Tuesday, June 25, 2024

How To Treat Inflammatory Arthritis

What Are Rheumatoid Arthritis Treatments

Treating inflammatory arthritis

Despite significant advances in treatment over the past decades, rheumatoid arthritis continues to be an incurable disease. While there is no cure, the goal of disease remission is frequently attainable. Treatment of rheumatoid arthritis has two major components:

  • reducing inflammation and preventing joint damage and disability and
  • relieving symptoms, especially pain. Although achieving the first goal may accomplish the second, many people need separate treatment for symptoms at some point in the disease.
  • Medication For Treating Rheumatoid Arthritis

    Early, aggressive treatment of RA can help control symptoms and complications before the disease significantly worsens, by reducing or altogether stopping inflammation as quickly as possible. It’s key to preventing disability.

    This strategy essentially amounts to treatment with anti-inflammatory drugs, and sometimes more than one medication at a time.

    How Well Do The Drugs Work Are They Dangerous

    All the drugs used to treat rheumatoid arthritis have been tested and have been proven useful in patients who have the disease. However, they all work on a different aspect of the inflammatory process seen in rheumatoid arthritis and their use as well as their side effects — depends on the current disease status of each patient and any associated medical problems that a patient may have. The effectiveness and the risks of drugs are considered when your rheumatologist plans your treatment.

    If a drug is very effective in treating an illness but causes a lot of side effects, it is not an ideal treatment for long-term use. For example, high doses of corticosteroids can make people with rheumatoid arthritis feel dramatically better. However, high doses of corticosteroids may cause serious side effects when taken over many months or years. Steroids have many possible side effects, including weight gain, worsening diabetes, promotion of cataracts in the eyes, thinning of bones , and an increased risk of infection. Thus, when steroids are used, the goal is to use the lowest possible dose for the shortest period of time.

    Testing for tuberculosis is necessary before starting anti-TNF therapy. People who have evidence of an earlierTB infection should be treated because there is an increased risk of developing active TB while receiving anti-TNF therapy.

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    How Is Ra Diagnosed

    RA is diagnosed by reviewing symptoms, conducting a physical examination, and doing X-rays and lab tests. Its best to diagnose RA earlywithin 6 months of the onset of symptomsso that people with the disease can begin treatment to slow or stop disease progression . Diagnosis and effective treatments, particularly treatment to suppress or control inflammation, can help reduce the damaging effects of RA.

    Exercise And Physical Therapy

    Home Remedies to Reduce Inflammation Naturally

    Results of randomized controlled trials support physical exercise to improve quality of life and muscle strength in patients with RA.32,33 Exercise training programs have not been shown to have deleterious effects on RA disease activity, pain scores, or radiographic joint damage.34 Tai chi has been shown to improve ankle range of motion in persons with RA, although randomized trials are limited.35 Randomized controlled trials of Iyengar yoga in young adults with RA are underway.36

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    Can I Cut Back On My Ra Medications If I Feel Ok

    If pain and stiffness start to fade, you may wonder if you can change your medications.

    RA is a long-term condition, and medicine keeps your symptoms under control. But with guidance from their doctor, some people may be able to lower the amount of medication they take.

    When was your last flare?

    Studies show that people who stop their RA medicine are likely to have a flare of symptoms 4 to 8 weeks later. If your disease stays active, you’re more likely to get permanent joint damage.

    Your doctor will want to know how long it’s been since you had any problems. Theyâll also do some tests. If everything looks good, your doctor may slowly lower the dose of your medications, usually starting with NSAIDs.

    You want to keep a constant and effective level of your RA drugs in your system, so if you are able to cut back on your medicine, it would be a slow change. It helps if you take your medicine at the same time every day.

    Do you have any trouble with side effects from your meds?

    If so, tell your doctor about them. They may be able to adjust your medicine. For example, many drugs used to treat RA can cause an upset stomach. To help, your doctor may suggest that take it at a different time or with food. They may also recommend medication to ease nausea and help with stomach acid.

    Do you use reminders to help you take medicine on time?

