There Is No One Cause Of Ra
We know there is no single cause of RA, and indeed there may be many different causes that lead to the disease, says Carl Ware, MD, head of the scientific advisory board of the Arthritis National Research Foundation and director of the Infectious and Inflammatory Disease Center at the Sanford Burnham Prebys Medical Discovery Institute.
This is important because it helps explain why some patients have strong results from a treatment that doesnt work well for others. Your doctor should be personalizing your therapy, helping you find which treatments work best for your individual situation, he adds.
Who Can Help With My Joint Pain Or Arthritis
Your PCP will guide you in the right direction regarding which specialist you need to see in further treating your health concerns. Many health insurance plans require that a PCP first refer the patient to a consulting specialist before a visit to this specialist is covered by your medical plan.
If you suffer pain and disability due to arthritis, body trauma, injury, or an accident , an orthopedist can help. The staff at Orthopaedic Associates utilizes both cutting-edge therapies and traditional treatments to address a variety of orthopedic conditions.
For more information or to schedule a consultation, call 892-1440 or fill out our easy-to-use online appointment request form. We look forward to hearing from you.
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.
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Everything You Want To Know About Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disease that can cause joint pain, inflammation, and damage throughout your body.
The joint damage that RA causes usually happens on both sides of the body.
So, if a joint is affected in one of your arms or legs, the same joint in the other arm or leg will probably be affected, too. This is one way that doctors distinguish RA from other forms of arthritis, such as osteoarthritis .
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Best Rheumatologists In Ottawa On
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Not Sticking To Treatment
After you are diagnosed with RA, your doctor will recommend a course of treatment to help manage RA symptoms and disease activity. If you fail to follow the treatment regimen by not filling prescriptions, not taking medication as directed, not exercising, or skipping appointments there is an increased risk of worsening symptoms and disease activity. Thats the case even when its unintentional, such as when you forget.
While your reasons for not following your treatment plan may be entirely valid, it is your responsibility to discuss those reasons with your doctor before you make changes to the prescribed regimen. You could benefit from a medication change or the addition of a treatment. Be sure to have that conversation with your doctor and decide on your next move together.
Want To Get More Involved With Patient Advocacy
The 50-State Network is the grassroots advocacy arm of CreakyJoints and the Global Healthy Living Foundation, comprised of patients with chronic illness who are trained as health care activists to proactively connect with local, state, and federal health policy stakeholders to share their perspective and influence change. If you want to effect change and make health care more affordable and accessible to patients with chronic illness, learn more here.
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Diagnosis Of Rheumatoid Arthritis
- Ordering laboratory tests.
- Ordering imaging studies, such as x-rays or ultrasound.
It can be difficult to diagnose rheumatoid arthritis when it is in the early stages because:
- The disease develops over time, and only a few symptoms may be present in the early stages.
- There is no single test for the disease.
- Symptoms differ from person to person.
- Symptoms can be similar to those of other types of arthritis and joint conditions.
As a result, doctors use a variety of tools to diagnose the disease and to rule out other conditions.
What Is Rheumatoid Arthritis
Arthritis is a general term for inflammation in joints. Rheumatoid arthritis is a type of chronic arthritis that occurs in joints on both sides of the body , which helps distinguish it from other types of arthritis.
In addition to affecting the joints, rheumatoid arthritis may occasionally affect other parts of the body, including the skin, eyes, lungs, heart, blood, nerves, or kidneys.
Rheumatoid arthritis is an autoimmune disease, meaning that patients immune system is overreacting against itself. The result can cause some or all of the symptoms of rheumatoid arthritis.
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Meet Your Rheumatoid Arthritis Health Care Team
Having a knowledgeable health care team can help manage symptoms of rheumatoid arthritis.
A diagnosis of rheumatoid arthritis means youll likely be partnering long-term with a team of providers who will help you manage your condition and optimize your health. “RA is a complex disease, and its treatments can also be complicated, so it often makes sense to draw on expertise from a number of professionals to guide you through the process and address specific problems, says Victoria Ruffing, nurse manager of the Johns Hopkins Arthritis Center in Baltimore.
RAs disease course is different for each individual. Although you may never need to see, for example, an occupational therapist or an orthopaedic surgeon, “consulting with them when theyre needed is a key reason people with RA can now get such excellent outcomes, Ruffing says.
