanent fixation of the joint (referred to as ankylosis)
- extensive muscle atrophy
- abnormalities of soft tissue around joint possible
Rheumatologists also classify the functional status of people with rheumatoid arthritis as follows:
- Class I: completely able to perform usual activities of daily living
- Class II: able to perform usual self-care and work activities but limited in activities outside of work (such as playing sports, household chores)
- Class III: able to perform usual self-care activities but limited in work and other activities
- Class IV: limited in ability to perform usual self-care, work, and other activities
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Alternative Natural Treatment For Arthritis
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Health: Conventional Treatment of Rheumatoid Arthritis (Joint - Inflammation)
Rheumatoid arthritis causes joint damage that can be both debilitating and disfiguring. Damage to your joints may make it difficult or impossible to go about your daily activities. You may find at first that tasks take more energy to accomplish. With time you may find you are no longer able to do them at all. Newer treatments may stop joint damage or prevent it so you can continue the activities you enjoy.
There is no known cure for rheumatoid arthritis. To date, the goal of treatment in rheumatoid arthritis is to reduce joint inflammation and pain, maximize joint function, and prevent joint destruction and deformity. Early medical intervention has been shown to be important in improving outcomes. Aggressive management can improve function, stop damage to joints as monitored on X-rays, and prevent work disability. Optimal treatment for the disease involves a combination of medications, rest, joint-strengthening exercises, joint protection, and patient (and family) education. Treatment is customized according to many factors such as disease activity, types of joints involved, general health, age, and patient occupation. Treatment is most successful when there is close cooperation between the doctor, patient, and family members.
Medication for rheumatoid arthritis
What medications you can consider will depend on the severity of your rheumatoid arthritis, the length of time that you've been experiencing signs and symptoms, results from blood tests and X-rays, your overall physical function, and other medical problems you have. Doctors use these factors to determine the duration of your disease, its severity and your prognosis, which help to develop a treatment plan.
Two classes of medications are used in treating rheumatoid arthritis: fast-acting "first-line drugs" and slow-acting "second-line drugs" (also referred to as disease-modifying antirheumatic drugs or DMARDs). The first-line drugs, such as aspirin and cortisone (corticosteroids), are used to reduce pain and inflammation. The slow-acting second-line drugs, such as gold, methotrexate, and hydroxychloroquine (Plaquenil), promote disease remission and prevent progressive joint destruction, but they are not anti-inflammatory agents.
The degree of destructiveness of rheumatoid arthritis varies from patient to patient. Patients with uncommon, less destructive forms of the disease or disease that has quieted after years of activity ("burned out" rheumatoid arthritis) can be managed with rest, pain and anti-inflammatory medications alone. In general, however, patients improve function and minimize disability and joint destruction when treated earlier with second-line drugs (disease-modifying antirheumatic drugs), even within months of the diagnosis. Most patients require more aggressive second-line drugs, such as methotrexate, in addition to anti-inflammatory agents. Sometimes these second-line drugs are used in combination. In some patients with severe joint deformity, surgery may be necessary.
Surgery for rheumatoid arthritis
Some people with rheumatoid arthritis require surgery to reconstruct or replace a damaged joint. Surgery is usually recommended when drug treatment alone can no longer improve the situation, although the timing of such surgery — and whether to go ahead with it — is up to you and your physician. Surgery is usually viewed as a last resort to reduce pain and improve function. One possible exception is hand surgery, as many hand surgeons advocate early surgical intervention to remove inflamed tissue and to help protect the joints and nearby tendons.
Many of the surgical procedures used to repair joints damaged by osteoarthritis are also used in rheumatoid arthritis. The most common surgical procedures for rheumatoid arthritis are arthroscopy, synovectomy (removal of the inflamed tissue that lines the joint), and arthroplasty (joint repair, including joint replacement). The choice depends, in part, on which joints are involved and whether you have any other medical problems. Total joint replacement, most commonly for severe hip or knee arthritis, is a major operation and carries the associated risks.If medications fail to prevent or slow joint damage, you and your doctor may consider surgery to repair damaged joints. Surgery may help restore your ability to use your joint. It can also reduce pain and correct deformities. Rheumatoid arthritis surgery may involve one or more of the following procedures:
- Total joint replacement (arthroplasty). During joint replacement surgery, your surgeon removes the damaged parts of your joint and inserts a metal and plastic prosthesis.
- Tendon repair. Inflammation and joint damage may cause tendons around your joint to loosen or tighten. Your surgeon may be able to repair the tendons around your joint.
- Removal of the joint lining (synovectomy). If the lining around your joint (synovium) is inflamed and causing pain, your surgeon may recommend removing the lining of the joint.
Surgery carries a risk of bleeding, infection and pain. Discuss the benefits and risks with your doctor.
Physical Therapy for rheumatoid arthritis
Range-of-motion exercises and individualized exercise programs prescribed by a physical therapist can delay the loss of joint function.
Joint protection techniques, heat and cold treatments, and splints or orthotic devices to support and align joints may be very helpful.
Sometimes therapists will use special machines to apply deep heat or electrical stimulation to reduce pain and improve joint mobility.
Occupational therapists can construct splints for the hand and wrist, and teach how to best protect and use joints when they are affected by arthritis.
They also show people how to better cope with day-to-day tasks at work and at home, despite limitations caused by rheumatoid arthritis.
Frequent rest periods between activities, as well as 8 to 10 hours of sleep per night, are recommended.
