What is Rheumatoid Arthritis?

Arthritis means in simple language joint inflammation. Inflammation is defined by redness, warmth, pain and swelling. Rheumatoid arthritis predominantly affects small joints of hands and feet and is symmetrical in nature meaning arthritis occurs on both sides of body which helps differentiating from other causes of arthritis. If not treated adequately, it starts involving large joints as well such as elbow, shoulders, hip, knees, ankles.

It is not restricted to joints and other organs such as skin, eyes, lungs , nerves, kidney and other major organs can be involved.

RA is the most common form of autoimmune arthritis, affecting more than 0.8-1% Indian population. Of these, about 75 percent are women.

In fact, 1–3 percent of women may get rheumatoid arthritis in their lifetime.

Its generally affects females in fourth to sixth decades of life, but young children, males and elderly can also be affected

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What Are The Symptoms Of Rheumatoid Arthritis? 

Joint pain -While RA can affect any joint, the small joints in the hands and feet tend to be involved most often. Gradually it involves large joints such as elbows , shoulder, hip, knees and ankles

Stiffness – especially in the morning or after sitting for long periods

Inflammation sometimes can affect organs as well, for instance, the eyes or lungs. 

Other signs and symptoms that can occur in RA include: Loss of energy, Low fevers, Loss of appetite, Dry eyes and mouth from a related health problem, Sjogren’s syndrome

Firm lumps, called rheumatoid nodules, which grow beneath the skin in places such as the elbow and hands

Rheumatoid arthritis affects each patients differently. If treated early i.e. within 3 months, chances of remission ( time with no symptoms) is high. If not treated, patients starts developing deformities of different joints causing difficulties in doing daily routine activities.

Rheumatoid arthritis affects each individual differently. In most people, joint symptoms may develop gradually over several years. In other people, rheumatoid arthritis may progress rapidly.

A few people may have rheumatoid arthritis for a limited period of time and then enter a remission (a time with no symptoms), then again joint symptoms recurs.

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How Is Rheumatoid Arthritis Diagnosed?

Rheumatologist/arthritis doctor after taking history and doing physical examination will order test for rheumatoid arthritis if suspicion is high

Some common test that are done are as following-

• Rheumatoid factor
• Antibodies to cyclic citrullinated peptides (pieces of proteins), or anti-CCP
• Elevated erythrocyte sedimentation rate , C reactive protein (CRP)
• X-rays can help in detecting RA. Sometimes MRI and ultrasound scanning are done to help judge the severity of RA. 

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Rest

Inflamed joints should be rested.  At the same time, maintaining a good range of motion in your joints helps prevent deformities of joints

Exercise :

Types of exercises that have been shown to be beneficial include range of motion exercises to preserve and restore joint motion, exercises to increase strength, and exercises to increase endurance (walking, swimming, yoga and cycling).

Nutrition And Dietary Therapy

Weight loss may be recommended for overweight

No herbal or nutritional supplements, such as cartilage or collagen, can cure rheumatoid arthritis. These treatments can be dangerous and are not usually recommended. Junk food, fried and processed food, food with high content of salt (chutney, aachar, namkeen) and sugar should be avoided.

Smoking And Alcohol

Smoking can improve the condition. People who smoke need to quit completely. 

Moderate alcohol consumption is not harmful to rheumatoid arthritis

Treatment

Rheumatoid arthritis treatment has improved greatly in the past 30 years.

There is no cure for RA.

Best rheumatologist do this by starting proper medical therapy as soon as possible, before your joints have lasting damage. 

No single treatment works for all patients. Many people with RA must change their treatment at least once during their lifetime.

Thus, patients with a diagnosis of RA should begin their treatment with disease-modifying antirheumatic drugs — referred to as DMARDs. These drugs not only relieve symptoms but also slow progression of the disease.

Common DMARDs include methotrexate ,leflunomide, hydroxychloroquine and sulfasalazine Patients with more serious disease may need medications called biologic response modifiers or “biologic agents.”

Rheumatoid arthritis biological treatment include

• 1.Adalimumab
• 2.Etanercept
• 3.Golimumab
• 4.Infliximab
• 5.Rituximab
• 6.Tocilizumab

Janus kinase (JAK) inhibitors are another type of DMARD. People who cannot be treated with methotrexate alone may be prescribed a JAK inhibitor such as tofacitinib.

You will need frequent visits through the year with your rheumatologist (rheumatologist near me). These checkups let your doctor track the course of your disease and check for any side effects of your medications.

Joint injections

If one joint is involved due to rheumatoid arthritis, then it can be treated with steroids that are injected into the affected joints. You should discuss it with best rheumatologist as they have expertise in giving these joint injections.

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