What Are The Treatments For Ra In The Hands
There is no cure for RA. However, there are a number of treatments that can reduce your symptoms and make you more comfortable.
Anti-inflammatory medications, both over-the-counter and prescription, can help control pain and inflammation during a flare up. Other medications can help prevent the flare ups that can cause pain and damage to your joints.
In some cases, resting the affected joints can help relieve pain. In others, people will find that regular exercise and/or stretching of the affected joints can relieve pain and stiffness. Physical therapy may be ordered to help strengthen the muscles that control those joints and to alleviate pain and swelling.
Foods that are rich in omega-3 fatty acids can help curb inflammation. These include fatty fish like salmon, sardines, trout and mackerel. If you do not like fish, you can add omega-3 fatty acids to your diet with flax seed oil, walnuts or purslane, a vegetable that is available in many Mexican and Asian markets.
High levels of stress seem to induce arthritis flare ups in some people. Avoiding stress can help you reduce the frequency and the severity of flare ups.
In some cases, surgery may be called for if the joints are severely damaged.
For a treatment at home, many people find that either ice or moist heat can help sooth RA pain. Using a hot compress against the affected area for 15 minutes can ease pain. This is especially helpful before exercise.
Early Signs Of Arthritis In Hands
A joint is the area where two bones meet. Within joints is a tissue called cartilage that acts as a cushion between two bony surfaces. Synovial fluid within joints protects them and helps facilitate movement. Synovial fluid is secreted by the inner lining of the joint called the synovial membrane. Hand arthritis occurs when there is inflammation in one or more joints of the hand and wrist. There are over 100 types of arthritis. A few of the common types of arthritis that affect the hands are osteoarthritis, rheumatoid arthritis, post-traumatic arthritis , psoriatic arthritis and gout. The two most common types of arthritis that affect the hands are osteoarthritis and rheumatoid arthritis. Hand osteoarthritis occurs when there is wear and tear of one or more joints of the hand as seen with increasing age. Rheumatoid arthritis occurs when the bodys immune system attacks the joints of the hand.
What Is Rheumatoid Arthritis In The Wrist And Hand
Rheumatoid arthritis is an autoimmune disease. The immune system normally fights of infections and strange germ cells in the body keeping you well and healthy from day to day. In cases of rheumatoid arthritis the immune system mistakes cells that line your joints for foreign unknown cells which pose a threat to your body. Once your immune system attacks the joint line cells your joint will swell up and stiffen with the high inflammation levels. Over time, this can damage the joint itself, the cartilage and nearby bone.
The Wrist is made of eight bones, referred to ascarpal bones. These small carpal bones form two rows of four cube-like bones that on one side articulate with the radius and ulna bones of the forearm and on the other side articulate with the metacarpal bones. The metacarpal bones connect your carpals to your phalanges which are individually divided into three parts distal, middle and proximal. Each one of these bones connects to another creating many joints within the wrist and hand.
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Central Nervous System Symptoms
RA-related inflammation may affect the cervical spine, causing swelling in the joints between the bones of the spine. This swelling may compress or squeeze the spinal cord, resulting in a range of symptoms like:1,3,6
- Neck pain
- Loss of normal sensation in various parts of the body
- Changes in blood pressure and breathing
What Is Rheumatoid Arthritis
Rheumatoid arthritis, or RA, is an autoimmune and inflammatory disease, which means that your immune system attacks healthy cells in your body by mistake, causing inflammation in the affected parts of the body.
RA mainly attacks the joints, usually many joints at once. RA commonly affects joints in the hands, wrists, and knees. In a joint with RA, the lining of the joint becomes inflamed, causing damage to joint tissue. This tissue damage can cause long-lasting or chronic pain, unsteadiness , and deformity .
RA can also affect other tissues throughout the body and cause problems in organs such as the lungs, heart, and eyes.
