What Are The Goals Of Treating Rheumatoid Arthritis
The most important goal of treating rheumatoid arthritis is to reduce joint pain and swelling. Doing so should help maintain or improve joint function. The long-term goal of treatment is to slow or stop joint damage. Controlling joint inflammation reduces your pain and improves your quality of life.
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A Potential Biological Link
It turns out there may be a direct, biological connection between depression and RA.
The pain and joint damage of RA comes, in part, from inflammation. And theres evidence of a link between inflammation and depression. Levels of C-reactive protein , one of the ways researchers measure inflammation, are often higher in people with depression. A 2018 study found that CRP may be significantly higher in those whose depression is hard to treat.
Its too early to say that inflammation is a reason why many people experience both conditions. But the potential link is an important new focus of research.
The coexistence of mental illness with forms of arthritis is well-known, but people living with RA arent always screened. This can lead to untreated mental health conditions.
The study in the British Journal of General Practice noted that people may begin to think of their depression or anxiety as normal. They may also think doctors place more importance on treating the physical symptoms of RA rather than potentially related mental health conditions.
Some people may be nervous to discuss their mental health or concerned that their doctor may dismiss their mental symptoms. But finding the resources to manage your mental health effectively is vital to your overall well-being. Whether you speak to your doctor, seek out a therapist on your own, or contact a support group, there are many options to help you address your mental health.
Does Stress Make Rheumatoid Arthritis Worse
Stress and rheumatoid arthritis are linked. When people experience stressful events, they can have a physical reaction called the flight, fight, or freeze response. This is when the body releases chemicals that can cause an immune or inflammatory response, especially if stress happens too often or lasts too long without relief. This immune or inflammatory response can lead to RA or increased symptoms of RA.
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Common Causes Of Anxiety
Patients diagnosed with arthritis or other diseases with chronic pain as a primary symptom may have worries and fears over many aspects of disease management. Here is a brief list of common things that arthritis patients have told us they worry about:
- Medication and treatment: Whether they are working now, will continue to work in the future, will have side effects, and whether they will be painful.
- Financial stress: What insurance will or wont cover the costs of treatments and specialists extra money spent on other aspects of disease management.
- Social concerns: Feeling lonely and isolated, losing friends, letting down loved ones, missing out on important activities and events, being pitied or babied, and people not understanding limitations and feelings.
- Personal changes: Losing a career or job, having to stop beloved hobbies, not being able to properly care for children or pets, and coping with mental health and mood changes.
- Meta worries: What the future will be like, potential disability, shortened lifespan, long-term care, lowered self-esteem, and chronic pain.
What Can Cause Hip Arthritis To Flare Up
The hip joint is a ball-and-socket joint and is one of the largest joints in the human body. The sections of bone in the joint are protected by cartilage, which is a tough, smooth tissue designed to absorb shock, reduce friction, and allow the bones to glide together smoothly. When the cartilage wears down, this causes arthritis due to bone-on-bone rubbing.
If you have hip arthritis, you know that some days can be better than others. When arthritis symptoms such as pain, stiffness, and swelling become worse or more intense, this is known as a flare-up.
A flare-up can come on unexpectedly and can take a toll on your lifestyle. Lets talk about what can cause hip arthritis to flare up, and where you can go for an orthopedic evaluation and treatment that reduces or eliminates your hip pain.
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When To Seek Help
If youre able to manage your RA with medications and lifestyle choices, you may only need to see your doctor for regular checkups. If your symptoms change or if flare-ups are becoming more frequent or more severe, see your doctor soon. Dont wait months for your next appointment.
Keep your doctor informed about your health. If youve started taking a new medication and suspect its interfering with your sleep, for example, tell your doctor. Your doctor may be able to recommend changes to your routine or healthcare plan that can have positive impacts on your health and the management of your RA.
Stress is a physical and psychological reaction to stimuli. Everyone experiences some stress at times. The burst of hormones produced when youre confronted with a threat triggers the fight-or-flight response. A little stress is part of a normal, healthy life. But too much stress or an inability to handle stress can be harmful.
Whats The Normal Sed Rate For Rheumatoid Arthritis
Sed rate is a blood test that helps detect inflammation in your body. Your healthcare provider may also use this test to watch how your RA progresses. Normal sed rates are as follows:
|People designated male at birth||Erythrocyte sedimentation rate|
|> 50 years old||30 mm/hr|
In rheumatoid arthritis, your sed rate is likely higher than normal. To take part in clinical trials related to rheumatoid arthritis, you usually need an ESR of 28 mm/hr. With treatment, your sed rate may decrease. If you reach the normal ranges listed above, you may be in remission.
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What Types Of Lifestyle Changes Can Help With Rheumatoid Arthritis
Having a lifelong illness like rheumatoid arthritis may make you feel like you dont have much control over your quality of life. While there are aspects of RA that you cant control, there are things you can do to help you feel the best that you can.
