Definition of Rheumatoid Arthritis
Rheumatoid Arthritis (RA) is a serious, inflammatory type of arthritis associated with systemic complications. It is the second most common type of arthritis in the UK and affects approximately 1.3 million Americans. Women above the age of 40 are three times more likely to get RA.
Rheumatoid arthritis is a slow, progressive autoimmune disease of small joints. RA can be a short-course arthritis or life-long debilitating illness.
Causes of Rheumatoid Arthritis
RA is an autoimmune type of arthritis. An autoimmune state is when the immune system starts attacking itself. The cells of the immune system, possibly after a trigger, start perceiving healthy, normal cells of the human body as foreign invaders and responds by releasing immune mediators to destroy these normal cells. The trigger factors have not been well established, but the following risk factors have been implicated in rheumatoid arthritis:
- Age >40 years
- History of smoking
- Long-standing history of consuming red meat
- Drinking coffee chronically
Symptoms of Rheumatoid Arthritis
RA is typically arthritis of the small joints. Middle-sized and large joints may be affected but to a lesser degree. Small joints include: wrist and finger joints. Onset of RA is gradual, with symptom severity escalating over days to weeks. The course of arthritis in RA is symmetrical and often polyarticular.
- Morning stiffness lasting more than one hour is reported in more than 75% of all cases of RA
- Joint pain that is intense and excruciating
- Joint swelling with severe tenderness to touch
- Loss of functional joint mobility
- Nodular swelling under the elbow joints called rheumatoid nodules
- Drying of the mucus membrane is an associated symptom of Sjogren’s syndrome. A connective tissue disease that is closely linked to RA.
- Other symptoms are dependent on the dissemination of RA to other parts of the body. These include: difficulty breathing, chest pain, breathlessness, easy fatigability etc.
Treatment of Rheumatoid Arthritis
Rheumatoid arthritis responds well to medical therapy when diagnosed early. Pain management, inducing remission and preventing complications are the common goals of pharmacologic treatment. Dr. Burke, an orthopedic surgeon with an extensively deep background in rheumatology, is your best bet when you have symptoms of RA. He employs his fine clinical skills to assess the stage of RA, and then carefully select the right medical therapy to ensure remission is effectively induced and complications are avoided. The following therapies are available:
- Disease Modifying Anti-Rheumatic Drugs (DMARDS) such as methotrexate, hydrochloroquine, sulfasalazine and etc. are important in tackling the autoimmune state, inducing remission and preventing complications.
- Other drugs include: NSAIDS, steroids
- Physiotherapy and occupational therapy are recommended
- Surgery (rare) e.g. joint reconstruction