    What Do I Do If I Think I Have Rheumatoid Arthritis

    If youre experiencing joint pain and inflammation, its important that you discuss your symptoms with your doctor. Getting a diagnosis as soon as possible means that treatment can start quickly. Early treatment will help you to control the inflammation, manage pain more effectively and minimise the risk of long-term joint damage and disability.

    If youre diagnosed with rheumatoid arthritis or suspected of having the condition, you may be referred to a medical specialist known as a rheumatologist for further investigations and medical treatment.

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    Complications Of Rheumatoid Arthritis

    Because RA damages joints over time, it causes some disability. It can cause pain and movement problems. You may be less able to do your normal daily activities and tasks. This can also lead to problems such as depression and anxiety.

    RA can also affect many nonjoint parts of the body, such as the lungs, heart, skin, nerves, muscles, blood vessels, and kidneys. These complications can lead to severe illness and even death.

    Ra Risk Factors Include:

    Managing Inflammatory Arthritis | Arthritis Talks
    • Poor diet:Not surprisingly, eating inflammatory foods like sugar, refined carbohydrates, and fried food.
    • Allergies: Similarly, food allergies can trigger inflammation.
    • Poor gut health: When the lining of the gut is damaged, inflammation can enter the bloodstream. This condition is called leaky gut syndrome: a condition also makes it difficult to absorb nutrients.
    • Toxicity:Exposure to environmental toxins, like air pollution and plastics, can cause hormone imbalances.
    • Smoking:This shouldnt come as a surprise, but tobacco and marijuana smoke promote inflammation.
    • Genetic factors: Some people are more likely to develop RA because of family history.
    • Obesity:In the long run, obesity increases the risk of RA, especially if it starts at a young age.
    • In the end, any of these factors can trigger destructive chemicals to attack joint tissue. Over time, these chemicals wear down the cartilage that cushions the joints.

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    Osteoarthritis Vs Rheumatoid Arthritis

    Osteoarthritis is the most common type of arthritis, affecting about 27 million people in the United States. Osteoarthritis is caused by degeneration of cartilage, and is also known as degenerative arthritis. In contrast, rheumatoid arthritis is caused by the immune system attacking the joints. This autoimmune process causes systemic inflammation, while in osteoarthritis, mechanical degeneration causes localized inflammation.

    Osteoarthritis commonly affects a single joint, such as one knee. Trauma, such as multiple injuries playing sports, is a risk factor for osteoarthritis. On the other hand, rheumatoid arthritis usually affects three or more joints, in a symmetric distribution . Rheumatoid arthritis frequently, but not always, causes elevation in blood levels of substances that are markers of systemic inflammation such as the ESR and CRP . In contrast, osteoarthritis does not cause abnormal blood test results. Both osteoarthritis and rheumatoid arthritis are hereditary. For example, if a woman has osteoarthritis or rheumatoid arthritis, her/his children are at increased risk of developing the same type of arthritis.

    Your Joints And Rheumatoid Arthritis

    Joints are places where bones meet. Bones, muscles, ligaments and tendons all work together so that you can bend, twist, stretch and move about.

    The ends of your bones are covered in a thin layer of cartilage. It acts like a slippery cushion absorbing shock and helping your joint move smoothly.

    The joint is wrapped inside a tough capsule filled with synovial fluid. This fluid lubricates and nourishes the cartilage and other structures in the joint.

    When you have rheumatoid arthritis:

    • your immune system attacks your joints, which causes:
    • a build-up of synovial fluid
    • inflammation of the tissues that line the joint
    • pain, heat and swelling
  • cartilage becomes brittle and breaks down because the cartilage no longer has a smooth surface, the joint becomes stiff and painful to move
  • ligaments, tendons and muscles surrounding the joint can also be affected, causing joints to become unstable.
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    When Is Surgery Needed For Rheumatoid Arthritis

    Some people with rheumatoid arthritis need several operations over time. Examples include removal of damaged synovium , tendon repairs, and replacement of badly damaged joints, especially the knees or hips. Surgical fusion of damaged rheumatoid wrists can alleviate pain and improve function. Sometimes rheumatoid nodules in the skin that are irritating are removed surgically.