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What Are The Symptoms Of Rheumatoid Arthritis
The joints most often affected by RA are in the hands, wrists, feet, ankles, knees, shoulders, and elbows. The disease often causes inflammation in the same areas on both sides of the body. Symptoms may begin suddenly or slowly over time. Each persons symptoms may vary, and may include:
These symptoms can seem like other health conditions. Always see your healthcare provider for a diagnosis.
How Is Arthritis In The Hand Treated
Treatment options depend on the type of arthritis, stage of arthritis, how many joints are affected, your age, activity level, the hand affected and other existing medical conditions.
Goals of treatment are to:
- Improve mobility and function.
- Increase your quality of life.
- In the case of rheumatoid or psoriatic arthritis, to slow the progression of the disease.
Treatment options include splinting/bracing, medications, injections, non-drug approaches and surgery.
Splits or braces support and protect the affected joint, reduce deformity, provide joint stability, lessen strain, and promote proper joint alignment. Your healthcare provider, occupational therapist or hand therapist will discuss splinting/bracing options, how and when to wear them and how long to wear them .
Steroids reduce inflammation and relieve pain. Steroids are usually used if medications dont control inflammation or if the inflammation is limited to a few joints. Injections are administered directly into the affected joint. Because steroids can weaken tendons and ligaments, injections are repeated only a few times.
Other management strategies
A complete treatment plan for arthritis of the hand includes these additional approaches:
If nonsurgical treatments no longer provide relief and the cartilage at the ends of your bones has worn away, surgery may be an option. There are several approaches:
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How Rheumatoid Arthritis Affects More Than Joints
Learn more about how the inflammation associated with RA can impact organs and systems beyond the joints.
Arthritis can cause painful, swollen knees or fingers that are impossible to ignore. But other parts of the body, including the skin, eyes and lungs can also be affected. Rheumatoid arthritis is a systemic disease, meaning it can affect many parts of the body.
In addition, the drugs used to treat RA can also cause health problems. Many of these problems such as bone thinning or changes in kidney function cause no immediate symptoms so your doctor may monitor you through lab tests or checkups. For other problems such as skin rashes or dry mouth its important to report any symptoms to your doctor, who can determine the cause, and adjust your treatments accordingly.
Its important to be aware of the affected areas of the body and side effects you may experience. This way, early aggressive treatment can help you avoid RA-related health issues.
What Does Rheumatoid Arthritis In The Hands Feel Like
When your hands are affected by rheumatoid arthritis, you may experience swelling around the affected joint, which leads to pain or tenderness. The joint may feel warm to the touch. Swelling tends to be symmetrical, which means it occurs in the same joints on both right and left hands.
Stiffness with immobility is characteristic of rheumatoid arthritis in the hands as well, says Lindsay S. Lally, MD, a rheumatologist at Hospital for Special Surgery in New York City. Symptoms like stiffness and pain are usually worse in the morning, and can last at least 30 minutes or more.
Together these hand symptoms can impair function and the ability to go about your daily routine and tasks.
This can manifest in difficulty using the fingers, decreased hand dexterity, inability to bend or straighten affected joints, and decreased strength, says Dr. Albayda. Sometimes RA can cause loosening of ligaments and tendons in the hands, resulting in permanent deformities of the hand, adds Dr. Lally. Evidence suggests that hand deformities commonly occur in the first year of rheumatoid arthritis if it goes untreated.
Some specific hand problems and deformities that can be caused or made worse by rheumatoid arthritis include:
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Hand Pain Is Worse With Activity
This type of hand pain tends to occur in osteoarthritis , a degenerative disorder where the cartilage that cushions the end of a joint breaks down over time. Joint symptoms of OA are more likely to be exacerbated by repetitive or overuse and effort, explains Dr. Lally for example, gardening or crafting.
In RA, on the other hand, pain and stiffness tend to come with lack of use and after periods of inactivity, such as when you wake up in the morning after being still all night.
