What You Should Know About Rheumatoid Arthritis
Rheumatoid Arthritis, also known as “RA” is a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. It is a disabling and painful inflammatory condition, which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles.
The symptoms that distinguish Rheumatoid Arthritis from other forms of arthritis are inflammation and soft-tissue swelling of many joints at the same time, also known as polyarthritis.
The joints are usually affected initially asymmetrically and then in a symmetrical fashion as the disease progresses. The pain generally improves with use of the affected joints, and there is usually stiffness of all joints in the morning that lasts over 1 hour. Thus, the pain of rheumatoid arthritis is usually worse in the morning compared to the classic pain of osteoarthritis where the pain worsens over the day as the joints are used.
As Rheumatoid Arthritis progresses the inflammatory activity leads to erosion and destruction of the joint surface, which impairs their range of movement and leads to deformity. The fingers are typically deviated towards the little finger and can assume unnatural shapes. Classical deformities in Rheumatoid Arthritis are the Boutonniere deformity and swan neck deformity.
The thumb may develop a “Z-Thumb” deformity with fixed flexion and subluxation at the metacarpophalangeal joint, leading to a “squared” appearance in the hand.
Rheumatoid Arthritis occurs most frequently in the 20-40 age group, although can start at any age. It is strongly associated with the HLA marker DR4. Hence family history is an important risk factor. The disease is 3 times more common in women than men and up to 4 times more common in smokers than non-smokers.
The cause of Rheumatoid Arthritis is still unknown to this day, but has long been suspected to be infectious. It could be due to food allergies or external organisms. Mycoplasma, Erysipelothrix, Epstein-Barr virus, parvovirus B19 and rubella have been suspected but never supported in epidemiological studies.
Pharmacological treatment of Rheumatoid Arthritis is divided into disease- modifying antirheumatic drugs, anti-inflammatory agents and analgesics. Disease- modifying antirheumatic drugs have been found to produce durable remissions and delay or halt disease progression. This is not true of anti-inflammatories and analgesics.
Common disease-modifying antirheumatic drugs used to treat RA include Humira, Remicade and Enbrel.
Typical anti-inflammatory agents include Glucocorticoids and non-steroidal anti- inflammatory drugs. Analgesics include Acetaminophen, Opiates and Lidocaine. Other therapies include weight loss, occupational therapy, physiotherapy, joint injections, and special tools to improve hard movements. Severely affected joints may require joint replacement surgery, such as knee replacement.
However, when drugs and surgery compound problems of rheumatoid arthritis rather than solve them, many people find relief by making consistent, lifelong changes to diet and lifestyle. Many natural healing practitioners attribute rheumatoid arthritis to toxemia, which can be caused by several things, including but not limited to the many poisons that enter our systems through food, air, and skin.
The course of the disease varies greatly from patient to patient. Some patients have mild short-term symptoms, but in most the disease is progressive for life.