Methotrexate And Other Dmards
Several different types of DMARDs are used to treat RA. The most common type is methotrexate.
Methotrexate suppresses your immune system by targeting fast-growing cells. Unfortunately, these cells include hair follicles. This can lead to hair loss. Methotrexate doesnt cause hair to thin for everyone who takes it, but minor hair loss is one of the potential side effects.
Other DMARDs may also cause your hair to thin.
What Are The Signs And Symptoms Of Ra
With RA, there are times when symptoms get worse, known as flares, and times when symptoms get better, known as remission.
Signs and symptoms of RA include:
- Pain or aching in more than one joint
- Stiffness in more than one joint
- Tenderness and swelling in more than one joint
- The same symptoms on both sides of the body
- Weight loss
Joint Subluxation And Dislocation
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 who’ve 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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Rheumatoid Arthritis Medication Treatment Goals
Pinpointing how to subdue an overactive immune system has stumped doctors for decades. Seventy-five years ago, one of the only rheumatoid arthritis treatments for patients was a weekly injection of gold into the gluteal muscle. Today, there are a plethora of treatment options.
Current treatments give most patients good or excellent relief of symptoms and let them keep functioning at or near normal levels, reports the website of the American College of Rheumatology.2
Since there is no cure for the disease, the aim of treatment is to reduce pain and halt joint breakdown. The goal is to not only control symptoms, but to prevent further damage and deformities, Dr. Chi said.
Many rheumatoid arthritis treatment drugs fall into a bucket labeled disease modifying antirheumatic drugs . While most patients receive some form of a DMARD, no single drug is a guaranteed solution as patients react to the drugs differently. Scientists designed some of the drugs to fight against certain immune cells, while other drugs reduce immune mediators or block immune cell functions. Patients may be treated with a DMARD in combination with nonsteroidal anti-inflammatory drugs or low-dose corticosteroids, which reduce swelling and pain.
Common first line DMARDs include methotrexate, leflunomide, hydroxychloroquine and sulfasalazine.
If first line medications dont work, rheumatologists can pull out a list of second line medications called biologic response modifiers or biologics.
How Is Rheumatoid Arthritis Treated
Your healthcare provider will figure out the best treatment for you based on:
- How old you are
- How well you handle certain medicines, treatments, or therapies
- If your condition is expected to get worse
- Your opinion or preference
There is no cure for RA. The goal of treatment is often to limit pain and inflammation, and help ensure function. You may have 1 or more types of treatments. Treatment may include:
- Medicines. Some medicines may be used for pain relief. Some are used to treat inflammation. Others can help to slow the disease from getting worse. Medicines should be managed by a rheumatologist. This is a doctor who specializes in arthritis and rheumatic diseases. You may need regular blood tests to check how the medicines affect your blood cells, liver, and kidneys.
- Splints. Splints may be used to help protect the joints and strengthen weak joints.
- Physical therapy. Physical therapy may be used to help increase the strength and movement of the affected areas.
In some cases, surgery may be an option if other treatments dont work. Surgery does not cure RA. It helps correct the deformities caused by the disease. After surgery, RA can still cause problems. You may even need more surgery. Joint repair or reconstruction can be done in many ways, including:
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Managing Foot Pain In Ra
Getting treatment for RA can help relieve your foot pain and prevent deformities. This usually involves prescription medications to stop the immune system from attacking your joints.
You may also need to find other ways to manage your foot pain and cope with deformities.
Common strategies include:
- Therapeutic footwear, or special shoes designed for people with RA
- Foot orthotics, shoe inserts that can help provide support and reduce pain
- Occupational therapy, which can help you with daily activities
The success of these strategies will depend on which joints are affected and to what degree. If these approaches don’t work, you may need to consider surgery. Deformities like bunions and hammertoes can often be surgically treated.
For some cases, a doctor can fuse bones that form a joint. This involves connecting bones together permanently, which limits motion and reduces pain. Depending on which bones are fused, you may or may not notice the loss of motion.
Etanercept And Other Biologics
Certain biologics, such as etanercept, can also cause your hair to thin. Experts arent sure why these medications affect your hair. It may be related to messenger molecules, called cytokines.
If you experience hair loss from taking biologic RA medications, it probably wont be severe. Your hair growth will likely return to normal once you stop taking the drug.
How Can Rheumatoid Arthritis Affect The Cervical Spine
Rheumatoid arthritis is a chronic, systemic, autoimmune disease in which the immune system, which is designed to attack foreign bodies like bacteria and viruses, mistakenly attacks other healthy areas of the body, including the spines facet joints and even organ systems. Untreated, attacked joints can become deformed and lose their mobility.
