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Rheumatoid Arthritis

What is Rheumatoid Arthritis

heumatoid arthritis (RA) is a chronic, inflammatory, systemic form of arthritis. It is an autoimmune disease which means that your immune system attacks your own body.Although RA can affect the entire body including the heart and lungs it is normally associated with joints.Inflammation in the joints causes pain, swelling and stiffness and, if not treated early on, can lead to permanent damage both to the joint and to surrounding tissue such as tendons and blood vessels.RA normally affects the smaller joints.

Who does it affect?

Rheumatoid arthritis can affect people in all age groups but it is most usual for the disease to start between 40 and 50 years.

Women are three times more likely to be affected by this disease than men.

Although RA can be found around the world the more serious cases are often found in northern Europe.

How many people are affected?

About 400,000 people in the UK are currently diagnosed with rheumatoid arthritis with approximately 20,000 new cases a year.

Causes and Risks

There is no single agreed cause of rheumatoid arthritis. Research indicates that either a virus or bacteria might be the cause but this hasn't been support by research.

Genetics - it has been stated that disease is hereditary. However I have read a lot of very contradictory material on this. From statements denying any hereditary components to one warning that you are 16 times more likely to have RA if a close relative has it. The Arthritis Research Council states that although it does tend to run in families most relatives of people with RA are unlikely to develop it and indeed children of RA suffers are more likely not to get it.

Risk factors associated with RA include: -Smoking, obesity, eating a lot of red meat, drinking a lot of coffee, heavy use of alcohol, recent blood transfusion and being either Caucasian or Native American are all associated with an increased risk of developing RA.

Rheumatoid Arthritis Symptoms

The most striking symptom of RA is pain in pairs of joints (both elbows, or both hips or both knees). It is rare for the pain to be in one joint only. Joints may become red, swollen and warm.The pain will usually develop slowly, over a number of weeks, though in a few cases there is a sudden onset.The level of pain is related to the amount of swelling. If the swelling goes down so will the pain.

Early morning stiffness is the next major symptom and again this is related to the amount of swelling. No swelling, no stiffness.

Rheumatoid nodules may develop. These are usually found on the Achilles tendon, the lower abdomen, the outside of the elbow joint, the underside of the fingers and on some toe joints. The nodules vary in size between a pea and a golf ball. They do not normally cause pain.

Bearing in mind that RA is a systemic disease, one that affects the whole body, other organs may be affected. During a flare-up about 50% of sufferers experience inflammation to other body parts.

Symptoms will vary depending on which joints and other organs are affected.

Many people with RA will feel extremely tired during a flare up and may feel depressed, lose their appetite, experience problems sleeping and develop anaemia. 

normal-joint
ra-joint

Rheumatoid Arthritis Diagnosis

There is no single test for rheumatoid arthritis and it is very important that you tell your doctor all the symptoms you have been experiencing whether or not you feel they are related to the pain you are experiencing in your joints.

In the early stages RA may be hard to differentiate from other forms of arthritis.

Two different types of tests are used to confirm the diagnosis: -

a) Blood tests. These will show if you are anaemic (80% of RA sufferers are), whether inflammation is occurring and for the presence of the "rheumatoid factor". None of these tests alone is definitive.

b) Imaging. X-rays can reveal any damage to the joints caused by inflammation but MRI (magnetic resonance imaging) and ultrasound screening are much more sensitive. These techniques are useful both in diagnosis and monitoring progress.

Rheumatoid Arthritis Treatment

Rest and exercise

- resting an inflamed joint will ease the pain however without regular movement the joints will become stiff and muscle start to waste away. A balance needs to be established between resting and exercise with perhaps less exercise during a flare-up and more (without over-doing it) during a remission.

Drugs

There are a wide range of drugs available to help with RA. These fall into four groups

  • Analgesics - for pain relief.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) - these are good for bringing down swelling and side effects can be treated with other medication.
  • Disease-modifying anti-rheumatic drugs (DMARDs) - these are aimed at treating the disease itself rather than reducing symptoms as in the previous two types. They can slow down the rate of the disease. Symptom relief does occur as a result of treating the main problem.
  • Corticosteroids - these are very effective at reducing inflammation but, if taken at a high dose over a long period of time, have a lot of side effects e.g. osteoporosis. Properly controlled use can be very effective in reducing the symptoms of RA.

Surgery

If the damage to the joint is severe it may be necessary for you to undergo surgery in particular joint replacement surgery. Please note that hip resurfacing is contra-indicated in cases of RA

vegan food pyramid

Diet

This is a controversial area. There are strong advocates of the role of diet in treating RA but there is no scientific evidence to back up their claims.

Some people notice that a particular food may lead to a flare up for them but it won't necessarily for another person. A diet high in vitamin C has been shown to help and there is some evidence that a very strict vegetarian diet may work.

Keeping your weight down is important. Due to the mechanical system of the body an extra stone of weight will result in 3-4 extra kilos being pushed through your hip joint.

My mother had RA for many years and refused to eat tomoatoes saying they alwasy resulted in a flare up. Other evidence has been put forward to suggest they may reduce inflammation. Different foods for different folks I guess



Related Links: 

Weight Loss 
Hip Resurfacing 
Preparing for Recovery

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