Health: Steps in Preventing Disability and Preserve Joint Function
Steps can be taken in caring for your body if you have rheumatoid arthritis. These self-care measures, when used along with your rheumatoid arthritis medications, can help you cope with the symptoms that would affect your quality of health:
- Exercise regularly. Gentle exercise can help strengthen the muscles around your joints, and it can help fight fatigue you might feel. Check with your doctor before you start exercising. If you're just getting started, begin by taking a walk. Try swimming or gentle water aerobics. Public pools and health clubs in your area may offer classes. Avoid exercising tender, injured or severely inflamed joints. If you feel new joint pain, stop. New pain that lasts more than two hours after you exercise probably means you've overdone it. If pain persists for more than a few days, call your doctor.
- Eat a healthy diet. A healthy diet emphasizing fruit, vegetables and whole grains can help you control your weight and maintain your overall health. However, there's no special diet that can be used to treat rheumatoid arthritis. It hasn't been proved that eating any particular food will make your joint pain or inflammation better or worse.
- Apply heat. Heat can help ease your pain and relax tense, painful muscles. One of the easiest and most effective ways to apply heat is to take a hot shower or bath for 15 minutes. Other options include using a hot pack or an electric heat pad set on its lowest setting. If your skin has poor sensation or if you have poor circulation, don't use heat treatments.
- Apply cold. Cold may dull the sensation of pain. Cold also has a numbing effect and decreases muscle spasms. Don't use cold treatments if you have poor circulation or numbness. Techniques may include using cold packs, soaking the affected joints in cold water and ice massage.
- Relax. Find ways to cope with pain by reducing stress in your life. Techniques such as hypnosis, guided imagery, deep breathing and muscle relaxation can all be used to control pain.
- Protect your joints. Find different ways to approach everyday tasks in order to take stress off your painful joints. For instance, if your fingers are sore, pick up an object using your forearms. Lean into a glass door to force it open, rather than pushing on the door with sore arms.
- Use assistive devices. Assistive devices can make it easier to go about your day without stressing your painful joints. For instance, using specially designed gripping and grabbing tools may make it easier to work in the kitchen if you have pain in your fingers. Try a cane to help you get around. Your doctor or occupational therapist may have ideas about what sorts of assistive devices may be helpful to you. Catalogs and medical supply stores may also be places to look for ideas.
- Complementary and alternative therapies. A number of alternative therapies have been advocated for rheumatoid arthritis, although most have not been rigorously studied. Researchers are sorting out which complementary approaches work best for people with rheumatoid arthritis.
Health: Joint Protection Measures for Rheumatoid Arthritis (Joint - Inflammation):
When you have arthritis, it's important to pay attention to your body's signals. Overuse of arthritic joints can lead to pain, swelling, and additional joint damage. A physical or occupational therapist can teach you how to conserve energy, protect your joints, accomplish daily tasks more easily, and adapt to lifestyle disruptions. Many of these strategies are simple common sense.
Keep moving. Avoid holding one position for too long. When working at a desk, for example, get up and stretch every 15 minutes. Do the same while sitting at home reading or watching television.
Avoid stress. Avoid positions or movements that put extra stress on joints. For example, opening a tight lid can be difficult if you have hand arthritis. One solution is to set the jar on a cloth, lean on the jar with your palm, and turn the lid using a shoulder motion. Better yet, purchase a jar opener that grips the lid, leaving both hands free to turn the jar.
Discover your strength. Use your strongest joints and muscles. To protect finger and wrist joints, push open heavy doors with the side of the arm or shoulder. To reduce hip or knee stress on stairs, lead with the stronger leg going up and the weaker leg going down.
Plan ahead. Simplify life as much as possible. Eliminate unnecessary activities (for example, buy clothing that doesn't need ironing). Organize work and storage areas; store frequently used items within easy reach. Keep duplicate household items in several places; for example, stock the kitchen and all bathrooms with cleaning supplies.
Use labor-saving items. In the kitchen, use electric can openers and mixers. In the bathroom, cut down on scrubbing by using automatic toilet bowl cleaners and spray-on mildew remover in showers or tubs.
Use adaptive aids. Numerous devices on the market can help you avoid unnecessary bending, stooping, or reaching. Long-handled grippers, for example, are designed to grasp and retrieve out-of-reach objects. People with limited movement might have an easier time getting dressed by using long-handled hooks to put on socks and long-handled shoe horns. Also helpful are shoes that slip on or fasten with Velcro, pre-tied neckties, and garments with Velcro fasteners, zippers, or hooks and eyes instead of buttons. Rubber grips are available to help you get a better handle on faucets, pens, toothbrushes, and silverware. Pharmacies, medical supply stores, and online vendors stock a variety of aids for people with arthritis.
Make home modifications. Using casters on furniture can make housecleaning easier. A grab bar mounted over the tub is a necessity for many people, as is a suction mat in the tub to prevent falls. Putting a bathing stool in the tub or shower is a good idea for people who have arthritis in the lower extremities.
Ask for help. Maintaining independence is essential to self-esteem, but independence at all costs is a recipe for disaster. Achieve a balance by educating family members and friends about the disease and the limitations it imposes and enlisting their support. Ask for help with specific tasks.
_______________________________________________________________________________________________________Disclaimer: This information is not presented by a medical practitioner. Therefore any content of this site is strictly intended for educational and informational purpose only. Any access to this site is strictly on a voluntary basis and at the sole discretion of the user. No content of this site is intended as a substitute for medical advice, diagnosis or treatment, nor constitute the practice of any medical profession or health care provider. The information provided on this site is here to educate visitors on health issues that may affect their lives. Otherwise, always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition. And never disregard professional medical advice or delay in seeking it because of something you have read.
Sources: NIH News In Health/National Institutes of Health/National Library of Medicine/Dept of Health and Human Services_______________________________________________________________________________________________________
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