Rheumatoid Arthritis- Battle Inside the Body

Rheumatoid Arthritis (RA) is another serious autoimmune disease where your white blood cells do not differentiate healthy tissue from invading organisms like bacteria. The end result is you have a multi-system disease that can attack virtually every organ in your body, and it particularly painful as it causes inflammation of the joints and surrounding tissues. Patients suffering from Rheumatoid Arthritis in the US number about 2.1 million people

Rheumatoid arthritis initially attacks the synovium, a connective tissue membrane that lines the cavity between joints and secretes a lubricating fluid.

There is also juvenile rheumatoid arthritis which causes joint inflammation and stiffness for more than six weeks in a child under the age of 16. It affects approximately 50,000 children in the US. Many children do not complain of pain but any joint can be affected and the inflammation causes redness, swelling, warmth and soreness in the joints.

Risk factors:

1. Sex. Women are more likely to develop rheumatoid arthritis than men.
   
2. Age. Rheumatoid arthritis can occur at any age, but it most commonly begins between the ages of 40 and 60

3. Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease. Doctors don't believe you can directly inherit rheumatoid arthritis. Instead, it's believed that you can inherit a predisposition to rheumatoid arthritis.

4. Smoking. Smoking cigarettes increases your risk of rheumatoid arthritis. Quitting can reduce your risk.

The disease usually begins with the following symptoms:

• Fatigue
• Loss of appetite
• Morning stiffness (lasting more than 1 hour)
• Widespread muscle aches
• Weakness

Gradually the joint pain will appear and when you haven’t used that joint for a wile it can become warm, tender to touch and stiff. Then the lining of the joint becomes inflamed giving off fluid and the joint becomes swollen. Usually both sides of the body are affected and the joints may include fingers, wrists, elbows, shoulders, hips, knees, ankles, toes and neck. That doesn’t leave out much. Joint destruction may occur 1-2 years after onset of the disease. It is a painful, very uncomfortable disease.

Additional symptoms that may occur:

• Anemia due to failure of the bone marrow to produce enough new red blood cells
• Eye burning, itching, and discharge
• Hand and feet deformities
• Limited range of motion
• Low-grade fever
• Lung inflammation (pleurisy)
• Nodules under the skin (usually a sign of more severe disease)
• Numbness or tingling
• Paleness
• Skin redness or inflammation
• Swollen glands

There is no known cause of RA, and it can occur at any age. There is no known prevention, other than not smoking. Research shows that women who smoke are twice as likely to get RA as non-smokers. Women again are affected more often than men. This disease usually requires lifelong treatment including medication, physical therapy, exercise, education and possible surgery for joint replacements, which is similar to the to the other autoimmune diseases.

The common drugs used to treat rheumatoid arthritis are Methotrexate, DMARD, anti-inflammatory drugs, such as ibuprofen, Plaquenil, and Azulfidine. There are several new medications available for RA patients, much more so than other auto-immune diseases. Drugs that specifically treat the inflammation are Humira, Enbrel and Remicade. There are also some drugs that are called white blood cell modulators to control inflammation called Orencia and Rituxan. Many of these drugs have some serious side effects and patients are monitored closely. Unfortunately these drugs do no work with Lupus patients

Physical therapy is important, with individualized exercise programs to prevent the loss of joint function. Hot and cold treatments and splints may be used to support and align joints.

There are possible serious complications such as rheumatoid vasculitis, which is an inflammation of the blood vessels and pericarditis which causes the outer lining of the heart to swell. Fortunately, these complications aren’t too common.

Prognosis: Regular blood and urine tests are used to determine how well the medications are working. RA differs from person to person. People who have the rheumatoid factor found in the blood test or those with subcutaneous nodules seem to develop a more sever form of the disease. I have a friend that has these nodules throughout her lungs, so she is on oxygen and her life is severely impaired. It is hard to see my friend suffer and know there is no cure. Other people with RA work full time but after many years 10% of those will become severely disabled.

Rheumatoid arthritis is a very painful and serious disease. It can affect all the organs in your body and become disabling through the years. There are some new medications that seem to be effective in stopping the progression of the disease.

There is a lot of research being done on RA and there are new medications on the horizon so patients are living longer overall and having a little better quality of life.

The copyright to this article is owned by Pamela Oglesby. Permission to republish this article in print or online must be granted by the author in writing.