Top 10 Facts About Rheumatoid Arthritis You Must Know

Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in the joints. It is one of many different types of arthritis. Although the exact cause is not known but we do know that it happens when the body's infection-fighting system, called the immune system, attacks the joints. There are many myths and misconceptions associated with RA, especially regarding the symptoms, diagnosis and treatment. Lack of awareness leads to delayed treatment and can increase the complications of RA.

Here are some facts about RA that can help an individual understand the disease better.

1. What causes RA?

RA is an autoimmune disease. Your immune system is supposed to attack foreigners in your body, like bacteria and viruses, by creating inflammation. In an autoimmune disease, the immune system mistakenly sends inflammation to your own healthy tissue. The immune system creates a lot of inflammation that is sent to the joints causing pain and swelling. If the inflammation remains present for a long period of time, it can cause damage to the joint. This damage typically cannot be reversed once it occurs. 

The cause of RA is not known. There is evidence that autoimmune conditions run in families. For instance, certain genes increase the likelihood of RA. 

2. Symptoms of RA

Stiffness for a long time in the morning is a clue that you may have RA, as this is not common in other conditions. It may last one to two hours (or even the whole day) but generally improves with movement of the joints. For instance, osteoarthritis most often does not cause prolonged morning stiffness. Other signs and symptoms that can occur in RA include: 

-Loss of energy 

-Low fevers 

-Loss of appetite 

-Dry eyes and mouth, from a related health problem, Sjogren's syndrome 

-Firm lumps, called rheumatoid nodules, which grow beneath the skin in places such as the elbow and hands 

There are diseases that can be mistaken for RA. It is important to get the correct diagnosis with necessary testing. 

3. Women are more prone to the disease

About 75% patients are women between 30-50 years of age. In fact, 1-3% women may get RA in their lifetime. However, it also occurs in males and can strike at any age. Since it affects females in the prime of their life, it adversely affects the entire family. 

4. RA can attack internal organs as well

RA initially affects the joints but is not limited to them. If left uncontrolled the disease not only damages the joints, bones and cartilage, but may also affect multiple internal organs, like eyes, skin, and lungs. Early diagnosis and timely treatment play a key role in preventing complications 

5. It is not a part of ageing

Most people believe that arthritis is a part of ageing. This may be true for degenerative conditions like osteoarthritis but certainly not for RA which can affect a person at any age. Even children can suffer from the disease which is commonly known as juvenile RA. 

6. RA diagnosis

RA is diagnosed by examining blood test results, examining the joints and organs, and reviewing x-ray or ultrasound images. There is no one test to diagnose RA. Blood tests are run to look for antibodies in the blood that can be seen in RA. Blood tests are also run to look for high levels of inflammation. Some viral infections can cause symptoms that can be mistaken for RA. A rheumatologist is a physician with the skill and knowledge to reach a correct diagnosis of RA and to recommend a treatment plan. 

7. RA treatment 

Once diagnosed, treatments for RA aim to lower inflammation, ease symptoms like pain or swelling, and prevent long-term joint damage. No single treatment works for all patients, and many people may change their treatment at least once during their lifetime. 

A disease-modifying anti-rheumatic drug (DMARD) is usually the first treatment usually prescribed for RA. Nonsteroidal anti-inflammatory drugs (NSAIDs) and/or low-dose corticosteroids may be used with DMARDs. If DMARDs alone don't control RA inflammation, a rheumatologist may prescribe a biologic drug. 

8. Consulting a Rheumatologist is a must

When pain in the joints, muscles or bones is severe or persists for more than a few days, it is time to see a Rheumatologist. Rheumatologists are specially trained to do the detective work necessary to discover the cause of swelling and pain. 

9. There are no dietary restrictions for RA

There are no dietary restrictions advised for any patient with arthritis except for those suffering from a disease called Gout, which is caused by high uric acid in the body. There are no specific dietary restrictions for a person suffering from RA. An otherwise healthy diet is recommended.

10. Advice to patients for a better quality of life: 

-Take all medications as prescribed, and speak up if drugs cause any side effects or problems

-Stay physically active most of the time, scale back activities when the disease flares

-Do low-impact aerobic exercises, such as walking, and exercises to boost muscle strength

-Gentle range-of-motion exercises, such as stretching will keep the joint flexible

Activity and a healthy diet can keep weight under control to put less strain on joints. A physical therapist (PT) can help guide exercises that are safe for joints. RA can cause stress, anxiety or depression too. Discuss these normal feelings with your health care providers. They can provide helpful information and resources.

(Dr Aniruddha Tembe is a senior Consultant Rheumatologist, who has been practicing in the city of Pune for over a decade)