    Some people with rheumatoid arthritis have involvement of the vertebrae of the neck . This has the potential for compressing the spinal cord and causing serious consequences in the nervous system. This is important to identify prior to anesthesia intubation procedures for surgery. These people with serious spinal involvement occasionally need to undergo surgical fusion of the spine.

    What Causes Inflammatory Arthritis

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    In general, most types of arthritis causes some degree of inflammation. But inflammatory arthritis causes an actual inflammatory response in the body.

    The bodys immune system perceives that there is something to fight, although there is nothing foreign to battle. This is called an autoimmune disease inflammatory arthritis conditions are generally this variety and an autoimmune disease causes damage to the body when there was no illness or infection to fight.

    As with other autoimmune diseases, doctors are unsure what starts the process. There does appear to be a genetic component to inflammatory arthritic conditions. For example, people with a family history of RA are known to have a higher risk of developing the disease.

    Other risk factors for developing inflammatory arthritis include gender women are more likely to develop these types of arthritic conditions. Age also plays a factor they typically start between the ages of 40 and 60

    Smoking also seems to increase the risk, especially in those who also have a genetic predisposition. Smoking may even worsen the intensity of these conditions. Being obese may also play a role, as can exposure to certain environmental factors.

    For example, exposure to asbestos and silica is known to increase the risk of RA. Emergency workers who were exposed to dust at the World Trade Center also have seen a higher incidence of RA.

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    What Are The Benefits Of Discovering Inflammatory Arthritis Early

    IA requires early diagnosis it can remit if left unchecked and undiagnosed in perhaps 5% of patients, but will much more likely evolve into a chronic inflammatory arthritis, most commonly RA. Conversely, early treatment can prevent future deformity and disability, and will likely help reduce collateral damage, such as atherosclerosis.

    In early arthritis there is a “window of opportunity, during which the disease can be treated before irreversible joint erosions evolve. This window is usually open 3 to 6 months after the onset of the disease. For this reason, RA can be considered a “medical emergency.”

    In a meta-analysis of 14 trials by the American College of Rheumatology , patients suffering from a shorter duration of their disease were more likely to show improvement than long-term sufferers when properly diagnosed and treated. This finding supports the concept of a window of opportunity, in that early treatment improves not only short-term but long-term outcome.

    Pharmacologic Treatment Of Pain

    The 3e initiative, a 17-nation collaboration that promotes evidence-based practice in rheumatology, recently published recommendations for pharmacologic pain management for inflammatory arthritis patients . The authors highlighted six factors to consider when making a decision regarding pharmacologic pain management:

  • type of pain

  • the presence of residual inflammation

  • comorbidities

  • the addictive potential of the medication and the patient.

  • The main treatment options included:

  • non-steroidal anti-inflammatory drugs and acetaminophen as first line therapy

  • NSAIDs+acetaminophen or an alternative NSAID second line therapy and

  • weak opioids when NSAIDs and acetaminophen have failed or are contraindicated .

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    What Other Risk Factors May Increase Your Likelihood Of Experiencing Ra

    * Gender: Women are much more likely to suffer from this autoimmune disorder.* Weight: Overweight individuals are more prone to developing RA.* Smoking: If you smoke, you are more likely to develop RA, and if you develop it, your symptoms may be more pronounced than those who do not smoke.* Age: RA is more likely to hit you in middle age * Environment: Certain environmental exposures have been found to elevate your risk of RA, including exposure to asbestos and silica.

    What Causes Rheumatoid Arthritis

    Natural Way To Treat Joint Pain | Treat Arthritis and Inflammation

    The exact cause of rheumatoid arthritis is unknown. However, it is believed to be caused by a combination the following factors:

    • Genetics
    • The environment
    • Hormones

    Normally, the immune system protects the body from disease. In people who have rheumatoid arthritis, somethingpossibly infections, cigarette smoking, and physical or emotional stress, among other causestriggers the immune system to attack the joints .

