Understanding Rheumatoid Arthritis Flares
Get more information about what flares of RA symptoms have shown researchers and how it could help you better communicate with your doctor and manage your condition.
Rheumatoid arthritis is a disease of ups and downs. One day, your joints feel pretty good. The next, swelling and pain ratchet up and you can barely get out of bed. These symptom episodes called flares can be unpredictable and debilitating. Because symptoms differ from person to person, doctors have had trouble agreeing on a standard definition to guide them in treating flares. New RA research hopes to develop tools to help doctors and patients bridge these gaps in understanding.
Understanding Flares Through Research
For the last decade, Clifton O. Bingham III, MD, has been working to make life easier for RA patients who experience flares, and the doctors who treat them. Hes led an international initiative from a group called OMERACT that aims to better understand and identify RA flares.RA patients from around the world were studied through focus groups, interviews and surveys to understand from the patients perspective what flare meant to them and what was involved when they experienced a flare. The concepts that came from this were that flares were a common part of the RA experience, even when the condition was otherwise well controlled, says Bingham, who is director of the Johns Hopkins Arthritis Center and director of research for its Division of Rheumatology.
Flare Types and Triggers
Signs And Symptoms Of Rheumatoid Arthritis
If you suffer from this condition, you will experience prolonged morning stiffness, stiffness of joints following periods of inactivity and warm and swollen joints that are tender to touch. Low-grade fever, listlessness, loss of appetite and weight loss are common too. Some people may also experience dry eyes and mouth. Sometimes, it may cause rheumatoid nodules, which are solid lumps growing under skin of elbows and hands.
How Your Treatment Changes As Ra Progresses
Early stage. A key focus is to control the inflammation. Thatâs especially critical in the early phase of the disease to prevent joint damage. You may get:
- A disease-modifying antirheumatic drug , such as methotrexate
- Nonsteroidal anti-inflammatory drugs , such as aspirin and ibuprofen, for pain
Quitting smoking and losing any extra weight also can help slow your RA.
Moderate stage. This is when you may have trouble with regular daily activities because of pain. You also may tire more easily. There are several options. Your doctor may have you try combining methotrexate with two other DMARD medications, sulfasalazine and hydroxychloroquine. Another option is a stronger form of DMARDs, called biologic DMARDs, including:
If a certain joint is particularly inflamed, your doctor may give the joint steroid shots. Once your pain is under control, itâs important to exercise to keep ahead of your RA. You also may need physical therapy.
Severe stage. If a TNF inhibitor fails to improve your symptoms, your doctor may recommend you try a different TNF inhibitor or a different class of biologic. If you donât respond to one, you may respond to another.
Surgery is a last-resort treatment for very severe RA. That includes when your joints are deformed and damaged and limit your mobility. The three most common surgeries for RA are:
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How To Know If Your Ra Is Progressing
You will know your joints will tell you, Dr. Bhatt says. The pain will get worse and you could have more swelling. Dr. Lally says that although periods of pain may resolve on their own in early RA, these episodes tend to become more frequent and longer in duration until the classic features of RA persist. In addition, Dr. Bhatt says to pay attention to non-joint symptoms like increased shortness of breath or red, painful eyes, which could be signs the RA is affecting other systems in the body. Let your doctor know if your RA symptoms are changing at all.
What Are The 4 Stages Of Rheumatoid Arthritis
RA consists of four stages, each with specific symptoms and treatment goals. Stage 1 is considered early stage RA and includes inflammation inside the joint, leading to swelling of the tissues. You may notice joint stiffness, swelling, or pain.
Stage 2, or moderate stage RA, is characterized by inflammation in the synovium that causes damage to the joint cartilage. This may result in pain, loss of mobility, and range of motion in the affected joint.
Stage 3 is considered severe RA because the damage extends to the bones. You may experience increased joint pain and swelling since the cushion between the bones is gone. Stage four is end stage RA. The joints no longer work because they are fused.
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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.
The Term Paper On Living Through The Pain Of Ankylosing Spondylitis
… widely used and often very effective for the treatment of rheumatoid arthritis. When prescribed for treating Ankylosing Spondylitis, it is … swelling from arthritis of the small joints, but also the intestinal lesions … medication that can be helpful to some people with this severe disease. It is known to effectively control not only pain and joint …
Phillips suggests six changes that will help you live a better life: plan activities in advance so you can avoid excessive physical and emotional fatigue and strain. Reorganize rooms, working areas, and other parts of your home to maximize efficiency and convenience. Try to arrange your tasks so you avoid trips back and forth. Try to avoid carrying items in hands when possible use shopping carts or bags to put less stress on your joints.
