Rheumatoid Arthritis: Types, Causes, Symptoms and Treatment
Rheumatoid Arthritis, or RA, is an autoimmune disease that develops when the immune system attacks its own body's tissues. Rheumatoid Arthritis can harm the skin, eyes, lungs, heart, and blood vessels in some people. It also damages the lining of the joints, which causes painful swelling. This may lead to bone erosion and joint deformity. However, RA is different from osteoarthritis because osteoarthritis causes damage from wear and strain, whereas Rheumatoid Arthritis causes inflammation that harms other bodily parts as well.
Despite the tremendous improvements in treatment options, severe Rheumatoid Arthritis can still result in physical complications.
What are the types of Rheumatoid Arthritis?
There are three main types of Rheumatoid Arthritis.
- Seropositive RA - A person suffering from seropositive RA has a positive rheumatoid factor or anti-CCP blood test result. These are antibodies that trick the immune system into attacking the body's cells and tissues. This is considered severe and causes joint damage, deformity, development of vasculitis, lung issues, and rheumatoid nodules.
- Seronegative RA: If a person experiences the symptoms of Rheumatoid Arthritis even after testing negative for anti-CCP and RF, they might have seronegative RA. Around 20-30 per cent of patients may still have RA, even when the test for RA is negative. The body produces antibodies that could still result in symptoms of RA but are not yet routinely measured in the laboratory. However, this type of RA is less severe, and its symptoms usually include joint swelling, morning stiffness, and pain.
- JIA (Juvenile Idiopathic Arthritis) - RA in kids aged 17 and under is referred to as juvenile idiopathic arthritis. Similar to other types of RA, these symptoms may include inflammation, stiffness, fever, rash, and swollen lymph nodes.
What Causes Rheumatoid Arthritis?
The immune system defends the body against illness and infection and fights off foreign bodies. However, when the immune system acts abnormally, it targets healthy joint tissues, causing Rheumatoid Arthritis. Additionally, it may also lead to health issues with your nerves, eyes, skin, heart, and lungs.
However, doctors are not yet sure about the exact origin of the condition. Although it is considered a hereditary disease, genes don't directly cause Rheumatoid Arthritis. Instead, they can increase susceptibility to environmental conditions. Sometimes, viruses and bacteria are also responsible for causing RA.
What are the Symptoms of Rheumatoid Arthritis?
Rheumatoid Arthritis affects everyone differently. Some may experience the condition for a very long period, while others start experiencing the symptoms early. Additionally, some people experience flares and remissions with little to no symptoms. Signs and symptoms of Rheumatoid Arthritis include:
- Pain, stiffness, edema, and soreness in joints
- Stiffness in the joints after sitting or lying down for a long time.
- Stiff and painful joints on both sides of the body.
- Extreme exhaustion or fatigue.
The symptoms of RA might range from mild to severe. No matter how intermittent your symptoms are, it's crucial to pay attention to them and seek medical attention. Early Rheumatoid Arthritis affects the smaller joints, such as finger joints and toes. Healthcare providers will be able to treat and manage Rheumatoid Arthritis if the symptoms are understood initially.
How is Rheumatoid Arthritis Diagnosed at Hinduja Hospital?
Our doctors at Hinduja Hospital first perform a physical examination to check the severity and area of the pain. To confirm RA, the doctor might prescribe the following tests:
- Blood Test - Rheumatoid Arthritis patients often exhibit high levels of C-reactive protein (CRP) or Erythrocyte Sedimentation Rate (ESR), which indicates the presence of inflammation. Rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies are the tests mostly prescribed by the doctors.
- Imaging Exams - To monitor the development of Rheumatoid Arthritis in the joints over time, our top doctors in Mumbai advise getting X-rays. Depending on the result, the doctor will assess the degree of the disease in the body. In addition, the doctors might also ask to do a CT scan, MRI, and ultrasound.
How is Rheumatoid Arthritis Treated at Hinduja Hospital?
The goal of treating Rheumatoid Arthritis is to reduce swelling and pain. Although there is no known cure for RA, certain medications can help patients manage the disease and avoid damage if treatment starts at an early stage.
Usually, the treatment for Rheumatoid Arthritis includes therapies, medicines, surgery, and lifestyle changes. The doctors consider the patient's age, medical history, current health, and the severity of the symptoms before suggesting treatment plans. The following are the treatment options for Rheumatoid Arthritis suggested by the doctors at Hinduja Hospitals:
- NSAIDs - NSAIDs, or nonsteroidal anti-inflammatory medicines, can reduce inflammation and relieve pain. However, heart and kidney conditions are some of the side effects of the medication.
