Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints, causing inflammation, pain, swelling, and eventually leading to joint damage and deformity. Unlike osteoarthritis, which is caused by wear and tear on the joints, RA occurs when the immune system mistakenly attacks the body's own tissues, particularly the synovium—the lining of the membranes that surround the joints.
Key Features of Rheumatoid Arthritis
Autoimmune Nature:
- The immune system attacks the synovium, leading to inflammation.
- Over time, this inflammation can cause the synovium to thicken and lead to the destruction of cartilage and bone within the joint.
Symmetric Joint Involvement:
- RA typically affects joints on both sides of the body, such as both wrists, both knees, or both hands.
Chronic and Progressive:
- RA is a long-term condition that can worsen over time, leading to increased joint damage and potential disability if not properly managed.
Causes
The exact cause of RA is unknown, but several factors are believed to contribute to its development:
- Genetics: A family history of RA or other autoimmune diseases increases the risk.
- Immune System Dysfunction: The immune system mistakenly attacks healthy joint tissue.
- Environmental Factors: Smoking, obesity, and certain infections may trigger the onset of RA in genetically predisposed individuals.
- Hormonal Factors: RA is more common in women, suggesting that hormonal factors may play a role.
Symptoms
RA symptoms can vary in severity and may come and go. Common symptoms include:
- Joint Pain and Tenderness: Especially in the small joints of the hands, wrists, and feet.
- Swelling and Warmth: Affected joints may become swollen, warm to the touch, and stiff.
- Morning Stiffness: Stiffness that lasts for more than 30 minutes to an hour after waking up is a hallmark of RA.
- Fatigue: Persistent tiredness and a general feeling of being unwell.
- Fever: Low-grade fevers can be associated with RA flares.
- Joint Deformity: Over time, chronic inflammation can lead to joint damage and deformities, such as ulnar deviation in the hands.
- Nodules: Firm lumps of tissue, known as rheumatoid nodules, can develop under the skin, often near the elbows.
Treatment
While there is no cure for RA, early and aggressive treatment can help manage symptoms, reduce joint damage, and improve quality of life. Treatment options include:
Medications:
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): For pain and inflammation relief.
- Corticosteroids: Such as prednisone, to reduce inflammation and immune system activity.
- Disease-Modifying Antirheumatic Drugs (DMARDs): Such as methotrexate, which slow the progression of the disease.
- Biologic Agents: Target specific components of the immune system, such as tumor necrosis factor (TNF) inhibitors or interleukin-6 (IL-6) inhibitors.
- Janus Kinase (JAK) Inhibitors: A newer class of medication that targets specific pathways in the immune response.
Physical Therapy:
- Exercise: Tailored exercises to maintain joint flexibility and muscle strength.
- Occupational Therapy: To help with daily activities and to recommend joint protection techniques.
Surgery:
- In severe cases where joints are severely damaged, surgical options may include joint replacement (such as knee or hip replacement), tendon repair, or joint fusion.
Lifestyle Modifications:
- Healthy Diet: Anti-inflammatory foods, such as omega-3 fatty acids, and maintaining a healthy weight can help manage symptoms.
- Smoking Cessation: Smoking is a risk factor for RA and can worsen symptoms.
If you would like to have additional information contact Dr. Vipul Shet, serving communities and people from all walks of live.