These are some of the specialists your RA health care team may include:
For a comprehensive of all the doctors that may comprise your rheumatoid arthritis health care team, click here.
Treatment Plan
You Cannot Smoke Not Even Socially
When it comes to RA, smoking has been shown to increase your risk of both getting arthritis in the first place and worsen your symptoms after you have it. This makes smoking one of the biggest risks for patients, Dr. Martin says. If youre serious about managing your RA you have to quit smoking. This includes even a social cigarette here and there.
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The Pain You Feel Isnt From Your Bones Grinding Together
A popular myth about RA is that the characteristic joint pain is caused by your bones rubbing together at the joint. Not so, says Ed Levitan, MD, of Five Journeys, a functional medicine practice in Newton, Massachusetts. Studies have shown that even if an X-ray shows bone on bone that does not equal pain the pain comes from inflammation of the joint, he explains. So while its important to protect your joints from further damage, with RA its equally important to work on reducing inflammation in your body, he says.
What Else Could It Be
When a doctor thinks about how likely you are to have one disease over another, or over several others, this is called a differential diagnosis. There are many conditions your doctor may consider besides RA, and besides other forms of autoimmune arthritis:
Viral arthritis: Rubella, parvovirus, and hepatitis B and C can lead to short-term arthritis symptoms that resemble RA.
Palindromic rheumatism: Periodic joint inflammation that may lead to RA, lupus, and similar diseases
Polymyalgia rheumatica: This is more common over age 50, generally less painful than RA, and associated more with shoulders and hips.
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Lab And Blood Tests For Ra
Here are some of the things you can expect to happen at your appointment if the doctor thinks you have RA.
Personal and family medical history: Your doctor will ask about your past and your relativesâ. If someone in your family tree has RA, you may be more likely to have the disease.
Physical exam: The doctor will check your joints for swelling, tenderness, and range of motion. RA tends to strike several joints.
Antibody blood tests: Doctors look for certain proteins that show up in your blood when you have RA. These proteins mistakenly target healthy cells and kick off the inflammation process. So a high or positive test result means inflammation is in your body.
- Rheumatoid factor : high levels
- Anti-CCP : high levels
- ANA, or antinuclear antibodies: the results are positive or negative
Not all people with RA have these proteins.
Other blood tests: Besides RF and anti-CCP, other blood tests could include:
Complete blood count: It helps your doctor find anemia , which is common in RA. It looks for four things:
- White blood cells 4.8-10.8
- Hematocrit 42-52
- Platelets 150-450
Erythrocyte sedimentation rate: This measures how fast your red blood cells clump and fall to the bottom of a glass tube within an hour. Your doctor might call it a sed rate.
Normal ranges are:
- Men younger than 50: 0-15 mm/h
- Men older than 50: 0-20 mm/h
- Women younger than 50: 0-20 mm/h
- Women older than 50: 0-30 mm/h
Your Herbal Supplements Are Probably Garbage
Theres a lot of buzz about natural remedies for RA. While some may be helpful as an add-on to a treatment plan prescribed by a rheumatologist many are snake oil designed to remove your money rather than your pain, says Don R. Martin, MD, of Sentara RMH Rheumatology in Harrisonburg, Virginia.
Patients need to remember that natural does not necessarily mean its healthy. Remember both arsenic and asbestos are naturally occurring substances, he explains. Supplements are not regulated by the FDA the same way prescription and over-the-counter drugs are, so the purity of agents and the quality of scientific studies regarding their effectiveness varies widely, he adds.
Two kinds he says can be effective as part of an overall treatment plan? Capsaicin and turmeric. But make sure your doctor knows about any supplements you take, since some could have an effect on other medications you take.
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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
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How Your Ra Treatment Plan Prevents Disease Progression
Perhaps the biggest factor that affects how RA progresses is if youre in treatment with a specialist who can put you on medications to slow the disease. Being on a DMARD or biologic therapy for RA is the best way to prevent progression, Dr. Lally says.