When it comes to spine pain, a rheumatoid arthritis diagnosis is limited to the cervical spine. People can have problems, such as facet joint arthritis, further down the spine, but this is likely not due to RA. It is possible to have both osteoarthritis and rheumatoid arthritis at the same time.
If you have RA, you are part of a group of 1.3 million other Americans who have the disease.1 The disease causes morning joint stiffness that can last one to two hours or the whole day. It generally improves with movement of the joints. Other signs and symptoms include loss of energy, low fevers, loss of appetite, and lumps in the elbows and hands, called rheumatoid nodules. About 75% of RA patients are women, but cervical spine involvement is more common in male patients and those with a positive rheumatoid factor.
When rheumatoid arthritis loosens ligaments, erodes bone or causes thickened tissue around the atlantoaxial joint, it can compress the spinal cord and brain stem, which can lead to paralysis or even death if the neck is moved in certain positions. Fortunately, there are many treatments to avoid these outcomes.
What Does Ra Feel Like
- The usual symptoms of rheumatoid arthritis are stiff and painful joints, muscle pain, and fatigue.
- The experience of rheumatoid arthritis is different for each person.
- Some people have more severe pain than others.
- Most people with rheumatoid arthritis feel very stiff and achy in their joints, and frequently in their entire bodies, when they wake up in the morning.
- Joints may be swollen, and fatigue is very common.
- It is frequently difficult to perform daily activities that require use of the hands, such as opening a door or tying one’s shoes.
- Since fatigue is a common symptom of rheumatoid arthritis, it is important for people with rheumatoid arthritis to rest when necessary and get a good night’s sleep.
- Systemic inflammation is very draining for the body.
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Research On Rheumatoid Arthritis
In the last decade, much research has been conducted to increase our understanding of the immune system and what makes it malfunction. There have also been new therapies developed to help treat the disease. Some of the topics of intense research include:
What are the genetic factors that predispose people to develop rheumatoid arthritis?
Some white blood cells, commonly known as T cells, are important in maintaining a healthy and properly functioning immune system. However, scientists have discovered a variationcalled single nucleotide polymorphism in a gene that controls T cells. When the SNP gene variation is present, T cells attempt to correct abnormalities in joints too quickly, causing the inflammation and tissue damage associated with RA. The discovery of SNP may help determine peoples risk for getting RA and might help explain why autoimmune diseases run in families.
At conception, twins have an identical set of genes. So why would only one twin develop RA?
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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Ra Diet: What Foods To Eat If You Have Rheumatoid Arthritis
Rheumatoid arthritis patients require a stable, healthy diet for a number of reasons. Patients may become overwhelmed by their chronic pain and inflammation, remain undernourished, or develop medical complications.
Maintaining a healthy diet is an important part of protecting your overall health, managing weight, improving energy levels, boosting your mental health and boosting your immune system. While diet alone cant treat your symptoms, the right diet for RA can certainly go a long way in helping you feel better overall.
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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How Ra Affects Feet
Rheumatoid arthritis is an autoimmune condition. When you have RA, your immune system tries to destroy the lining of your joints, called synovium. It also attacks the fluid in your joints, called synovial fluid. It does this because it mistakes these parts of your body for disease-causing invaders.
RA causes damage and inflammation that makes your joints swell and feel warm. The small joints, like those in the feet, are the most common targets of these attacks.
Eventually, long-term inflammation thickens the synovium. This causes cartilage and bone to wear away. In the feet and toes, the joints may become deformed. This leads to poor range of motion and considerable pain. Walking, standing, and even wearing shoes can become difficult.
Proper treatment may help reduce the damage and inflammation to your foot joints. It may also prevent or delay deformities and other problems.
Are There Any Specific Vaccine Side Effects To Be Aware Of With Rheumatoid Arthritis
Some COVID-19 vaccine side effects could mirror those of a disease flare. Its important to carefully track your symptoms and talk to your doctor if you have any concerns. Typically, vaccine side effects only last a few days .
The CDC lists the following common side effects from the COVID-19 vaccine:
- Pain on the arm where you got the shot
- Redness on the arm where you got the shot
- Swelling on the arm where you got the shot
Some vaccine side effects that can overlap with rheumatoid arthritis disease activity may include muscle aches, joint pain, temporary fever, and fatigue, says clinical rheumatologist Magdalena Cadet, MD, Associate Attending Physician at NYU Langone Health in New York City.
