What Causes Juvenile Idiopathic Arthritis
Like adult rheumatoid arthritis, JIA is an autoimmune disease. This means the body’s immune system attacks its own healthy cells and tissues. JIA is caused by several things. These include genes and the environment. This means the disease can run in families, but can also be triggered by exposure to certain things. JIA is linked to part of a gene called HLA antigen DR4. A person with this antigen may be more likely to have the disease.
Transcutaneous Electrical Nerve Stimulation
This form of therapy uses low-voltage electric currents to stimulate nerves and interfere with pain pathways. TENS is usually used for stubborn, chronic pain and not as a first-line treatment for RA, Ali says. One of the benefits of this treatment is the low occurrence of side effects. If youre interested in trying TENS for pain relief, talk with your physical therapist. If you have a pacemaker, a heart problem, or epilepsy or youre pregnant get your doctors approval first before trying TENS.
Tips For Rheumatoid Arthritis Pain Management
Other than the pain itself, rheumatoid arthritis can cause many other problems and disruptions in life. There are some things you can do to stay healthy and reduce your pain. These are in addition to your regular treatments.
Here are some tips to help you with your rheumatoid arthritis pain management and coping with the disease:
Dont smoke: Smoking can have serious health consequences on rheumatoid arthritis patients. Smoking causes inflammation, which can complicate these disease and cause more pain.
Be conscious of your use of joints: Try reducing the stress on your joints by being conscious of your daily activities. Picking up items and turning door handles can add pressure to your joints causing them to feel sore. Look for ways to adjust your daily habits and limit the aggressive use of your joints.
Talk to your doctor and rheumatologist: If you still feel pain despite treatment, or you notice new pain, be sure to communicate with your physician and your rheumatologist. There may be additional pain relieving options available.
Seek emotional support: Deal with any stress or trauma you may feel by joining a support group of other rheumatoid arthritis patients. Professional counseling may also help improve your mood and help you to remain positive.
If you continue to experience chronic pain, there are several options for you to try. Talk to your rheumatologist about rheumatoid arthritis pain management options that are right for your individual case.
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Shortness Of Breath Or Coughing
The lungs are often affected in people diagnosed with rheumatoid arthritis. Lung conditions may cause coughing, shortness of breath, and chest pain. Rarely, these conditions become life-threatening.
- Interstitial lung disease is an umbrella term used to describe many disorders that cause scarring of the walls of the lungs and certain nearby structures. In people with RA, scarring is typically caused by chronic inflammation. The initial symptoms of interstitial lung disease typically include shortness of breath and a cough.
- Pleural effusion, also called pulmonary effusion or water on the lungs, occurs when fluid collects in the chest cavity outside the lungs. Pleural effusion can cause sharp chest pain, coughing, and shortness of breath. It may be noticeably more difficult to breathe when lying down.
nodules in the lungs typically have no symptoms but may increase the risk for potentially life-threatening conditions, such as a collapsed lung.5,6Rheumatoid nodules in the lungs are rare and account for less than 1% of all rheumatoid nodules.
The chances of developing lung conditions related to RA are increased by smoking.
What Does It Mean If Your Family Member Has Rheumatoid Arthritis
According to the National Rheumatoid Arthritis Society , first-degree relatives of a person with RA are three times more likely to develop the condition than first-degree relatives of people who dont have RA.
Genetic factors may be involved in 53% to 68% of the causes of RA. Researchers calculated this estimate by observing twins. Identical twins have the same genes.
According to NRAS, about 15% of identical twins are likely to develop RA. In fraternal twins, who have different genes like other siblings, the number is 4%.
two to three times more likely to develop RA than people assigned male at birth.
People assigned female at birth who have RA usually receive a diagnosis between ages 30 and 60. Researchers attribute this number to female hormones that may contribute to developing RA.
People assigned male at birth usually receive a diagnosis later, after the age of 45, and the overall risk increases with age.
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Associations Of Parental Rheumatoid Arthritis With Mental Disorders In Offspring
Table shows the demographic characteristics and prevalence of mental disorders among the parents and the offspring of parents with or without RA. Our results showed no coincidence of RA in both parents. Comparing 23,981 parentchild pairs in the RA-parentchild cohort with 239,810 parentchild pairs in the non-RA-parentchild cohort demonstrated no significant differences in income and urbanization between the two cohorts. However, preliminary analysis showed significantly higher prevalence of ASDs , ADHD , bipolar disorder and major depressive disorder in offspring of parents with RA compared with that in offspring of parents without RA but such an association was not observed between parental RA and schizophrenia in offspring .
How Is Juvenile Idiopathic Arthritis Treated
The goal of treatment is to reduce pain and stiffness, and help your child keep as normal a lifestyle as possible.
Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is.
Treatment may include medicines such as:
Nonsteroidal anti-inflammatory medicines , to reduce pain and inflammation
Disease-modifying antirheumatic medicines , such as methotrexate, to ease inflammation and control JIA
Corticosteroid medicines, to reduce inflammation and severe symptoms
Medicines called biologics that interfere with the bodys inflammatory response. They are used if other treatment isnt working.
