Rheumatoid arthritis is an autoimmune disease which typically attacks the small joints of the body. These include the fingers, wrists, elbows, ankles, and feet. In some more serious cases, it can attack internal organs such as the heart and lungs. It is a serious, chronic, and debilitating disease which, if left untreated, can cause significant deformity to the joints and severe disability.
Rheumatoid arthritis affects mostly woman, and usually begins between the ages of 30 and 50. Children and men can be affected as well, although women make up 70% of the cases. However, in men, its attacks are often more severe and less responsive to treatment.
The symptoms of Rheumatoid arthritis are often confused for other diseases, and it can take several years for a diagnosis to be made. No single blood test gives the diagnosis. Rather, diagnosis is made after an overall assessment of indicators is completed by the doctor, usually a rheumatologist.
Rheumatoid arthritis symptoms include flu-like symptoms, including low grade fever, muscle aches, loss of appetite, and in some cases, sweating in the hands and feet. At this stage most sufferers dismiss these as symptoms of a flu virus. However, within a short time, in some cases overnight, one or more joints will become swollen, red, painful and hot to the touch. Usually, RA attacks the joints symmetrically. That means that if your right hand is affected, your left hand is also affected simultaneously.
Other symptoms of Rheumatoid arthritis include stiffness in some of the joints upon awakening, and lasting for an hour or more. Prolonged sitting often aggravate the stiffness. Weight loss, depression and extreme fatigue are also reported.
Diagnosis of Rheumatoid arthritis usually requires blood tests for inflammatory markers, x-rays or bone scans of the affected joints and a thorough clinical exam including specific assessments of all of the joints, whether they are sore or not at the time of the exam.
Once Rheumatoid arthritis is diagnosed, there are several treatment options. Most of the rheumatologists today tend to treat the disease at its onset with aggressive treatments, regardless of the severity of the disease. In the past, doctors would begin with more of a 'wait and see' approach. They would give aspirin or acetaminophen to help with the pain. However, it has recently been shown that joint destruction can continue even without pain or swelling.
While every treatment plan is unique, most doctors prescribe a NSAID (non-steroidal anti-inflammatory drug) such as ibuprofen, mobicox, or celebrex, along with methotrexate to begin. If the swelling and pain is especially severe, prednisone, a corticosteroid with strong anti-inflammatory properties may be prescribed for a short period. Long term treatment with prednisone is often avoided due to its significant side effects. Cases which remain unresponsive to conventional treatment sometimes require the newest arsenal in treatment: 'biologics.' Biologics inside cells in an attempt to interrupt the inflammation process where it begins.
"Flares" or exacerbations of symptoms still occur for most RA sufferers from time to time. While rheumatoid arthritis cannot be cured, the pain, swelling and associated symptoms can often be successfully managed. Lifestyle changes and medications are often enough to keep the symptoms under control.
Arthritis research is ongoing, finding newer and better ways to treat the disease, and patients have reason to be optimistic for the possibility of a pain free future.
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