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When Does Rheumatoid Arthritis Start

Complications Of Rheumatoid Arthritis

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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.

When To Call Your Doctor

Dr. Cotter urges anyone who experiences sudden symptoms of arthritis to seek medical attention immediately. If left untreated, these symptoms could lead to long-term problems in the joint.

“It is not normal for a joint to suddenly swell, and getting the correct diagnosis is of the utmost importance,” she says. “Early diagnosis and intervention will mean a better outcome.”

Any persistent issues warrant a call to your doctor as well, she says. For example, if you have joint pain without swelling or joint swelling without pain that persists, you should see your doctor for an evaluation.

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.

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How To Manage Symptoms To Slow Or Halt Ra Joint Damage And Diseaseprogression

Getting on medication right away is the No. 1 thing people can do to improve RA symptoms and stop the disease from progressing. Your doctor should start you on methotrexate, according to guidelines published in July 2021 by the American College of Rheumatology .

If this treatment alone doesn’t yield the desired results, biologics should be added, the ACR advises.

“There is a window of opportunity at the beginning of the disease when you have the best chance of treating with drugs to stop RA from causing damage and the earlier a person starts aggressive drug therapy, the better, says Dr. Greer.

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If you suspect you may have rheumatoid arthritis or your doctor has recently diagnosed youthen youre probably already experiencing the classic symptoms of painful, achy, and swollen joints, especially first thing in the morning or after a long day sitting at work.

Unlike other types of arthritis that can be brought on by too much activity, rheumatoid arthritis symptoms tend to happen when youve been at rest, not using your joints. Maybe you wake up in the morning and feel stiff. Or maybe you get out of the car after a long trip and find your body will barely move. The discomfort in your joints is the result of an overactive immune system that mistakenly attacks the tissue that lines your joints. The result is pain and inflammation and, over time, damage to the joints that can lead to deformity and disability. You may not know anyone else with the disease, but if you have rheumatoid arthritis, youre in good company: RA is the second most common type of arthritis, affecting 1.3 million Americans.

The good news about rheumatoid arthritis is that there are many different treatment options. When someone comes in with rheumatoid arthritis, I tell them that I can get them feeling better and halt the progression of their disease, says Rebecca Blank, M.D., Ph.D., a rheumatologist at NYU Langone Health in New York City. The question is, which treatments work best and which ones are safest? Start with these joint-saving options.

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When Does Rheumatoid Arthritis Start

Rheumatoid arthritis is a long lasting, chronic inflammatory disease in which the body immune system goes awry and causes swelling in many parts of the body. Though it primarily affects the joints, it can also affect non-joint structures. When and how it starts may vary from patient to patient. But it usually develops gradually!

Rheumatoid Arthritis Is An Autoimmune Disease

The body immune system, as the name suggests, is responsible to protect the body from any antigens such as germs and infectious organisms. It is a complex system made up of special cells, tissues, proteins and organs to defend your body against disease. But sometimes, it goes awry and leads to illness. For such case, it is called autoimmune disease.

Your immune system doesnt work as well as usual if you have autoimmune disease. It can mistakenly attack the wrong targets, healthy tissues of your body for example. As a result, this abnormality can lead to a number of serious problems.

The exact answer of how the body immune system malfunctions in this way is not clear yet, though there are some theories. Some experts believe that the disease may be associated with virus /bacteria, certain medication, or chemical /environmental irritants. Also, it seems that this abnormality runs in family your risk of developing the disease might increase if you have a family history of the same condition.

There are a number of different types of autoimmune diseases. Rheumatoid arthritis is one of the most common ones.

The effect of autoimmune disease can be systemic. Systemic means it affects many different types of body tissue /organ, depending on the type.

Here are some of other autoimmune disorders:

  • Systemic lupus erythematosus, an autoimmune condition that affects many parts of the body including the joints, skin, brain, kidney, or other organs.
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    Heart Disease Risk Increases With Ra

    One of the most concerning conditions that can evolve in people with RA is cardiovascular disease, especially ischemic heart disease, in which thereâs a reduced blood supply in the heart.

    Other cardiovascular issues people with RA are at increased risk for include heart attack, stroke, congestive heart failure, peripheral vascular disease, and atrial fibrillation.

    Its crucial that people with RA continue to be monitored for heart disease risks by their general practitioner or cardiologist. In a review of preventative measures for people with RA, published in June 2020 in the journal Nature Reviews Rheumatology, the authors noted that catching risk factors early, such as high blood pressure or high blood lipids, is especially important for preventing a serious cardiac event.

