Rheumatoid arthritis is usually associated with people over 40. However, experts say it can occur at any age and is more common in women than in men.
Rheumatoid arthritis is a chronic inflammatory disorder that typically affects the small joints of the hands and feet.
Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects lining of the joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.
An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks the body tissues.
In addition to causing joint problems, rheumatoid arthritis sometimes can affect other organs of the body, such as the skin, eyes, lungs and blood vessels.
“Many people with arthritis and rheumatic diseases suffer from joint pain and stiffness, which can cause a person to avoid exercise out of the fear of increasing pain or causing injury.
“However, exercise, when properly planned and safely executed, can do just the opposite,” explained Dr. Eze Obinna, a general practitioner.
He said though rheumatoid arthritis can occur at any age, it usually begins after age 40, and the disorder is much more common in women than in men and has been shown to be an increased risk in children if a parent is affected.
Arthritis is usually chronic and it progresses slowly. Specific causes for most forms of arthritis are not yet known.
Obinna said the three most prevalent forms of arthritis are osteoarthritis, fibromyalgia, and rheumatoid arthritis.
“Osteoarthritis, the most common type, involves the joints, particularly the weight-bearing joints such as the knee, hip, and spine.
“Osteoarthritis is characterised primarily by the destruction of cartilage and narrowing of the joint space. It can also include bone overgrowth, spur formation, and impaired function.
“It occurs in most people as they age, but also may occur in young people as a result of injury or overuse.
“Fibromyalgia is a chronic, widespread pain in muscles and soft tissues surrounding the joints throughout the body; while rheumatoid arthritis is an inflammatory disease that involves the lining of the joint.
“The inflammation may affect all of the joints.”
The signs and symptoms of rheumatoid arthritis may include:
• Pain and stiffness in the joints.
• Swelling in one or more joints.
• Continuing or recurring pain or tenderness in a joint.
• Difficulty using or moving a joint in a normal manner.
• Warmth and redness in a joint.
Early rheumatoid arthritis tends to affect the smaller joints first, particularly the joints that attach fingers to hands, and toes to feet. As the disease progresses, symptoms often spread to the knees, ankles, elbows, hips and shoulders.
In most cases, symptoms occur in the same joints on both sides of the body.
The symptoms may vary in severity and may even come and go, and over time, rheumatoid arthritis can cause joints to deform and shift out of place.
In addition to a complete medical history and physical examination, diagnostic procedures for arthritis usually include:
• X-rays or other imaging procedures to show the extent of damage to the joint, blood tests and other laboratory tests.
• Rheumatoid factor test, to determine if rheumatoid factor is present in the blood.
• Urinalysis, to determine levels of protein, red blood cells, white blood cells, and casts and white blood cell count, to determine level of white blood cells in the blood).
“There is no cure for rheumatoid arthritis. Medications and physiotherapy can reduce joint inflammation in order to relieve pain and prevent or slow joint damage. However, severely damaged joints may require surgery,” said Obinna.
“Physiotherapy suggests pain and joint relief management, which may include new ways to do daily tasks, which will be easier on joints. For example, if the fingers are sore, one may want to pick up an object using the forearms.
“Assistive devices can make it easier to avoid stressing painful joints. For instance, a kitchen knife equipped with a saw handle helps protect the finger and wrist joints.
“Tools such as buttonhooks can make it easier to get dressed.”
If medications fail to prevent or slow joint damage, Obinna said doctors may consider surgery to repair damaged joints. Surgery may help restore ability to joints, reduce pain and correct deformities.
According to him, certain self-care measures, when used along with medications, can help manage the signs and symptoms. These include:
• Regular gentle exercise helps strengthen the muscles around joints, and help fight fatigue. However, avoid exercising tender, injured or severely inflamed joints.
• Apply heat or cold. Heat can help ease your pain and relax tense, painful muscles. Cold may dull the sensation of pain. Cold also has a numbing effect and decreases muscle spasms.
• Relaxing techniques such as light naps and deep breathing can be used to control pain.
• Plant oils such as evening primrose, borage and black currant contain a type of fatty acid that may help with rheumatoid arthritis pain and morning stiffness.
• Some studies have found that fish oil supplements may reduce rheumatoid arthritis pain and stiffness.
With time, Obinna said, an arthritis patient would find what strategies work best for him or her.
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