Another way to distinguish the two: swelling in your hand and wrist is hard and bony in OA boggy and squishy in RA, says Dr. Albayda.
What Hip Symptoms Of Ra Feel Like
Hip pain doesnt always indicate rheumatoid arthritis. It may be from another kind of arthritis, like psoriatic arthritis, or from a pinched nerve, tight muscles around the hips and buttocks, or simple overuse.
When your hip pain is due to inflammation caused by RA, you may experience other symptoms as well.
Here are some of the signs of hip pain from RA:
- dull ache around the groin, buttocks, or thighs
- heat or warmth to the touch around the hips, buttocks, thighs, and groin
- pain or stiffness in the morning, which may reduce with movement or activity
- difficulty standing or walking, due to pain in the hip joint
- limping, often after RA progression leads to further joint damage
As RA can affect your whole body, you may also experience generalized symptoms like:
- high temperature
RA can affect both hips, as the condition often creates symptoms in the same joint on both sides of the body.
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How Is Rheumatoid Arthritis Diagnosed
Diagnosing RA may be difficult in the early stages. This is because symptoms may be very mild, and signs of the disease may not be seen on X-rays or in blood tests. Your healthcare provider will take your medical history and give you a physical exam. Tests may also be done, such as:
- X-ray. This test uses a small amount of radiation to create images of internal tissues, bones, and organs onto film.
- Joint aspiration. For this test, a small fluid sample is taken from a swollen joint. It is done to look for signs of infection or gout.
- Nodule biopsy. Tiny tissue samples are taken to look at under a microscope. This helps to check for cancer or other abnormal cells.
- Blood tests. These tests are done to find certain antibodies, called rheumatoid factor, cyclic citrullinated antibody, and other signs of RA.
- Ultrasound or MRI. These imaging tests can look for bone damage and inflammation.
How Doctors Diagnose Arthritis Hand Pain
To determine whats behind your hand pain, your doctor will rely on your medical history, a physical exam, and imaging and blood tests to make a diagnosis and determine what kind of arthritis hand pain you have.
Feeling a patients joints during the exam can help differentiate between OA and inflammatory arthritis, Dr. Byram says. The swelling feels harder in those with OA because extra bone at the joints, called osteophytes, forms over time. The swelling in RA and other inflammatory disease feels softer.
Imaging tests, such as X-rays or an MRI, can reveal joint erosion and osteophytes and loss of cartilage .
If your doctor suspects inflammatory arthritis, they will also order blood tests to detect the presence of certain antibodies, such as rheumatoid factor or anti-CCP, that help identify RA and other types of inflammatory arthritis.
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What Are The Different Types Of Rheumatoid Arthritis
Symptoms of rheumatoid arthritis usually begin gradually in several joints. Sometimes the symptoms begin only in one joint, and sometimes the symptoms begin initially in the whole body, with generalized stiffness and aching, and then localize to the joints.
- Typical “classic” rheumatoid arthritis is the most common type of rheumatoid arthritis. Classic rheumatoid arthritis involves three or more joints. Usually, people have a gradual onset of joint pain, stiffness, and joint swelling, usually in the fingers, wrists, and forefeet. Elbows, shoulders, hips, ankles and knees are also commonly affected.
- About 80% of people with rheumatoid arthritis are classified as “seropositive,” which simply means the rheumatoid factor blood test is abnormal. Some people with an abnormal rheumatoid factor also have an abnormal anti-CCP blood test. This is another blood test for rheumatoid arthritis.
- Approximately 20% of people with rheumatoid arthritis are classified as “seronegative,” which means the rheumatoid factor blood test is negative, or normal. In this case, the anti-CCP blood test may be abnormal or normal. Other blood tests, such as the ESR measure of inflammation, may be abnormal.
Atypical presentations of RA
- Persistent arthritis of just one joint may be the first symptoms of rheumatoid arthritis in some people.
