Living And Coping With Rheumatoid Arthritis
Like all chronic illnesses, RA poses many frustrations and challenges — physical, emotional, financial, and otherwise. It affects all dimensions of a person’s life including work, family, and relationships. In addition, many patients with RA are diagnosed while in their prime adult years, when they may have responsibilities for taking care of children or older parents.
It is absolutely normal and natural for patients to feel overwhelmed, especially after first receiving a diagnosis. It is important to know that the newer medications, when started early for RA, have markedly improved the long-term outlook for RA. Specialists called rheumatologists are most familiar with these medications and treatments for RA.
The following are some tips for living and coping with RA:
Surgery For Spinal Arthritis
Surgery may be recommended for spinal arthritis if other treatments donât sufficiently relieve pain. The goals of the surgery may include:
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Stabilizing the spine by fusing several segments together in a procedure called spinal fusion
These surgeries can be performed as open procedures or with a minimally invasive approach. There are pros and cons to each method. The surgeon will review and discuss the options before the operation.
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.
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When Should I See A Specialist For Rheumatoid Arthritis
In general, patients with RA will benefit from seeing a specialist as early as possible. Most often, the specialists treating this disease are trained in rheumatology. Their knowledge of medications to treat this disease can help patients make informed decisions consistent with their values and goals. These specialists can also help provide a balanced perspective on the benefits of treating the disease well vs. any potential side effects.
Patients diagnosed with RA are encouraged to become a fully involved member of their multidisciplinary team of health providers. These include the primary care physician, the rheumatologist, the physical or occupational therapist, social worker, health educators and other members of the healthcare system associated with care. The primary care physician or internist commonly works in partnership with a rheumatologist. Note that every RA patients healthcare team is a little different, so its important for the patient to understand what role each member plays. For example, in many situations all medication changes will need to be cleared with the rheumatology, and sometimes the primary care physician may be taking a more active role. Referral to a specialist in rheumatology most commonly occurs in the following situations:
Who Should Diagnose And Treat Ra
A doctor or a team of doctors who specialize in care of RA patients should diagnose and treat RA. This is especially important because the signs and symptoms of RA are not specific and can look like signs and symptoms of other inflammatory joint diseases. Doctors who specialize in arthritis are called rheumatologists, and they can make the correct diagnosis. To find a provider near you, visit the database of rheumatologistsexternal icon on the American College of Rheumatology website.
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Signs And Symptoms Of Rheumatoid Arthritis
The main joint symptoms are related to the inflammation and include pain, swelling, redness, warmth and limitation in range of motion of the affected joints. These joints will be tender to pressure and can occasionally appear red. Inside the joints, the immune system has been activated, and many cells proliferate in the joints releasing multiple chemicals, such as cytokines, which cause fluid and additional inflammatory cells to enter the joint, and to cause pain. If the process remains active, the inflammatory process can cause damage in the joint .
Joint involvement in RA tends to affect multiple joints on both sides of the body, in what is called a symmetric pattern. That is, if your left knee is affected, your right knee will likely also be affected .
The joints most likely to be affected are the:
- small joints of the hands and feet
However, many other joints can be affected, such as the neck joints in the cervical spine, the shoulders, hips or temporo-mandibular joints .
Trigger : Poor Dental Health
Brush, floss, and schedule regular dental exams. For years, scientists have observed a link between gum disease and rheumatoid arthritis, and new evidence from Johns Hopkins suggests why. Turns out, both conditions are triggered by a common factor: the bacterium A. acitnomycetemcomitans, which attacks immune cells and causes chronic inflammation. Almost half of RA patients have been infected by this type of bacteria, compared with 11% of healthy people. So take good care of your teeth it just might save your joints, too.
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The Immune Response And Inflammatory Process
The immune system determines the body’s responses to foreign or dangerous substances such as viruses, toxins, or abnormal proteins. The immune response helps the body to fight infection and heal wounds and injuries. The inflammatory process is a byproduct of the immune response.
Two important components of the immune system that play a role in the inflammation associated with RA are B cells and T cells, both of which belong to a family of immune cells called lymphocytes. Lymphocytes are a type of white blood cell.
A key feature of a healthy immune system is the ability to tell what is normal or “self” and what is foreign and possibly harmful or “non-self.” If the T cell “sees” an antigen as “non-self” or dangerous, it will produce chemicals that cause B cells to multiply and release many immune proteins . These antibodies circulate widely in the bloodstream, recognizing the target particles and triggering inflammation in order to rid the body of the invasion.