Talk with your childs healthcare provider about the risks, benefits, and possible side effects of all medicines.
Other treatments and lifestyle changes may include:
Physical therapy, to improve and maintain muscle and joint function
Occupational therapy, to improve ability to do activities of daily living
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People With Rheumatoid Arthritis Have Nearly A 50 Percent Greater Risk Of Developing Cardiovascular Disease Knowing The Different Factors That Can Affect Your Heart Disease Risk Is The First Step In Lowering It
Check out A Patients Guide to Understanding Rheumatoid Arthritis and Heart Disease for more information on this topic.
For people with rheumatoid arthritis , swollen and painful joints are often the most obvious and challenging symptoms. Even if you sometimes develop random fevers, fatigue, or other RA symptoms, you still likely think of RA as a joint condition.
But the truth is that this inflammatory disease can do far more than just damage your joints, especially if it is not well-controlled. Rheumatoid arthritis causes inflammation throughout your body, which can impact many different organs and systems.
In particular, rheumatoid arthritis-related inflammation can impact the heart and blood vessels, raising the risk of cardiovascular disease in RA patients.
Numerous studies have examined the connection between RA and cardiovascular disease, and the findings can sound alarming. According to an analysis of several earlier studies, RA patients have, on average, nearly a 50 percent higher risk of developing CVD compared to the general population. They also have a 50 percent greater chance of dying from it making heart disease one of the leading causes of death for people with RA.
Whats more, many people with rheumatoid arthritis are not aware of this link between RA and their heart.
While this information is certainly scary, the news isnt all bad.
Step one: Learn more about how and why RA impacts your cardiovascular system.
An Overall Model Of Ra Development
Based on available data it is likely that RA develops as described in Fig. 1 , where initially genetic, environmental and perhaps stochastic factors combine to initiate autoimmunity. Once an initial break in tolerance has occurred, over time, and influenced by ongoing factors that include the same or perhaps additional genetic and environmental factors, autoimmunity evolves to a more pathogenic stage. This state is manifested by expansion of autoreactive T and B cells, epitope spreading, increases in inflammation, up-regulation of signalling molecules, increases in autoantibody levels and alterations of autoantibodies pathogenicity such as changes in glycosylation rendering them more capable of inducing disease. Ultimately, tissue injury occurs to a sufficient degree that the clinical symptoms and signs of RA develop.
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How Is Rheumatoid Arthritis Treated
Joint damage generally occurs within the first two years of diagnosis, so its important to see your provider if you notice symptoms. Treating rheumatoid arthritis in this window of opportunity can help prevent long-term consequences.
Treatments for rheumatoid arthritis include lifestyle changes, therapies, medicine and surgery. Your provider considers your age, health, medical history and how bad your symptoms are when deciding on a treatment.
Whats The Connection Between Rheumatoid Arthritis And
The relationship between catastrophizing and pain was explored in a 30-day daily pain diary study, which found catastrophizing to be associated with more accurate recall of pain intensity . The authors suggest that this may be due to an increase in somatic awareness or exaggeration of actual and recalled pain, which can affect the effectiveness. Rheumatoid arthritis and lupus are autoimmune diseases.They result from your immune system mistakenly attacking your own body. With RA, your immune system mainly goes after your joints
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What Are The Complications Of Juvenile Idiopathic Arthritis
Nearly half of all children with JIA recover fully. Others may have symptoms for years. Some will have rashes and fever. Others may have arthritis that gets worse. Problems may include slow growth and thinning bones . In rare cases, there may be problems with the kidneys, heart, or endocrine system.
Early Life Environmental Factors
The genetically determined risk of developing RA is set and at present unalterable. This is not true for environmental factors, which may vary over life in type and intensity. For example, during fetal life and infancy, sufficient nutrition is vital to ensure healthy growth and development of the immune system. During infancy and early childhood, infectious exposures have a major effect on shaping the immune repertoire, whereas exposure to smoking and occupational exposures are likely to come later in life. An understanding of the variation in the exposures experienced during life encourages greater sophistication in our studies of environmental risk factors. One result of this has been closer scrutiny of the effect of environmental factors experienced throughout life. In particular, it has stimulated an interest in the effects of early life environmental factors on the development of RA.
In a similar fashion, several pieces of evidence support the importance of early exposure to environmental factors in RA. The first is that juvenile idiopathic arthritis , including the RA-like phenotype, can be seen in children. This suggests that environmental factors of importance are present in childhood. In addition, markers of the immunopathology of RA, including RF, ACPA and raised high-sensitivity C-reactive protein , are present many years before the onset of clinically apparent disease .
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What Is The Safest Drug For Rheumatoid Arthritis
The safest drug for rheumatoid arthritis is one that gives you the most benefit with the least amount of negative side effects. This varies depending on your health history and the severity of your RA symptoms. Your healthcare provider will work with you to develop a treatment program. The drugs your healthcare provider prescribes will match the seriousness of your condition.