- Some people experience generalized aching, stiffness, weight loss, and fatigue as their initial symptoms of rheumatoid arthritis.
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How Rheumatoid Arthritis May Affect Your Mouth
Research shows that people who have rheumatoid arthritis may be more likely to develop periodontal disease, which usually starts with a gum infection.
They are also more likely to have dry mouth, which can predispose them to tooth decay.
The flip side of this may be true too: Poor oral health may lead to the onset or worsening of RA. Experts believe that inflammation in the mouth may stimulate the immune system, and in a people predisposed to RA the inflammation may trigger the body to start making antibodies associated with the disease.
Researchers have been working to better understand the mechanism behind this, but the takeaway is that treating gum disease and preventing unnecessary gum infections is good for your RA, as well. Schedule frequent dental checkups to catch minor issues before they become major problems.
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Signs And Symptoms Of Rheumatoid Arthritis
- Fatigue, fever, excessive sleep and loss of appetite
- Gentle, warm, swollen joints
- Joint stiffness that worsens especially in the morning and after prolonged inactivity
Rheumatoid arthritis initially affects small joints, especially the joints that connect the fingers to the hands and the toes to the feet.
As the disease develops, symptoms spread to the wrists, knees, ankles, elbows, hips, and shoulders. In most patients, the symptoms occur in the same joints on both sides of the body.
Approximately a third of people with rheumatoid arthritis also experience signs and symptoms in which the joints are not involved. Other affected areas include:
- Salivary glands
- Bone Marrow
The symptoms and signs of rheumatoid arthritis affect each person individually and some have symptoms that come and go.
Intervals of high disease activity, called flares, alternate with remission time, where swelling and pain fade or disappear.
Gradually, rheumatoid arthritis can damage the joints and cause them to move out of place.
If someone has permanent joint discomfort and swelling that is hindering normal activity, you should visit your doctor.
Timely medical intervention can significantly slow the progression of the disease.
At Eva Hospital, Dr. Tanveer Bhutani has experience in treating rheumatoid arthritis and helping people to live painless life.
Signs Your Hand Pain Is Not Due To Rheumatoid Arthritis
Pain and stiffness in the hand are hallmark signs of rheumatoid arthritis, but these symptoms can stem from many other different conditions.
Sometimes, it can be very difficult to make the distinction of whether current symptoms in the hand are from ongoing inflammation, from damage or another condition like OA, or a whole other entity, says Dr. Albayda.
Some clues that your hand pain may not stem from rheumatoid arthritis include:
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When Should I See My Doctor
If you notice symptoms of rheumatoid arthritis, or you are concerned that you may have rheumatoid arthritis, you should see your doctor as soon as possible. Your doctor may refer you to a rheumatologist who is a doctor that specialises in joints. It is important to act quickly. The sooner you start treatment, the less likely you are to experience permanent joint damage and deformity.
Rheumatoid Arthritis Can Impact A Large Number Of Other Organs
RA can significantly affect a number of other organs as it progresses, especially if the disease is not controlled with medications, including:
- The Eyes Episcleritis, an inflammation of the episclera a tissue in the white part of the eye can occur.
- The Lungs Lungs can show scarring or develop interstitial lung disease, which can cause difficulty breathing, breathlessness, or a mild cough. Usually this is seen as the disease progresses, but it can show up in some early-stage patients, says Mannon.
- The Skin Some patients may develop blisters or nodules under the skin that are caused by inflamed blood vessels. Rashes and skin ulcers can erupt as well.
- The Mouth People with RA are twice as likely to have gum disease as those without RA. Research suggests that underlying gum disease may be a trigger for developing RA, and that getting treated for gum disease can improve joint symptoms.
- The HeartHeart failure is twice as common in people with RA, and theyre also 50 percent more likely to have a heart attack.
- The Kidneys RA can also damage the kidneys, especially when RA is not well controlled.
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