    In addition, people with RA are more likely to develop type 2 diabetes another cardiovascular risk factor as those without RA, possibly because the inflammation of RA affects blood sugar levels and insulin resistance.

    Joint Subluxation And Dislocation

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    Joint erosions, which are visible on X-ray, are associated with limited joint mobility and function. As the joint becomes eroded and cartilage is damaged, bone-on-bone contact can be the painful end result.

    Severe damage to cartilage, tendons, ligaments, and bone can cause joints to become unstable. Joint instability can lead to subluxation or, less often, dislocation.

    While many joints can become deformed or subluxed due to RA, toes are among the more common ones. The associated pain, damage, and functional limitations often lead to a loss of mobility.

    People whoâve had RA for more than a decade are at risk of developing a condition called cervical myelopathy, in which joints of the spine can dislocate and put pressure on the brain stem, spinal cord, and spinal nerve roots. This is an uncommon but serious problem that needs to be corrected with surgery to avoid permanent damage.

    Rheumatoid Arthritis Healthcare Provider Discussion Guide

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    Malnutrition In Ra Patients

    Patients with RA are often at a higher risk of malnutrition for multiple reasons. First of all, weight loss is a common symptom in RA patients. Its thought to be due to the autoimmune condition itself producing inflammatory responses which cause an increase in metabolic rate. This means that the body burns through more calories than normal, which can lead to weight loss. This is not considered healthy weight loss. This type of weight loss can potentially leave the patient undernourished or malnourished.

    Secondly, many patients taking the common disease-modifying antirheumatic drug called methotrexate, have been known to have a deficiency in certain vitamins and minerals. Many RA medications produce side effects such as stomach ulcers and other digestive concerns which can make it difficult to eat. These conditions combined with weight loss further compound the problems of malnourishment in patients. Some of the most common nutrient deficiencies in RA include a lack of the following vitamins and minerals:

    • Vitamin B6
    • Magnesium
    • Selenium

    A proper diet for RA that is rich in these vitamins and minerals is important for keeping patients healthy.

    Finally, many RA patients are at risk of developing osteoporosis, a weakening of the bones caused by a calcium or vitamin D deficiency. RA patients should be aware of this potential risk and ensure their diet accounts for this potential deficiency.

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    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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    How Is Rheumatoid Arthritis Diagnosed

    The diagnosis of rheumatoid arthritis is based on a combination of factors, including:

    • Morning stiffness that lasts at least one hour and has been present for at least six weeks
    • Swelling of three or more joints for at least six weeks
    • Swelling of the wrist, hand, or finger joints for at least six weeks
    • Swelling of the same joints on both sides of the body
    • Changes in hand x-rays that are hallmarks of rheumatoid arthritis
    • Rheumatoid nodules of the skin
    • Blood test that is positive for rheumatoid factor* and/or anti-citrullinated peptide/protein antibodies

    * The rheumatoid factor may be present in people who do not have rheumatoid arthritis. Other diseases can also cause the rheumatoid factor to be produced in the blood. A test called CCP antibody can sometimes help to determine whether the rheumatoid factor antibody is due to rheumatoid arthritis or some other disease. This is why the diagnosis of rheumatoid arthritis is based on a combination of several factors and NOT just the presence of the rheumatoid factor in the blood.

    It is also important to note that not all of these features are present in people with early rheumatoid arthritis, and these problems may be present in some people with other rheumatic conditions.

    In some cases, it may be necessary to monitor the condition over time before a definitive diagnosis of rheumatoid arthritis can be made.

    Rheumatoid Arthritis Can Lead To Other Health Complications

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    The symptoms of pain, inflammation, and redness usually spread to other organs such as the eyes, mouth, lungs, and heart. In addition, patients with Rheumatoid Arthritis cannot wear contact lenses as there is not sufficient moisture in the eyes. Instead, doctors often recommend patients lubricate their eyes with artificial tears.

    Furthermore, having painful joints can make patients reluctant to exercise. It can lead to weight gain depending on the type of diet. Weight gain can occur after susceptibility to other diseases such as diabetes, high cholesterol, high blood pressure, and heart disease.