Disease-modifying anti-rheumatic drugs are usually the first line in medication. Methotrexate is the anchor drug for rheumatoid arthritis, Dr. Bhatt says. Some patients are scared because methotrexate is also used for cancer chemotherapy so they dont want to take a chemo pill, but those we use for RA are a very small dose with lesser chance of side effects. Your doctor will reassess in a month or so and see if its necessary to add in other drugs.
If after three to six months they have still not responded then we progress to medications called biologics, Dr. Bhatt says. These genetically engineered drugs target the inflammation process specifically, and are usually self-injected or infused via IV in your doctors office or a medical center. There are sub-classes and different types, Dr. Bhatt says. Your doctor will try various medications to see which you respond best to.
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What Does An Orthopedist Do
Orthopedists handle the disorders, injuries, prevention, treatment, and repair of the skeletal system and its related joints, ligaments, and muscles.
Orthopedists and orthopedic surgeons are specially trained in the diagnosis and treatment of bone and joint disease. They use an array of testing modalities to aid in diagnosis and treatment.
Maintaining A Healthy Weight Matters
When it comes to weight and RA, the connection is clear: Excess pounds not only put extra pressure on your already over-taxed joints, but being overweight or obese can also contribute to inflammation throughout your body, which can further worsen your symptoms, Dr. Levitan says.
A 2017 study from the Hospital for Special Surgery of nearly 1,000 people with RA found that overweight patients were 25 percent less likely and obese patients were 47 percent less likely to experience a sustained remission compared to healthy weight patients, even though all received similar treatments. Losing weight may reduce RA symptoms and help drugs that treat RA work better.
Other research indicates that weight can be a factor in the onset of RA. A Mayo Clinic study from 2012 found that obese people were 25 percent more likely to develop rheumatoid arthritis than those at a healthy weight. The connection may have to do with the inflammatory activity of fat cells.
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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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Who Treats Rheumatoid Arthritis
Diagnosing and treating rheumatoid arthritis requires a team effort involving you and several types of health care professionals. These may include:
- Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.
- Primary care providers, such as internists, who specialize in the diagnosis and medical treatment of adults.
- Orthopaedists, who specialize in the treatment of and surgery for bone and joint diseases or injuries.
- Physical therapists, who help to improve joint function.
- Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
- Dietitians, who teach ways to eat a good diet to improve health and maintain a healthy weight.
- Nurse educators, who specialize in helping people understand their overall condition and set up their treatment plans.
- Mental health professionals, who help people cope with difficulties.
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Rheumatoid Arthritis Specialists And Care Centers
Northwestern Medicine Rheumatology focuses primarily on the diagnosis and treatment of arthritis and autoimmune diseases, including rheumatoid arthritis.
Rheumatoid arthritis specialists may include:
- Rheumatologists
- Physical rehabilitation specialists
- Pulmonary, cardiology and nephrology specialists
Improving our patients quality of life is one of our goals. To help our patients deal with the sometimes debilitating effects of musculoskeletal problems, arthritis, and autoimmune disorders, we offer a variety of treatments and procedures.
In the spirit of keeping you well-informed, some of the physician and/or individual identified are neither agents nor employees of Northwestern Memorial HealthCare or any of its affiliate organizations. They have selected our facilities as places where they want to treat and care for their private patients.
Ann & Robert H. Lurie Childrens Hospital of Chicago at Northwestern Medicine Central DuPage Hospital and Northwestern Medicine Delnor Hospital is a collaborative program between Northwestern Memorial HealthCare and Lurie Children’s and its affiliated physician groups. The physicians participating in this program are neither agents nor employees of Northwestern Medicine Central DuPage Hospital or Northwestern Medicine Delnor Hospital.
Treatment Of Rheumatoid Arthritis
Treatment of rheumatoid arthritis continues to improve, which can give many people relief from symptoms, improving their quality of life. Doctors may use the following options to treat RA:
- Medications.
- Routine monitoring and ongoing care.
- Complementary therapies.
Your doctor may recommend a combination of treatments, which may change over time based on your symptoms and the severity of your disease. No matter which treatment plan your doctor recommends, the goals are to help:
- Relieve pain.
- Prevent, slow, or stop joint and organ damage.
- Improve your ability to participate in daily activities.
Rheumatoid arthritis may start causing joint damage during the first year or two that a person has the disease, so early diagnosis and treatment are very important.
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