It is an autoimmune condition that directly targets joints such as knees, hands, and wrists. It can also affect other body parts including nerves, eyes, lungs, skin, and heart.
Causes of rheumatoid arthritis: (1)
No one is clear how the immune system gets distracted and targets the healthy tissues to cause rheumatoid arthritis. Genetic factors are more likely to be involved in developing rheumatoid arthritis. If one has a genetic feature in them, bacteria or viruses increase the risk of causing rheumatoid arthritis. Synovium gets attacked by the immune system in rheumatoid arthritis. Pain and inflammation occur in the joint due to this attack. Synovium gets thickened due to inflammation. If you treat the inflammation it will invade and damage the cartilage that is the connective tissue that covers the bones.
Tendons and ligaments weaken and stretch because of inflammation. Joints lose their shape and configuration. When the damage occurs at joints it is quite severe.
Signs and symptoms of rheumatoid arthritis:
Signs and symptoms of rheumatoid arthritis are as follows:
- Swollen, warm, and tender joints
- Stiffness in joints is worst in the morning or especially after inactivity.
- Fatigue and fever
- Loss of appetite
Smaller joints get affected in the early stage of rheumatoid arthritis. Joints of fingers that attach the fingers to hands and joints between toe and feet get affected. When the progression of rheumatoid arthritis starts, symptoms are usually observed in the knees, elbows, shoulders, wrists, and hips. Other signs and symptoms are also seen in about forty percent of patients with rheumatoid arthritis. Other symptoms are observed in the areas of:
- Blood vessels
- Salivary glands
- Lungs
- Heart
- Skin
- Bone marrow
- Eyes
- Kidneys and
- Nerve tissues
Symptoms may vary in severity from person to person. Symptoms may come and go. When the symptoms are in the active phase it is called flares and when symptoms disappear it is known as remission. Swelling and pain are not felt in the remission phase. When the disease progresses, joints may deform or moves out of the right place.
The complication with rheumatoid arthritis:
Complications that are associated with rheumatoid arthritis or that may increase the risk of developing other conditions are as follows:
- Osteoporosis:
When medications are used for treating rheumatoid arthritis it increases the risk of developing osteoporosis. Osteoporosis is the condition in which bones become and easy to get a fracture.
- Rheumatoid nodules:
Tissue bumps are formed around the pressure joints for example around the elbows. Moreover, these nodules can be found anywhere in the body such as near the heart and lungs.
- Dry eyes and mouth:
Sjogren syndrome is developed in people with rheumatoid arthritis. It is the condition in which the amount of moisture is reduced in the mouth and eyes.
- Infections:
Many infections can occur due to rheumatoid arthritis itself and medicine used to deal with rheumatoid arthritis. Vaccinations should be done to avoid other infections in the body such as COVID-19, pneumonia, and influenza virus.
- Abnormal body composition:
The composition of the body is disturbed in patients with rheumatoid arthritis as the amount of fat is extra in such patients as compared to normal people. It can also develop in people with normal body mass index (BMI).
- Carpal tunnel syndrome:
If your wrist is damaged with rheumatoid arthritis then the inflammation around the wrist will suppress the nerve that assists your hands and fingers the most.
- Heart problems:
Arteries around the heart can get blocked due to rheumatoid arthritis and inflammation can take place in the sac that covers the heart. This will increase the heart problems such as heart failure.
- Lung disease:
Lung tissues can develop the risk of scarring and inflammation due to rheumatoid arthritis. This inflammation leads to shortness of breath and other respiratory problems.
- Lymphoma:
Lymphoma is increased in patients with severe rheumatoid arthritis. Lymphoma is a condition in which blood cells form cancer and destroy the lymph system.
Treatment for rheumatoid arthritis (2)
No cure is specified for rheumatoid arthritis. But according to clinical studies, the remission phase can be introduced if the treatment has begun early for rheumatoid arthritis. Disease-modifying anti-rheumatic drugs (DMARDs) are recommended for treating rheumatoid arthritis.
Medications used: doctor recommended medications according to the stage and type of severity you have. It also depends on how long you are suffering from rheumatoid arthritis. Medications are given below:
- NSAIDs: are non-steroidal anti-inflammatory drugs that assist in reducing inflammation and pain relief. OVER THE COUNTER NSAIDs include drugs such as:
- Naproxen sodium
- Ibuprofen
Other strong NSAIDs are available only on prescription. Certain side effects are linked with these drugs that include damage to the kidney, heart disease, and irritation in the stomach.
- Steroids: prednisone is the only corticosteroid that is recommended in the case of rheumatoid arthritis. It helps to reduce inflammation and pain and slow the damage to joints. Gain of weight, diabetes, and bone thinning is the side effects that are seen after taking steroids. Steroids are recommended for quick relief to taper off the medication gradually.
- Conventional DMARDs: Drugs recommended from this class slow down the disease progression and secure the joints from permanent damage. Side effects can vary from person to person but mostly liver damage and lung infections are reported. Drugs include:
- Methotrexate
- Leflunomide
- Hydroxy chloroquine
- Sulfasalazine
- Biologic agents: they are also called BIOLOGIC RESPONSE MODIFIERS. Drugs included in this class are:
- Abatacept
- Certolizumab
- Etanercept
- Golimumab
- Infliximab
- Rituximab
- Tocilizumab
- Sarilumab
They work effectively for rheumatoid arthritis when they are given a combination of conventional DMARDs. This combination can increase the risk of certain infections.
- Targeted synthetic DMARDs:
If conventional DMARDs and BIOLOGIC DMARDs won’t work for rheumatoid arthritis then synthetic DMARDs are recommended. Targeted synthetic DMARDs include the drugs:
- Barcitinib
- Tofacitinib
- Upadacitinib
Several side effects are also related to these medications for example tofacitinib increases the risk of cancer, heart disease, and clotting of blood in the lungs.
Surgery:
Surgery is recommended when medications fail. Here are the following procedures of surgery:
- Synovectomy
- Tendon repair
- Joint fusion
- Total replacement of joint
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