What is Rheumatoid arthritis?
Rheumatoid Arthritis (RA) is an autoimmune disease which affects about 1.5 million individuals in the United States.
It occurs when a person's immune system that normally functions by attacking foreign substances such as bacteria & viruses, mistakenly attacks the joints and creates inflammation.
The tissues lining inside the joints start to thicken which results in pain and swelling around the joints.
When the inflammation goes unchecked, it damages the cartilages covering the ends of the bones.
Over time, it results in complete loss of cartilage, causing pain in the joints and thus affecting mobility.
Such damage to the joints cannot be reversed but when diagnosed early, aggressive treatments may help.
What are the first signs of rheumatoid arthritis?
Joint pain and stiffness are the main signs of RA.
There are a few warning signs, especially those specific to joint pain that is indicative of RA, particularly if either or both joints are affected.
Given below is a list of some warning signs of RA:
- Fatigue
- Slight fever
- Weight loss
- Stiffness
- Joint pain
- Joint tenderness
- Joint swelling
- Joint redness
- Joint warmth
- Numbness & tingling
- Trouble bending the wrist back and forth
- Joints affected on both sides
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What is the main cause of rheumatoid arthritis?
RA is an autoimmune disease caused by the body's immune system mistakenly attacking the healthy body tissue.
Various theories attempt to explain why the immune system starts to attack the joints, although none have been proved.
The following are some of the risk factors for RA:
Genes: There's evidence that RA can run in the families but the risk of inheriting it is thought to be low since genes are only thought to play a very small role.
Hormone: RA is more prevalent in women than men, which indicates the role of estrogen hormone (although this association has not been proven yet)
There is also some evidence that smoking increases the risk of RA.
What is the rheumatoid factor?
Rheumatoid factor test is a blood test primarily used to diagnose RA. Â
Rheumatoid factors are the proteins synthesized by the immune system which attacks healthy tissues in the body in the blood.
The amount of rheumatoid factors in the blood is measured by the rheumatoid factor test.
During the test, a small sample of blood is drawn from a vein in one's arms and sent to the laboratory for getting tested.
A positive rheumatoid factor test result indicates that the level of rheumatoid factor in the blood is high.
But it is important to note that for some people with RA, the levels of rheumatoid factor in the blood might be low; it might also be high in some healthy people without the disease.
A high rheumatoid factor level is associated with rheumatoid arthritis and a number of other diseases like cancer, sarcoidosis, chronic infections, Sjogren's syndrome, lupus, etc.
How long does someone live with rheumatoid arthritis?
Due to the vast number of unpredictable variables involved in RA, the life expectancy of an affected person can be difficult to calculate.
Research emphasizes that it is not the disease itself that reduces a patient's life expectancy, but it is the varying complications which can shorten the life expectancy.
It can sometimes cause respiratory and cardiovascular conditions that might lead to a shortened lifespan and eventually even become fatal.
In general, it is believed that RA shortens life expectancy by about 10-15 years. Â
Where does rheumatoid arthritis usually start?
The symptoms of RA usually come and go, and might progress over a period of weeks or months.
Fatigue is the first sign of RA and is usually experienced before the onset of other symptoms.
Fatigue could be accompanied by depression or a feeling of ill health.
One could also experience morning stiffness, joint stiffness, joint pain, fever, minor joint swelling, decrease in range of motion, numbness & tingling, weight loss, difficulty in sleeping, dry mouth, loss of appetite, eye discharge, etc during the early stages of development of the disease.
Is rheumatoid arthritis curable?
There isn't any known cure for RA currently.
A healthy diet, appropriate rest, regular physical activity and stress management can help improve the quality of life among RA patients.
OTC medications and complementary treatments are also available for relieving pain and reducing inflammation.
Let’s take a look at some of the options:
- Topical medicines that help ease symptoms, prevent joint damage and lessen the manifestation of RA. Topical gels, creams, and lotions that can be rubbed onto the skin to help relieve pain in the joints. They also come in forms of sprays and patches.