For reasons that are still not completely understood, both T cells and B cells become overactive in patients with RA and attack normal tissue as if it were foreign. This is why conditions like RA are referred to as “autoimmune” diseases: the body’s immune system produces antibodies that attack it.
An antigen is a substance that can trigger an immune response. Normally, antigens are substances that are not present in the healthy body.
What Are The Risk Factors For Ra
Researchers have studied a number of genetic and environmental factors to determine if they change persons risk of developing RA.
Characteristics that increase risk
- Age. RA can begin at any age, but the likelihood increases with age. The onset of RA is highest among adults in their sixties.
- Sex. New cases of RA are typically two-to-three times higher in women than men.
- Genetics/inherited traits. People born with specific genes are more likely to develop RA. These genes, called HLA class II genotypes, can also make your arthritis worse. The risk of RA may be highest when people with these genes are exposed to environmental factors like smoking or when a person is obese.
- Smoking. Multiple studies show that cigarette smoking increases a persons risk of developing RA and can make the disease worse.
- History of live births. Women who have never given birth may be at greater risk of developing RA.
- Early Life Exposures. Some early life exposures may increase risk of developing RA in adulthood. For example, one study found that children whose mothers smoked had double the risk of developing RA as adults. Children of lower income parents are at increased risk of developing RA as adults.
- Obesity. Being obese can increase the risk of developing RA. Studies examining the role of obesity also found that the more overweight a person was, the higher his or her risk of developing RA became.
Characteristics that can decrease risk
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Lifestyle Changes That Help Ease Ra Symptoms
In addition to treatment with drugs, the following remedies and lifestyle approaches can help alleviate symptoms at any stage of RA:
Occupational or Physical Therapy Rheumatologists frequently refer patients to occupational or physical therapy practitioners to help patients find ways of moving that are less painful, and that strengthen muscles, says Manno. Decreased movement can cause muscles to atrophy and can reduce a persons cardiovascular fitness.
Causes Of Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune condition, which means it is caused by the bodys immune system attacking itself. However, it is not yet known what triggers this.
Normally, your immune system makes antibodies that attack bacteria and viruses, helping fight infection. But if you have rheumatoid arthritis, your immune system mistakenly sends antibodies to the lining of your joints, where they attack the tissue surrounding the joint.
This causes the thin layer of cells covering your joints to become sore and inflamed.
This inflammation in turn causes chemicals to be released that thicken the synovium and damage nearby:
- National Rheumatoid Arthritis Society : Possible causes and risk factors
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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:
Rest
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.
Exercise
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 .
Small Joint Inflammation: Symptoms In The Fingers Wrists Toes And Ankles
For more than half of RA patients, the first symptoms will occur in one or more of the small joints of the fingers , the wrists, the toes , or the ankles. Symptoms can begin slowly and subtly over a period of weeks or months, worsening over time.
In the majority of patients, this swelling and pain is symmetrical, meaning the same joints are affected on both sides of the body.
But this is not always the case. Its important not to wait to treat until the disease becomes symmetric. Early diagnosis and treatment are key to prevent joint damage even if only one joint on one side of the body is affected, notes Rebecca Manno, MD, a rheumatologist and adjunct assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.
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Symptoms And Diagnosis Of Pannus
The most common symptoms that patients experience in their joints when they have pannus formations are:
Pannus formations can be very painful, Dr. Mehta says. They can even cause joints to swell so much that they appear misshapen.
So, how do you know if you have pannus formations from RA? You wont be diagnosed with pannus itself, Dr. Yu points out, because pannus is just one part of the overall diagnosis for RA. Youll instead undergo the typical process for RA diagnosiswhich includes seeing a specialist called a rheumatologist, who will likely:
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Take a clinical history
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Perform a physical exam
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Order RA blood tests and imaging
If pannus is causing extensive symptoms, your doctor can determine how large the formations are with an imaging test like an X-ray, ultrasound, or MRI scan.
How Does Rheumatoid Arthritis Affect How People See Themselves
Rheumatoid arthritis is relatively common in young women. The limitations it can cause come right at a time when most of their peers are in good health, and that can be hard to deal with.