Such lifestyle changes include:
When your joints are inflamed, the risk of injury to your joints and nearby soft tissue structures is high. This is why you need to rest your inflamed joints. But its still important for you to exercise. Maintaining a good range of motion in your joints and good fitness overall are important in coping with RA.
Pain and stiffness can slow you down. Some people with rheumatoid arthritis become inactive. But inactivity can lead to a loss of joint motion and loss of muscle strength. These, in turn, decrease joint stability and increase pain and fatigue.
Regular exercise can help prevent and reverse these effects. You might want to start by seeing a physical or occupational therapist for advice about how to exercise safely. Beneficial workouts include:
- Range-of-motion exercises to preserve and restore joint motion.
- Exercises to increase strength.
- Exercises to increase endurance .
Stretch Out Your Joints Daily
Exercise doesnt have to be an all-or-nothing thing. In fact, having that mentality can make exercise more stressful. For Elizabeth this means skipping long runs and formal yoga classes in favor of taking a walk and doing some full-body stretches at home. It keeps her limber, her joints flexible and lubricated, and, most importantly, reduces her stress. You could start with a short gentle yoga routine at home or try some water exercises at your local pool.
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What Medications Treat Rheumatoid Arthritis
Early treatment with certain drugs can improve your long-term outcome. Combinations of drugs may be more effective than, and appear to be as safe as, single-drug therapy.
There are many medications to decrease joint pain, swelling and inflammation, and to prevent or slow down the disease. Medications that treat rheumatoid arthritis include:
Non-steroidal anti-inflammatory drugs
Biologics tend to work rapidly within two to six weeks. Your provider may prescribe them alone or in combination with a DMARD like methotrexate.
Finding The Silver Lining
What is this teaching me? This is a question I often ask myself. We cant control stressful events, but we can try to control how we react. What we give our time and energy to matters. Something trivial may not matter weeks or years down the road.
The way we react is catalyst to whether we allow our emotions to overstay their welcome or if we allow ourselves to feel it to heal.
When I was diagnosed over a decade ago, I remember the medical staff handing me pamphlets on exercise, diet, and lifestyle changes. Emotional stress wasnt outwardly asked but I was offered social work services as an option. It wasnt mandatory back then as everyone has freewill to decide if they want to talk to someone, but I wish it was.
There tends to be a stigma placed around talking to a therapist that makes people hesitant in seeing one in the first place. At the time I felt very overwhelmed and bombarded with everything thrown at me that the thought of adding in another task made my stress worse.
For me clarity came in the form of daily prayer, meditation, a set routine, and honing-in on spiritual practices. Being open with my struggles through writing and members of the arthritis community, has opened a window of healing too.
However, I have found that when a rheumatologist is willing to be your co-worker and ally, when it comes to your health, emotional stress lessens.
Below I will share some tips that have helped me and hopefully can do the same for you or a loved one in need.
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Implement A Bedtime Routine
Chronic pain and sleeplessness can turn into a vicious cycle fast and nothing is more stressful than insomnia. To make sure she gets enough sleep Meghan has developed a bedtime routine that helps her make sure her body is prepped to fall asleep and stay asleep. What routine works best for you will vary but it may include things like a warm bath, a heating pad, a special pillow set-up, a half-hour of quiet reading, meditation, or whatever else makes you feel calm.
Symptoms Of Stress Induced Arthritis
If you suffer from this form of arthritis, you will experience symptoms that are common to other types of arthritis. Stiffness in your joints, painful and swollen joints and morning stiffness are common. You may also get tired easily and have fever from time to time. Other symptoms of this condition are unexplained loss of appetite, weight loss, numbness and tingling of limbs and insomnia. Anxiety attacks and difficulty in breathing are also common.
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Investing In Quack Cures
A quack cure is essentially hope in a bottle, an unproven remedy that is ineffective at best and potentially harmful at worst. It is a waste of time and money, especially if you abandon the prescribed treatment from your rheumatologist in favor of the unproven remedy that is cloaked in deception. You risk making your RA worse.
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Chronic Ra Is Overwhelming
Being sick is unpleasant. The symptoms are uncomfortable and often interfere with daily life. Pain and fatigue can mean missing out on fun activities and lost time from work, which can translate into less time spent with friends and family and lower-income.
Chronic disease means the symptoms are long-term, and so are the adverse effects. There is no cure for rheumatoid arthritis, which means it is a lifelong condition. Living with a lifelong condition, especially when the symptoms interfere with daily life, can be overwhelming.
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When To See A Doctor About A Flare
If youre experiencing joint pain that flares up from time to time, Dr. Alam recommends being evaluated.
For many people, arthritis starts as a flare-up, and its important to seek a diagnosis. Remember, you need to know the specific type of arthritis youre suffering from to be able to prevent or alleviate future flare-ups, says Dr. Alam.