Try to avoid excessive bending, straining or reaching sit, if you can, rather than stand. When you have prolonged periods of activities you should have a period of rest. One of the best ways to help with your rheumatoid arthritis is to be educated. There are numerous books that are filled with information about rheumatoid arthritis.
You can find information on the internet, but you have to be careful because not all sites contain valid information. Making changes in your diet may benefit the fight against rheumatoid arthritis by eating more foods with omega 3 in them, like fish, green soy beans and white and black walnuts are beneficial .
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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 .
How Is Rheumatoid Arthritis Treated
Although there is no known cure for RA, the treatment of RA has undergone an enormous and successful explosion over the past 15 years. There are now many highly effective treatments for RA that not only reduce or eliminate the painful symptoms of RA, but will also stop or significantly slow damage to the joints. Some of these medications are taken by the mouth. Others must be taken by injection or infusion these types of medication are called biologics. Whether taken by mouth or injections, these treatments are all referred to as disease-modifying agents because they stop or slow the normal process of joint destruction. Your doctor may recommend a combination of these disease modifying agents if your RA inflammation is not controlled by one medication alone. Some patients may want to supplement their RA treatments with “complementary” therapies such as fish oil, acupuncture, and other strategies these are less well studied and should not be used as the sole treatments for RA. Emotional and social support can help minimize stress.
An occupational therapist will suggest products and techniques that can help you with daily tasks like buttoning a blouse, which is difficult to do with joints stiff from RA. A physical therapist can teach you exercises to help keep your muscles strong and joints flexible.
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Drugs For Rheumatoid Arthritis
The goal is to reduce inflammation as a means of preventing erosions, progressive deformity, and loss of joint function. Disease-modifying antirheumatic drugs are used early, often in combination. Other drug classes, including biologic agents such as tumor necrosis factor -alpha antagonists, an interleukin -1 receptor inhibitor, IL-6 blockers, B-cell depleters, T-cell costimulatory molecule modulators, and Janus kinase inhibitors, seem to slow the progression of RA. nonsteroidal anti-inflammatory drugs are of some help for the pain of RA but do not prevent erosions or disease progression, may increase cardiovascular risk, and thus should be used only as adjunctive therapy. Low-dose systemic corticosteroids may be added to control severe polyarticular symptoms, usually with the objective of replacement with a DMARD. Intra-articular depot corticosteroids can control severe monarticular or even oligoarticular symptoms but with chronic use may have adverse metabolic effects, even in low doses.
The optimal combinations of drugs are not yet clear. However, some data suggest that certain combinations of drugs from different classes are more effective than using DMARDs alone sequentially or in combination with other DMARDs. In general, biologic agents are not given in combination with each other due to increased frequency of infections. An example of initial therapy is
Rheumatoid Arthritis A Debilitating Disease
Filed Under: Essays
Rheumatoid Arthritis a Debilitating Disease It began seven years ago when Sandra woke up and was getting out bed. She went to stand up and she felt this severe pain in both of her feet. When she looked at her feet they were swollen and bluish red and warm to the touch. She could not understand what was happening.
At first she thought she might have frozen her feet. But as time went by she started to get lumps on the bottom of her feet so she went to see the doctor. The doctor did some tests and he diagnosed Sandra with having a disease called rheumatoid arthritis though it was a mild case at the time. Over the past seven years it has became more severe, even doing little day- to- day jobs has become more difficult. Rheumatoid arthritis can be a crippling disease that causes painful swelling and stiffness that mainly affects the wrists and fingers but it can also affect other areas of the body .
The Statistics from the Canadian Arthritis Society say it affects 300, 000 Canadians, that is 1 in 10 will develop rheumatoid arthritis.
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Managing Rheumatoid Arthritis With Dietary Interventions
- Disease Biology Laboratory, School of Biotechnology, KIIT University, Bhubaneswar, Odisha, India
Self-help by means of dietary interventions can help in management of various disorders including rheumatoid arthritis , a debilitating autoimmune disease. Dietary interventions necessitate a widespread appeal for both patients as well as clinicians due to factors including affordability, accessibility, and presence of scientific evidences that demonstrate substantial benefits in reducing disease symptoms such as pain, joint stiffness, swelling, tenderness and associated disability with disease progression. However, there is still an uncertainty among the community about the therapeutic benefits of dietary manipulations for RA. In the present review, we provide an account of different diets and their possible molecular mechanism of actions inducing observed therapeutic benefits for remission and management of RA. We further indicate food that can be a potential aggravating factor for the disease or may help in symptomatic relief. We thereafter summarize and thereby discuss various diets and food which help in reducing levels of inflammatory cytokines in RA patients that may play an effective role in management of RA following proper patient awareness. We thus would like to promote diet management as a tool that can both supplement and complement present treatment strategies for a better patient health and recovery.