- Aspirin or NSAIDs like naproxen, ibuprofen, Anaprox, Celebrex, Daypro, Disalcid and Feldene could provide temporary relief for inflammation and pain.
- Targeted medications such as oral corticosteroids, hydroxychloroquine, minocycline, methotrexate, and sulfasalazine are used to treat RA.
- Fish oil supplements can help reduce stiffness and pain due to RA.
- Plant oils are thought to reduce morning stiffness and pain linked to RA. Evening primrose oil containing gamma-linolenic acid might also provide some pain relief.
- Heat & cold packs can be applied over inflamed joints to help ease swelling.
- Assistive devices like splints, braces, neck collars, canes, crutches, etc can help RA patients remain mobile.
- Reconstructive surgery like synovectomy can help repair damage to tendons and relieve pressure on the nerves and remove inflamed joint linings.
- It has been proven that Tai Chi improves joint functionality in RA patients.
At what age does arthritis usually start?
Most commonly, arthritis usually starts between ages 30-50. However, it might be surprising to learn that individuals of any age including children can get arthritis.
Younger people who suffer joint pain, swelling or stiffness might not even consider arthritis to be the cause.
What is end-stage rheumatoid arthritis?
At the end stage of RA, the inflammatory process stops and joints cease to function altogether.
The main symptoms of this stage are pain, swelling, stiffness, and loss of mobility.
Can you inherit rheumatoid arthritis?
Usually, people with RA have little to no family history of it.
Many of the genetic areas that are linked to RA are also associated with other autoimmune diseases like lupus, celiac disease, inflammatory bowel disease, etc.
However, the following two genes are reported to be involved with the development of RA:
The HLA-DRB1 gene: The strongest known genetic risk factor associated with an increased risk for developing RA.
It has been observed that those who possess variants of this gene and also smoke might be at a higher risk of developing RA.
The PTPN22 gene: Though there isn't much clarity about how this gene predisposes one to autoimmune diseases, it is known to be linked to a stronger likelihood of developing RA.
How quickly does rheumatoid arthritis develop?
RA typically begins in an insidious manner with signs and symptoms developing slowly over weeks to months.
The patients notice stiffness in joints usually accompanied by pain while moving and tenderness in the joints.
From time to time, patients experience symptoms developing in multiple joints within 24-48 hours.
In another pattern of development, the patients might experience swelling in either or both the joints which may last for a few days to weeks and then completely disappear to return later in some other joints in such a way that it gets worse over time.
What happens if you leave rheumatoid arthritis untreated?
If left untreated, one could experience unfortunate outcomes such as chronic pain, disability, and excess mortality.
About 80-85% of cases could experience joint damage and untreated patients are twice as likely to die compared to normal people their age.
The disease is also associated with higher risks for anemia, lymphoma, osteoporosis, and depression.
How painful is rheumatoid arthritis?
RA can cause pain, swelling, and deformity.
Symmetric pain in multiple joints is a typical symptom of RA and is the symptom that differentiates it from other types of arthritis.Â
One might feel pain in both left and right hands, knees and/or wrists.
Joint pains can range from mild to moderate or even severe.
It can sometimes feel like a sprain or a broken bone.
Certain areas of one's body might even get painful to touch.
Apart from pain, RA also causes stiffness in the joints that are affected, which can make mobility difficult.
What is the most painful type of arthritis?
Gout is the most painful type of arthritis which causes intense pain, swelling, and joint stiffness.
This kind of arthritis is caused by excess uric acid in the bloodstream which crystallizes, causing inflammatory arthritis in the joints that leads to pain.
What causes rheumatoid arthritis to flare-up?
The following are the triggers of RA flare-up:
- Overexertion
- Stress
- Infection
- Poor sleep
- Untreated RA
- Discontinuing RA treatment
Do I have rheumatoid arthritis or fibromyalgia?
Although RA and fibromyalgia share some symptoms, they are both unrelated and have different causes.