For instance, you wont know whether to use ice or heat to relieve your joint pain unless you know if its rheumatoid arthritis or gout as opposed to osteoarthritis.
In addition, and particularly for rheumatoid arthritis, seeking a diagnosis early on gives you a better chance of avoiding the permanent joint damage this condition can cause, explains Dr. Alam.
And even if youve been diagnosed, there are still times you may need to see your doctor about a flare-up.
Its very important to call your doctor if youre experiencing pain in a new joint or if your flare-up is severe, since this could be a sign of arthritic infection, warns Dr. Alam.
If youre experiencing a mild flare-up in a joint youre used to experiencing pain, your doctor may be able to help you manage that pain by prescribing medications over the phone but only if he or she is already familiar with you and your condition.
Lastly, Dr. Alam recommends approaching supplements with skepticism.
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How Stress And Arthritis Affect Each Other
Stress affects your illness in two major ways, according to a meta-analysis of 10 studies on the relationship between stress and arthritis, published in the journal Arthritis Research and Therapy. Stressful events work on a physical level, increasing levels of the hormone cortisol in your body. This then triggers the immune system hyperactivity that is the hallmark of inflammatory types of arthritis while also reducing your immune systems ability to fight off harmful germs. Stress also affects you on a mental level, making you less resilient and able to deal with the symptoms of your disease. When our patients say that stress worsens their disease, they may be correct, the researchers concluded.
Fortunately, you can manage this vicious cycle of stress and its impact on managing arthritis. Here are some tips from Dr. Larsen and from fellow arthritis patients on how they cope with stress to minimize its impact on their arthritis.
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Let Others Know What They Can Expect From You
Letting down loved ones is high on the list of anxieties people with arthritis have. One way to ameliorate this is to be open with them, Lawrence says. Communicating with others about what you feel and experience is important for people in your life to understand what you are going through and be able to be supportive, she explains. There may be times when you dont quite act like yourself and it will be helpful for others to understand and youll worry less about what theyre thinking. Consider sharing this article about the truth of what living with arthritis is really like.
Understanding The Role Of Emotions
Researchers say such findings point to the need for more studies about exactly how stress and worrying impacts the disease process. One presumption is that stress leads to changes in the functioning of the autonomic, neuroendocrine and/or immune systems. Another possible explanation is because worrying affects emotional well-being and behaviour, it could lead to less treatment adherence.
Despite the growing evidence that emotional stress can affect the immune system, explaining the effect can be difficult due to the subjectivity of stress and peoples response to different stressors.
While the medical community continues to search for answers, there is no question patients with the tendency to worry extensively can be helped with psychological interventions like cognitive-behavioural therapy.
For tips on how to deal with stress read Best stress relievers for RA
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Can Food Allergies Or Sensitivities Trigger Or Aggravate Rheumatoid Arthritis
As early as 1993, some rheumatologists acknowledged that There are now sufficient good scientific studies, from the UK and abroad, to suggest that, at least in some patients with RA, dietary therapy may influence at least the symptoms and possibly the progression of the disease.
Recent scientific data shows that 3 of every 4 rheumatoid arthritis patients who eat foods that they are allergic to, experience significantly more stiffness, pain, tender and swollen joint counts, higher Ritchieâs articular index, sedimentation rate, C-Reactive Protein levels as well as higher TNF-alpha and IL-1 alpha levels.
Surprisingly, 1 out of 5 rheumatoid patients whose test results did not detect a food allergy still had worse pain when they ate certain foods.
In addition, several physicians of nutritional medicine or integrative medicine write that food allergies are one of the causes of rheumatoid arthritis.
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Exploring The Connection Between Stress And Autoimmune Disease
In this new study, researchers analyzed more than 100,000 people diagnosed with stress-related disorders and compared their tendency to develop autoimmune disease at least one year later with 126,000 of their siblings, and another million people who did not have stress-related disorders.
The study found that individuals diagnosed with a stress-related disorder
- were more likely to be diagnosed with an autoimmune disease
- were more likely to develop multiple autoimmune diseases
- had a higher rate of autoimmune disease if younger.
*Patient-years is an expression that combines how many and for how long people are assessed in a study. If the frequency of a condition is 9 per 1,000 patient-years, that means 9 people would develop the disease among ,1000 patients monitored for 1 year, or among 500 patients monitored for 2 years, and so on).
A particularly important observation was that, for those with PTSD who were being treated with an SSRI , the increased rate of autoimmune disease was less dramatic. While these observations are intriguing, they dont tell us why or how a stress-related disorder might provoke or cause autoimmune disease.
- By Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing
A new study has raised the possibility that stress may cause autoimmune disease, such as lupus or rheumatoid arthritis, because it found a higher incidence of autoimmune diseases among people who were previously diagnosed with stress-related disorders.
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