Some women worry that they cant be a good mother or partner. Young women who have rheumatoid arthritis often wonder whether they should even have children. Having this disease doesnt mean that getting pregnant isnt an option. But its important to keep in mind that not all of the rheumatoid arthritis medication can be taken before and during pregnancy or while breastfeeding. You can talk to a rheumatologist or gynecologist about this early on. Men who are trying for a baby with their partner also need to stop taking certain rheumatoid arthritis medications for a while.
Some people are concerned about loss of status if they have to give up their job or take on a different position. The pain and loss of strength can also affect how you see yourself. It can be hard to show weakness or accept help, especially for men. Quite a few people even try ignoring the condition as much as possible because it doesnt fit in with how they view themselves. Theyd like to stay in control and continue living the life theyre used to as much as possible. This can be physically and emotionally draining, though. It can sometimes lead to depressive thoughts, frustration and aggression.
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What Causes Rheumatoid Arthritis
The exact cause of rheumatoid arthritis is unknown. Researchers think its caused by a combination of genetics, hormones and environmental factors.
Normally, your immune system protects your body from disease. With rheumatoid arthritis, something triggers your immune system to attack your joints. An infection, smoking or physical or emotional stress may be triggering.
Is rheumatoid arthritis genetic?
Scientists have studied many genes as potential risk factors for RA. Certain genetic variations and non-genetic factors contribute to your risk of developing rheumatoid arthritis. Non-genetic factors include sex and exposure to irritants and pollutants.
People born with variations in the human leukocyte antigen genes are more likely to develop rheumatoid arthritis. HLA genes help your immune system tell the difference between proteins your body makes and proteins from invaders like viruses and bacteria.
Heres Why The Disease Progresses What To Expect And How To Stop It
Rheumatoid arthritis is a chronic condition for which there is no cure. But even though the disease is progressive, newer disease-modifying drugs may actually be able to slow or even halt it getting worse. We have many effective treatments for RA that help control the symptoms of joint pain and stiffness, but also prevent progression of the disease and the development of permanent damage, says Lindsay Lally, MD, a rheumatologist at Hospital for Special Surgery in New York City.
Early treatment for RA is key, because whatever joint damage has already occurred cant be reversed. Find out how to recognize the symptoms at each stage of RA, and what can be done to treat it.
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Chaunie Brusie Bsn Rn
Sudden arthritis is not a real medical condition, but the symptoms of arthritis namely, joint pain and swelling can develop very abruptly in some people, according to the Centers for Disease Control and Prevention .
Arthritis can also come and go, so you could feel tip-top one day and wake up feeling sore and achy the next.
Heres more on why arthritis might seem to come on all of a sudden, including when you should call a doctor about your symptoms.
Complications Of Rheumatoid Arthritis
- Cardiopulmonary disease resulting from RA can take different forms. Your breathing may be affected either with pleurisy or intrapulmonary nodules . Pericarditis and atherosclerosis can both cause chest pain. Atherosclerosis is the leading cause of death in RA so be sure to tell your doctor if you experience any chest pain symptoms.
- Sjögrens syndrome develops in 10-15 percent of RA patients. Sjögrens is characterized by dry eyes and/or a dry mouth.
- Peripheral neuropathy or nerve damage is an occasional complication of the nervous system in RA patients. It is typically a mild numbing feeling in the lower extremities like your legs and feet that can cause poor coordination. Other neuropathies can occur because RA causes joint tissue swelling that compresses the nerve tissue. Carpal tunnel symptoms can often be relieved by a cortisone shot to the wrist. If this is not successful, surgery may be required to open the tunnel and relieve pressure on the nerve.
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Does Rheumatoid Arthritis Cause Fatigue
Everyones experience of rheumatoid arthritis is a little different. But many people with RA say that fatigue is among the worst symptoms of the disease.
Living with chronic pain can be exhausting. And fatigue can make it more difficult to manage your pain. Its important to pay attention to your body and take breaks before you get too tired.
What are rheumatoid arthritis flare symptoms?
The symptoms of a rheumatoid arthritis flare arent much different from the symptoms of rheumatoid arthritis. But people with RA have ups and downs. A flare is a time when you have significant symptoms after feeling better for a while. With treatment, youll likely have periods of time when you feel better. Then, stress, changes in weather, certain foods or infections trigger a period of increased disease activity.
Although you cant prevent flares altogether, there are steps you can take to help you manage them. It might help to write your symptoms down every day in a journal, along with whats going on in your life. Share this journal with your rheumatologist, who may help you identify triggers. Then you can work to manage those triggers.