Nausea may be present in some individuals after the vaccine, but rheumatoid arthritis patients may also experience that symptom with medications used to treat rheumatoid arthritis, like methotrexate or sulfasalazine, she adds.
Another common symptom of the vaccine is swollen lymph nodes under the arms on the side of the body where you received the vaccine, per the Cleveland Clinic. The swollen lymph nodes typically appear a few days after the vaccine and tend to subside within a few days to a few weeks. Although uncommon, swollen lymph nodes can also appear with rheumatoid arthritis.
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Are There Any Home Remedies For Rheumatoid Arthritis
If someone has joint pain or stiffness, he or she may think it is just a normal part of getting older and that there is nothing he or she can do. Nothing could be further from the truth. There are several options for medical treatment and even more to help prevent further joint damage and symptoms. Discuss these measures with a health-care professional to find ways to make them work.
- First of all, don’t delay diagnosis or treatment. Having a correct diagnosis allows a health-care professional to form a treatment plan. Delaying treatment increases the risk that the arthritis will get worse and that serious complications will develop.
- Learn everything about rheumatoid arthritis. If there are any questions, ask a health-care professional. If any questions remain, ask the health-care professional to provide reliable sources of information. Some resources are listed later in this article.
- Know the pros and cons of all of treatment options, and work with a health-care professional to decide on the best options. Understand the treatment plan and what benefits and side effects can be expected.
- Learn about the symptoms. If someone has rheumatoid arthritis, he or she probably has both general discomfort and pain in specific joints. Learn to tell the difference. Pain in a specific joint often results from overuse. Pain in a joint that lasts more than one hour after an activity probably means that that activity was too stressful and should be avoided.
Increase physical activity.
Rheumatoid Arthritis Can Drain Your Brain And Mood
The fear that comes with living with any chronic illness, as well as dealing with daily pain and limited mobility, can take a toll on emotional wellness. But when it comes to RA, depression may be more than just an emotional response to the disease. There is a clear link between RA and depression, says Daniel Solomon, MD, MPH, the chief of the clinical sciences section in the division of rheumatology at Brigham and Womens Hospital in Boston. We dont yet understand how much of the depression is from a reaction to the disease and how much is the inflammation of the disease, but they both contribute somehow.
What experts do know is that treating RAs inflammation helps quell the inflammation associated with depression. The opposite may also be true: Treating depression may lessen the pain of the disease. According to research presented in early June 2021 at the annual congress of the European Alliance of Associations for Rheumatology , catastrophizing about pain makes it worse, and it can actually physically impact the chances of RA remission.
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Ra In The Muscular System
When inflammation makes it harder to move your joints, the attached joints will get weak. According to a 2017 report in the journal EBioMedicine, a 2575% reduction in muscle strength has been observed in people with RA when compared to others without RA of the same ages.
People with RA can develop a condition called rheumatoid myositis that causes weakness, swelling, and pain. While rheumatoid myositis is poorly understood, researchers speculate a number of causes, including inflammation, the medications used to treat RA, impaired joint flexibility, and reduced activity levels.
Rheumatoid Arthritis Doctor Discussion Guide
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Rheumatoid Arthritis: Causes Symptoms Treatments And More
Rheumatoid arthritis is an inflammatory type of arthritis that can causes joint pain, swelling and damage. Learn what causes RA and how to treat it.
Rheumatoid arthritis causes joint inflammation and pain. It happens when the immune system doesnt work properly and attacks the lining of the joints . The disease commonly affects the hands, knees or ankles, and usually the same joint on both sides of the body. But sometimes, RA causes problems in other parts of the body as well, such as the eyes, heart and circulatory system and/or lungs. For unknown reasons, more women than men get RA, and it usually develops in middle age. Having a family member with RA increases the odds of developing RA.
In a healthy person, the immune system fights invaders, such as bacteria and viruses. With an autoimmune disease like RA, the immune system mistakes the bodys cells for foreign invaders and releases inflammatory chemicals that attack, in the case of RA, the synovium. Thats the tissue lining around a joint that produces a fluid to help the joint move smoothly. The inflamed synovium gets thicker and makes the joint area feel painful and tender, look red and swollen and moving the joint may be difficult.
Researchers arent sure why some people develop RA. They think that these individuals have certain genes that are activated by a trigger in the environment, like a virus or bacteria, or physical or emotional stress or some other external factor.
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