    Gender, heredity, and genes largely determine a person’s risk of developing rheumatoid arthritis. For example, women are about three times more likely than men to develop rheumatoid arthritis.

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    The Structure Of The Eye And Where Arthritis Strikes

    The eye is a complicated structure. Different types of arthritis can cause different types of eye problems. Its important to understand some general eye anatomy:

    The entire eye is covered by a white outer coat called the sclera. The sclera is covered by a thin semi-transparent mucous membrane that has blood vessels, which is called conjunctiva.

    At the very front of the eye is the cornea, which is the transparent layer that transmits and focuses light.

    Behind the cornea is the iris, which is the colored part of the eye that helps regulate the amount of light that enters the eye like the diaphragm of a camera. The pupil is the dark hole in the middle of the iris, which adjusts in size to let in more or less light.

    Just behind iris and pupil is the lens, which is like the lens of the camera. The lens is suspended in the eye cavity through some fine fibrils that attach to the ciliary body.

    The back of the eye contains these important structures:

    • Choroid: A layer that contains blood vessels, located between the sclera and retina
    • Retina: A nerve layer that lines the back of the eye it creates electrical impulses from light that are sent to the brain via the optic nerve
    • Macula: An area in the retina with special light-sensitive cells
    • Optic nerve: A bundle of nerves that transmits visual messages from the eye to the brain

    Common Complications Of Rheumatoid Arthritis Include:

    • Small lumps of tissuecan develop under the skin around the joints.
    • Heart problemsdue to inflamed blood vessels and decreased circulation.
    • Nerve damage occurs when the nerve cells dont get enough blood flow.
    • Higher risk of stroke
    • Increased chance ofheart disease
    • Lung scarringand other lung damage
    • Chest pains
    • Feeling tired all the time
    • Enlarged spleen
    • Carpal tunnel syndrome
    • Vision problems

    All things considered, roughly 15 percent of RA patients develop issues like heart disease, kidney problems, and eye conditions.

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    Living With Rheumatoid Arthritis

    Rheumatoid arthritis is a lifelong disease. When its treated, it may go away for a little while, but it usually comes back. Its important to see your doctor as soon as symptoms begin. The earlier you start treatment, the better your outcome. Some of the damage from RA is irreversible, so finding the disease and treating it early is very important.

    If left untreated, RA can cause other health problems. Your hands may become bent or twisted. Other joints can become deformed. Inflammation will affect your cartilage and bones. Lung and heart problems also can occur. Talk to your doctor if you notice any new symptoms or problems.

    Physical And Occupational Therapy For Rheumatoid Arthritis

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    An occupational therapist can teach you how to modify your home and workplace and better navigate your surroundings to effectively reduce strain on your joints and prevent further aggravation of the inflammation during your day-to-day activities. Additionally, they can teach you how to perform regular tasks in different ways to better protect your joints.

    They’ll teach you joint protection techniques, such as how to maintain proper body position and posture, body mechanics for specific daily functions, and how to distribute pressure to minimize stress on individual joints.

    Occupational and physical therapists can also teach you about the hand exercises that are best for you.

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    How Do You Differentiate Between Mechanical Arthritis And Inflammatory Arthritis

    Whereas mechanical arthritis most commonly presents after the age of 50 and increases in frequency with age, inflammatory arthritis tends to involve a broader age spectrum, often striking patients in the peak working and child-rearing age group.

    Mechanical arthritis is joint-localized, presents with spurs of new bone from the joints, and tends not be associated with systemic symptoms. However, patients with IA present with joint warmth , soft swelling of the joints, and constitutional symptoms such as fever, weight loss, malaise, morning stiffness greater than 30 minutes and generalized fatigue. These symptoms are accompanied by extra-articular manifestations such as nodules, eye inflammation, and skin abnormalities.

    A simple test of the metacarpal-phalangeal joints can be performed to rule out osteoarthritis. In this test, the second through fourth metacarpo-phalangeal joints or the metatarso-phalangeal joints are squeezed together to test for tenderness. A positive result is an indication of the presence of inflammatory arthritis.

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