Rheumatoid Arthritis In The Spine
The bones of the spine are the vertebrae . The spine is divided into 4 regions: cervical , thoracic , lumbar , and sacral .
A vertebra has 2 pairs of facet joints located on each side at the back of the vertebral body: one pair faces upward, the other pair downward. These hinge-like joints link the vertebrae together and play an important role in flexibility and mobility.
The joint surfaces are covered with cartilage to allow the joints to move smoothly against each other. As with other joints, the facet joints are surrounded by a thin layer of connective tissue called the synovium, which produces synovial fluid for lubrication and nourishment. When rheumatoid arthritis develops, the immune system mistakenly identifies the synovium as foreign and attacks it, leading to inflammation. A cascade of chemicals causes the synovium to thicken, resulting in swelling. Over time, the inflammation can destroy the cartilage and bone, and the muscles, tendons, and ligaments supporting the joint in turn weaken and lose function.
The damage can begin within the first 2 years of onset, so it is important that you receive early diagnosis and treatment.
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Causes Of Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease. This means your immune system attacks the cells that line your joints by mistake, making the joints swollen, stiff and painful.
Over time, this can damage the joints, cartilage and nearby bone.
It’s not clear what triggers this problem with the immune system, although you’re at an increased risk if:
- you are a woman
- you have a family history of rheumatoid arthritis
Find out more about the causes of rheumatoid arthritis.
What Is The Difference
Rheumatoid arthritis vs. osteoarthritis
Rheumatoid arthritis and osteoarthritis are both common causes of pain and stiffness in joints. But they have different causes. In osteoarthritis, inflammation and injury break down your cartilage over time. In rheumatoid arthritis, your immune system attacks the lining of your joints.
Rheumatoid arthritis vs. gout
Rheumatoid arthritis and gout are both painful types of arthritis. Gout symptoms include intense pain, redness, stiffness, swelling and warmth in your big toe or other joints. In gout, uric acid crystals cause inflammation. In rheumatoid arthritis, its your immune system that causes joint damage.
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When To Get Medical Advice
See a GP if you think you have symptoms of rheumatoid arthritis, so they can try to identify the underlying cause.
Diagnosing rheumatoid arthritis quickly is important, because early treatment can prevent it getting worse and reduce the risk of joint damage.
Find out more about diagnosing rheumatoid arthritis.
Rheumatoid Arthritis And Women: A Debilitating Condition
Counseling rheumatoid arthritis patients is challenging, requiring gender-specific counseling issued for women RA patients.
Dr. Zanni is a psychologist and health systems consultant, Alexandria, Virginia.
Rheumatoid arthritis , affecting 1.3 million Americans, is a chronic autoimmune systemic inflammatory disease with unknown etiology.1 RA primarily targets synovial linings of peripheral joints symmetrically, although other organs can be affected.2,3 Its insidious onset starts with morning joint stiffness, fatigue, malaise, and pain.3
RA progresses in 3 stages: synovial lining swelling pannus thickening the synovium and inflamed cells releasing enzymes, causing misshapen, misaligned, painful joints.4 Destructive changes in the periarticular bone are called bony erosions. RA is also characterized by generalized osteoporosis and periarticular osteoporosis. Clinicians measure disease severity and treatment response using radiographic scoring systems.2
RA is progressive and incurable. Disease progression includes remissions and exacerbations with eventual disability: 70% have difficulty performing common tasks, 33% cannot work after 5 years, and 50% have substantial disability after 10 years.3 RA also increases morbidity, shortening life by 5 to 10 years.
The ACR released revised RA treatment recommendations in 2008.7 ACR treatment guidelines consider disease duration and severity.
Pregnancy or Becoming Pregnant
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Rheumatoid Arthritis Severity Scale
In studying the progression of RA, it was discovered that there are four common stages of disease progression. Each of these stages requires its own specific course of treatment to help patients live the best quality of life possible.
Stage 1 Rheumatoid Arthritis: In the earliest stage of the disease, a patient experiences inflammatory activity in the joint capsule, synovial tissue swelling and resultant pain and stiffness of the affected joint.
Stage 2 Rheumatoid Arthritis: As rheumatoid arthritis worsens to this stage, damage to the cartilage occurs, which results in occasionally decreased the range of motion or loss of mobility.
Stage 3: At this severe stage of RA, not both bone and cartilage are suffering the ravages of inflammation of the synovial tissue.
Pain and swelling of the joints may become intense at this stage, resulting in decreased muscle strength, difficulties with mobility or even physical joint deformities.
Stage 4: Otherwise known as end-stage rheumatoid arthritis, joints may cease to function as pain and swelling increase to a state of immobility.