- Standard DMARDs - These medications can stop the evolution of Rheumatoid Arthritis and prevent irreparable damage to the joints and other tissues. Standard DMARDs might have some serious side effects, such as lung infections and liver damage.
- Biologicals - These are newer and more effective medications that are better at controlling RA symptoms, but they are only used in cases where standard treatment doesn't work.
- Steroids - Corticosteroid drugs lessen pain and inflammation while also slowing joint deterioration. Diabetes, bone weakening, and weight gain are some of the possible side effects. Corticosteroids are frequently prescribed by doctors to quickly alleviate symptoms with the intention of progressively weaning down the drug.
The doctor might suggest that the patient visits a physical or occupational therapist who can help them with stretches and exercises to keep their joints flexible. The therapist might recommend some new and regular stretching techniques that the patient can do at home. They might also prescribe some assisted devices to avoid stress on the joints and reduce soreness. For example, a kitchen knife with a hand grip helps safeguard the wrist and finger joints, or buttonhooks can make getting dressed simpler. There are many tools that one can find in medical stores.
If Rheumatoid Arthritis cannot be managed with therapy and medications, the doctor may discuss having surgery to restore damaged joints. This is because it can help restore movement and the ability to use the joints. The doctor might use the following surgical methods for treating Rheumatoid Arthritis:
- Synovectomy - Synovectomy is done to remove the inflamed joint lining, also known as synovium. This helps reduce the pain and inflammation, resulting in improved joint movement.
- Joint Fusion - Surgically fusing a joint may be advised to stabilise or realign a joint as well as to relieve discomfort.
- Joint Replacement - The surgeon will remove the damaged joint components during the procedure and replace them with a metal and plastic prosthesis.
- Tendon Repair - Tendons surrounding the joint may rupture or become loose due to joint injury and inflammation. These damaged tendons are surgically repaired around the joint to improve movement of the joints.
Like any other surgeries, Rheumatoid Arthritis surgeries also carry risks of bleeding, infection, and pain. Thus, it is advisable to discuss the complications and risks that might arise after the surgery. Also, a patient must also discuss any health conditions such as diabetes, blood pressure, etc., as these might also contribute to higher risks of complications.
How can Rheumatoid Arthritis be Prevented?
Rheumatoid Arthritis is a chronic condition that might make a person feel like they have little control over their life. However, there are things one can do to improve their well-being. Below are some preventive measures for Rheumatoid Arthritis:
When the joints are inflamed, the risk of injury to the joints and adjacent soft tissue structures (such as tendons and ligaments) is significant. It is advisable to rest sore joints. However, one should continue to exercise. This is crucial because managing RA requires keeping the joints functioning properly and maintaining good health.
Stiffness and pain can make a person move more slowly, leading to inactivity in some individuals. However, lack of activity can cause muscular weakness and loss of joint motion. These factors reduce joint stability and increase pain and exhaustion. But with regular exercises, these complications can be avoided and reversed. A physical therapist might suggest the following exercises:
- Exercises to build muscle.
- Endurance-building exercises such as walking, swimming, and cycling.
- Exercises that improve range of motion to protect and restore joint motion.
Doctors usually suggest the patient have foods with anti-inflammatory properties, as they reduce pain and inflammation. Moreover, it is advisable to eat food rich in antioxidants, such as green tea, fresh fruits, vegetables, and nuts. Also, having fibre-rich foods, such as whole grains, nuts, beans, fruits, and vegetables, can be a great option.
People with Rheumatoid Arthritis could feel that their level of pain and weariness is constantly fluctuating. It's crucial that they let their healthcare professional know about these symptoms. Diagnosis of Rheumatoid Arthritis, like X-rays and blood test reports, will help the doctors chart out a treatment plan. Most people are able to control their Rheumatoid Arthritis and continue with their favourite activities. Usually, the condition is treated with medication and therapy. However, if neither of them works, the doctor might suggest surgery.
For a comprehensive and best Rheumatoid Arthritis treatment in Mumbai, visit Hinduja Hospital. Our doctors are specialised and trained to help people with Rheumatoid Arthritis.
Q1. Rheumatoid Arthritis: is it hereditary?
Ans. Rheumatoid Arthritis risk is higher in people born with polymorphisms in the HLA (human leukocyte antigen) genes. The immune system utilises HLA genes to differentiate between proteins originating from your body and those generated by external entities such as viruses and bacteria.
Q2. What are the objectives of Rheumatoid Arthritis treatment?
Ans. Control of inflammation and prevention of joint damage, and reduction of joint pain and swelling is the main objective of Rheumatoid Arthritis treatment. Doing so should support maintaining or enhancing joint function. Slowing or halting joint deterioration is the long-term therapy goal. Managing joint inflammation will increase your quality of life and reduce your pain.