Its important to meet with your healthcare provider regularly. Theyll watch for any side effects and change your treatment, if necessary. Your healthcare provider may order tests to determine how effective your treatment is and if you have any side effects.
Breastfeeding And Bottle Feeding
Australian guidelines recommend exclusive breastfeeding for babies to around six months of age. Breastfeeding is then recommended to continue alongside suitable foods for infants until 12 months or age and beyond, for as long as the mother and child wish.
Whether to breastfeed or not, or for how long, is a very personal decision. Even mothers without arthritis can have issues that can prevent breastfeeding, or make it very difficult.
There are usually no physical reasons that prevent women with arthritis from breastfeeding, apart from possible discomfort if you and your baby are not positioned correctly during feeding. You can get advice on this from your child health nurse or lactation consultant at your local hospital. The choice to either breast or bottle feed your baby will depend on many factors, such as your milk supply, your baby and the medications you are taking.
Breastfeeding and medications
Many arthritis medications are safe to take during breastfeeding as they do not pass into breast milk, or only in very low levels that are safe for the baby. Others can pass into your breast milk and will not be safe for your baby. Talk to your healthcare team, including your rheumatologist, about your plans for breastfeeding so that the best treatment plan, for both you and your baby, can be put into action when your baby is born.
See the table above for a summary of the safety of arthritis medications during breastfeeding.
Breastfeeding and joint pain
Here are some tips:
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How Long Do Ra Flares Last
The length of time an RA flare lasts can vary widely, from a few hours to several days or weeks. If a flare does not improve after 7 days, it may be a good idea to contact a physician. The doctor may suggest adjusting the persons medication.
Before a RA flare begins, a person may experience fatigue or feel that something is not quite right.
During a flare, symptoms tend to increase until they reach their peak. As the peak passes, the symptoms will lessen and may completely disappear.
The frequency and severity of flares can vary widely between individuals. With treatment, a person may spend months or years in remission, while others may experience flares more frequently.
RA flares can be predictable or unpredictable. A flare will occur when something triggers an increase in disease activity, which means that levels of inflammation go up.
Predictable flares usually occur in response to one or more triggers.
Some flares have no apparent trigger, and a person may be unable to identify why it started. This can make them harder to avoid.
In 2017, a involving 274 people with RA who attended a clinic in Turkey found the following appeared to worsen their symptoms:
- emotional or physical stress
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Surprising Triggers Of Chronic Hives
You already knew that heat can trigger hives, but did you know that tooth decay and stress can, too?
For most healthy people, an outbreak of hives is as worrisome and temporary as catching a cold. But for those who have chronic hives, or urticaria, the condition can seem relentless.
Chronic idiopathic hives are itchy red welts that persist for at least six weeks and have no known cause, says Miriam Anand, MD, an allergist with Allergy Associates and Asthma in Tempe, Arizona. The condition is marked by periods of exacerbation and remission, and for many who have it, the hives may persist for more than five years.
If you have chronic hives, its important to try to identify your triggers, if possible, and take steps to avoid them so you can lower the risk of an exacerbation. While you may already be aware of common triggers, such as allergies to pollen, pet dander, and shellfish, here are some lesser-known triggers of chronic hives:
1. Tooth decay and other infections
Heres an additional reason to brush, floss, and see your dentist regularly: In a study published in April 2013 in the journal Advances in Dermatology and Allergology, researchers found that tooth decay and several other infections can play a significant role in the development of chronic hives. Bacterial infections and viral infections were also found to be triggers of chronic hives.
2. Working out
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How Your Ra Treatment Plan Prevents Disease Progression
Perhaps the biggest factor that affects how RA progresses is if youre in treatment with a specialist who can put you on medications to slow the disease. Being on a DMARD or biologic therapy for RA is the best way to prevent progression, Dr. Lally says.
Disease-modifying anti-rheumatic drugs are usually the first line in medication. Methotrexate is the anchor drug for rheumatoid arthritis, Dr. Bhatt says. Some patients are scared because methotrexate is also used for cancer chemotherapy so they dont want to take a chemo pill, but those we use for RA are a very small dose with lesser chance of side effects. Your doctor will reassess in a month or so and see if its necessary to add in other drugs.
If after three to six months they have still not responded then we progress to medications called biologics, Dr. Bhatt says. These genetically engineered drugs target the inflammation process specifically, and are usually self-injected or infused via IV in your doctors office or a medical center. There are sub-classes and different types, Dr. Bhatt says. Your doctor will try various medications to see which you respond best to.
Ra Progression Isnt Inevitable
Thanks to the newer treatments available and more on the horizon RA doesnt have to mean a life of eventual disability or even limited mobility. Its not an inevitable thing nowadays, says Dr. Bhatt. People can have a normal life.
But patients do have to be sure to follow their treatment plan and doctors recommendations. Routine follow-up with a rheumatologist who performs joint exams, follows levels of systemic inflammation in the blood and can assess function is the best way to ensure RA is being controlled and is not progressing, Dr. Lally says.
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