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    How Ra Symptoms Progress Over Time

    Everyone is different, but there are a few common patterns in the way RA plays out over the years:

    • Long remissions. When you’re in one of these periods, your pain and stiffness go away or get much better, but you aren’t cured. In a few people with RA — about 5% to 10% — the disease starts suddenly, and then they have no symptoms for many years, even decades.
    • Symptoms that come and go. This happens to about 15% of people with rheumatoid arthritis. You may have periods of few or no problems that can last months between flare-ups.
    • Progressive rheumatoid arthritis. Most people in this situation need a long-term treatment plan and a coordinated medical team to manage the condition and slow or stop it from getting worse.

    Does Rheumatoid Arthritis Come On Suddenly

    In a few people with RA about 5% to 10% the disease starts suddenly, and then they have no symptoms for many years, even decades. Symptoms that come and go. This happens to about 15% of people with rheumatoid arthritis. You may have periods of few or no problems that can last months between flare-ups.

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    Why Age Of Ra Onset Matters

    The age of onset of rheumatoid arthritis matters for several reasons. Depending on the age of onset, the severity, progression, and treatment options for RA may look different.

    Studies have shown late-onset rheumatoid arthritis , also referred to as elderly-onset RA, is associated with greater disease activity, reduced function at baseline, and more radiological damage. On the other hand, young-onset RA results in a long road with the disease and presents in a different way physically and in blood testing.

    Overall, it’s important to get diagnosed and treated early if possible, given the progressive, systemic nature of RA.

    Age Of Onset For Women With Rheumatoid Arthritis

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    RA is often thought to be a condition related to old age, but this is not the case.

    According to the Arthritis Foundation, the average onset of RA is between the ages of 30 and 60 years old, and children can also get it.

    Women tend to be diagnosed slightly earlier than men, potentially due to hormonal changes in the mid-30s and then again after the mid-40s.

    RA is a chronic condition that can progress over time with periods of increased disease activity, called flares, and periods of remission.

    Symptoms of RA vary from person to person depending on the severity of their condition.

    An older study on a small group of middle-aged women with RA found that they reported fewer joint symptoms during post-ovulation in their menstrual cycles and also during pregnancy. This is when levels of estrogen and progesterone are higher.

    Medical experts tend to agree that the effect of sex hormones combined with environmental and genetic factors could explain the higher prevalence of women diagnosed with RA.

    Research continues to seek more answers.

    As mentioned, RA isnt only a disease for older people.

    According to the , the diagnoses in the United States of all types of arthritis from 2013 to 2015 are as follows:

    Age range
    • unintentional weight loss

    These signs can precede the painful joint symptoms commonly associated with RA.

    Recurrent bouts of fatigue along with a general sense of not feeling well may occur weeks or months before other symptoms.

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    Early Detection And Diagnosis

    As with most diseases, early detection and diagnosis are crucial for being able to treat symptoms, manage pain, and slow progression. An early diagnosis of RA can help you and your team of physicians and specialists put together an individualized treatment plan so that you can continue living a high quality of life.

    Early on, you will want to discuss your case with a rheumatologist or RA specialist who can provide you with the treatment you need to delay the diseases progression. Generally, early diagnosis treatment is aggressive and targeted to properly manage the disease and prevent it from progressing.

    If your RA was diagnosed in the early stage when symptoms first appeared, your chances of achieving longer periods of remission typically increase drastically. Thats not to say you wont experience flare-ups. Early diagnosis simply helps manage the disease and cannot guarantee the complete elimination of symptoms.

    Initial Ra Signs: What Are The First Signs Of Rheumatoid Arthritis

    Jump to:RA StatisticsRA CausesSigns and SymptomsLiving with RA

    You just hit your early 30s. You notice that it is harder to get up every morning than it was even five years ago. Theres a general feeling of stiffness over your entire body that you can never quite escape. You initially wrote it off as just an unfortunate part of the aging process , but now youre starting to think there may be something more serious going on.

    Youve also started losing weight, but not because you are dieting nor exercising. You originally thought it was because of you have no appetite or real interest in food, but even when you DO eat it seems to have no effect on your weight. All of this has contributed to a sense of depression something that youve never had to deal with previously. Unfortunately, there IS something serious going on. These are just a few of the major early signs and symptoms of rheumatoid arthritis .

    RA is a long-term autoimmune disorder that typically affects a persons joints. What usually begins as a warm feeling or swollen hands can quickly turn into pain that just wont go away. Internally, the disease can also manifest itself as a low red blood cell count, inflammation of the lungs or even inflammation of the heart.

    A crucial part of seeking appropriate medical treatment as quickly as possible involves knowing what to look for and what to be concerned about. Most importantly, it is essential to know when things are getting serious.

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