While fibromyalgia causes pain, stiffness, and tenderness in connective tissues and muscles throughout the body, RA causes pain, swelling, and tenderness in joints.
Fibromyalgia is a chronic neurological condition, whereas, RA is an autoimmune condition.
Symptoms specific to Fibromyalgia:
- Skin tenderness
- Widespread pain impacting more than a part or half of the entire body,
- Pain in the tissues of torsos, thighs, back, arms, and back of the head
- Gastrointestinal issues like constipation and diarrhea
- Dizziness and headaches
- Restless leg syndrome
- Painful menstrual cycle
- Problems in memory and cognition
- Sensitivity to sounds, temperatures
- Random symptoms that are not easy to communicate
Symptoms specific to RA:
- Fever
- Anemia
- Pain & tenderness impacting only the joints & which is felt equally on both sides of the body
- Severe peripheral joint swelling
What is the best vitamin for rheumatoid arthritis?
Diet plays a vital role in many chronic conditions like RA and it is important that individuals suffering from RA get adequate vitamins, minerals, and other nutrients to help relieve symptoms and lower their risks of complications.
Vitamin D is especially important for RA patients since certain RA medications could put them at risk of vitamin D deficiencies that might lead to other complications.
Since RA is an autoimmune disorder, vitamin D which plays an important role in the immune system might help.
It can also help reduce inflammation.
It is recommended that RA patients get their vitamin D levels checked and take supplements if required.
Other vitamins that help RA patients are:
Vitamin E potent antioxidants that decrease damage to the linings of joints and reduces pain and swelling.
Folic acid & bromelain that have anti-inflammatory & pain-relieving properties.
What is rheumatoid arthritis diet?
It has been identified that RA patients should follow a certain diet that includes certain foods which can help control inflammation.
Here's a list of ideal foods for RA patients:
Omega-3 containing fish like salmon, tuna, sardines, anchovies can reduce a couple of inflammatory proteins like C-reactive proteins (CRPs) and interleukin-6.
Anti-oxidant rich fruits & vegetables like blueberries, strawberries, blackberries, cherries, spinach, broccoli, and kale can support the immune system to fight inflammation.
Monounsaturated fat-rich nuts and seeds such as walnuts, pine nuts, almonds, and pistachios helps fight inflammation and can also help reduce weight since they're rich in protein and fiber.
Pinto, black and red kidney and garbanzo varieties of beans that contain antioxidant and anti-inflammatory compounds.
Onions are rich in beneficial antioxidants which may reduce inflammation and reduce bad cholesterol.
Fibers can lower CRPs that are responsible for inflammation.
Carotenoid-rich foods like carrots, peppers, etc also lower CRP.
Are tomatoes bad for arthritis?
Tomatoes are often thought to make arthritis worse.
This is because it produces a toxin called Solanine which is believed to cause inflammation, swelling and joint pain.
However, there is no known relationship that exists between tomato consumption and arthritis pain.
Is banana not good for arthritis?
Bananas being a rich source of vitamin B-6, folates and vitamin-C can help arthritis patients by aiding the production of collagen that serves as a building block for joints.
They also help in the eradication of joint-destroying free radicals that increase the body's intake of B vitamins that might be depleted by the inflammation caused by arthritis.
However, some websites caution that bananas should be avoided as it aggravates arthritis.
Is coffee bad for rheumatoid arthritis?
Although coffee contains antioxidant polyphenols and is believed to protect against gout, it is also believed that it can increase one's risk for osteoporosis. Thus, it is best to follow the thumb rule of consuming in moderation (not more than a couple of cups daily).
What foods should be avoided with rheumatoid arthritis?
- Saturated fats like red meat, dairy full-fat dairy products, pasta and grain-based desserts which can cause inflammation in fat tissue.
- Omega-6 fatty acids like corn oil, sunflower oil, safflower oil, soy oil, and vegetable oils.
- Trans fats like fried foods, fast foods & processed foods.
- Foods that contain excessive amounts of salt. The ideal quantity is <1500 mg per day
- Sugar: It aids the production of cytokines that kick-start the inflammation process. Avoid fructose and sucrose sugars.
- Alcohol: It doesn't get along with RA medication. NSAIDs can cause stomach ulcers and bleeding which might get worse with alcohol consumption.
- Fried or grilled foods: It can raise AGE (advanced glycation end products) levels in the blood that causes inflammation.
Can rheumatoid arthritis get worse?
Living with RA can be like a rollercoaster ride when symptoms get suddenly good or extremely worse.
There are certain foods, activities or situations that can trigger the symptoms and understanding them can help manage RA.
Some of these triggers include:
- Stress
- Lack of adequate sleep
- Consumption of foods like beef, pork, bacon, wheat, rye, milk, coffee or processed foods.
- Overexertion
- Infections
- Pregnancy
- Smoking
Is exercise good for rheumatoid arthritis?
- Physical activities like stretching, strengthening and aerobic exercises are all vital for managing RA. One can stretch their muscles before performing daily chores like gardening, etc.
- Tai Chi especially is proven to relieve stiffness and improve their balance and strength.
- Low-impact aerobic exercises that put a minimal impact on the affected joints, such as aerobic dance, walking, stationary bicycles, and water exercises are recommended.
- Resistant exercises like machines, elastic bands, and free weights can help strengthen muscles.
- Swimming can also be considered good for RA patients since the water supports the body and limits the amount of stress on the joints and makes muscles stronger.
- Weight-bearing exercises can be helpful for preserving bones.
How can I reduce arthritis inflammation?
Various treatment options are available for inflammatory joint diseases like medications (NSAIDs, corticosteroids, biologic therapy, and narcotic pain relievers), rest, exercise and surgery to correct joint damage.
The prescribed treatment option will depend on factors such as the type of arthritis, the patient's age, medications taken, medical history, overall health, and severity of symptoms.
What is the correlation between rheumatoid arthritis and multiple sclerosis?
Studies suggest that MS diagnosis increases the likelihood of a subsequent diagnosis of RA in patients independent of attributes like age, gender and smoking history.
The findings also suggest that the pain associated with RA limit mobility, physical activity and disrupt normal activity in MS patients.
Also, depression and anxiety that are more prevalent in MS lead to higher disease activity, subclinical atherosclerosis, and mortality in RA patients.
Thus co-occurrence of these two conditions might represent a disease entity that might require aggressive treatment.
What is the correlation between rheumatoid arthritis and Alzheimer's disease?
RA increases one's risk for Alzheimer’s disease.
Although RA is a kind of arthritis affecting joints, it is also a chronic autoimmune disease that promotes the release of cytokines that spreads inflammation throughout the body.
Inflammation can increase the production and deposition of amyloid proteins- that are responsible for Alzheimer’s disease.
It is also suggested that both RA and Alzheimer's require an environmental trigger for genetic predisposition.
A specific cytokine- tumor necrosis factor alpha contributes to both the inflammatory process of RA as well as the development of Alzheimer's disease.
What is the correlation between Rheumatoid arthritis and celiac disease?
Both celiac disease and RA are autoimmune diseases that share comparable environmental influences and associated antibodies.
Pathophysiologically, both of them are mediated by endogenous enzymes in the target organs and both of them share multiple non-HLA loci - the genes that are important for activating and regulating adaptive and innate immunity.
What is the correlation between Rheumatoid arthritis and cystic fibrosis?
RA can cause chronic joint pain and affect other organs like the lungs and cause severe breathing problems.
Also, using anti-inflammatory medication can increase a person's risk of developing pulmonary fibrosis.
Although the link between RA and cystic fibrosis isn't fully understood, it is estimated that about 40% of RA patients have pulmonary fibrosis.
References:
https://www.nhs.uk/conditions/rheumatoid-arthritis/causes/
https://www.ncbi.nlm.nih.gov/pubmed/20205741
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4937922/
https://www.ncbi.nlm.nih.gov/pubmed/26190704
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