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Rheumatoid arthritis

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What is rheumatoid arthritis?

Rheumatoid arthritis (RA) affects around 400,000 people on the UK. It belongs to the collection of diseases referred to as autoimmune; which means that it is a condition caused by your immune system wrongly attacking your body. Instead of defending your body against viruses and germs your immune system attacks your own tissues.

The condition causes your immune system to attack the lining of your joints, resulting in inflammation, pain and swelling in your joints, such as your fingers, feet and wrists. This swelling and stiffness can be very uncomfortable and make everyday tasks difficult, such as writing or walking.

What is the main cause of rheumatoid arthritis?

It isn’t known why rheumatoid arthritis develops, what triggers the condition or why it only affects certain people, even though there is lots of research and plenty of studies being carried out. However there are a number of lifestyle and hereditary factors that can increase your risk of developing the condition.

These include:

  • Smoking – this makes rheumatoid arthritis more likely
  • Being a woman – it is more common in women than in men, which is thought to be because of the hormone oestrogen
  • Your genes – rheumatoid arthritis is believed to run in families, although you can get the condition even if no one in your family has it. On the other hand just because a relative has the condition it does not mean that you will develop it.
  • Environment – an infection, trauma or a virus can cause rheumatoid arthritis to develop

Commonly, rheumatoid arthritis affects those aged between 30 and 50 years old, however you can get rheumatoid arthritis at any age, if you are especially young this is called early-onset arthritis.

What are the first signs of rheumatoid arthritis?

Rheumatoid arthritis and its symptoms tend to develop gradually, however this time span can vary from person to person, as can the severity of the symptoms. Your symptoms may appear over several weeks, or you may notice the signs over a number of days. They could be there one day and gone the next, or change over time. They may progressively get worse or you could experience flare ups where they are particular severe.

Rheumatoid arthritis symptoms in your joints include:

  • Pain
  • Swelling
  • Stiffness
  • Warmth
  • Redness

Rheumatoid arthritis affects the joints around your body; you may notice these symptoms in your hands, feet or knees. You may find that they feel particular stiff throughout the day, and many people say that the cold weather makes the pain worse, even though weather is not a cause of arthritis.

Alongside the symptoms that affect your joints, such as pain and stiffness, you may notice that your mood is affected and that your daily task or routines are being disrupted.

Other symptoms of rheumatoid arthritis:

  • Tiredness
  • Lack of energy
  • Mood changes, such as depression or irritability
  • Sweating
  • Changes in your appetite, more commonly a poor appetite
  • Weight loss
  • Flu like symptoms
  • Sweating
  • Inflammation in the eyes

If you experience any of these symptoms alongside the less common ones listed above, then visit your GP. They can offer lifestyle and treatment advice to help manage you condition.

Detecting and diagnosing arthritis early can help to slow the disease’s progress, as well as help you to find out how you can manage your symptoms more effectively. You’ll be able to put a treatment plan in place with your healthcare practitioner that can help you to continue living your life the way you want to, by managing the disease. Treatments may also help to prolonging the amount of time that you experience mild symptoms, while decreasing the frequency of any flare ups.

What are the stages of rheumatoid arthritis?

There are four stages of rheumatoid arthritis that you may experience, however everyone is different and your condition may not progress in the same way. These stages are complete with their own range of treatments and your doctor will be able to offer advice about what might be best for you.

The stages of rheumatoid arthritis:

Stage 1: The first and very early stage of rheumatoid arthritis is when the lining within your joints called synovium, become inflamed. As a result of this the surrounding tissue will become inflamed, causing pain, swelling and stiffness.

Stage 2: This is referred to as a moderate stage, where in which the inflammation of the synovial tissue worsens and starts to cause damage to the cartilage within your joints. The affected joint will become stiff and you won’t be able to move it like you used to, motion will become less frequent.

Stage 3: This stage is known as severe rheumatoid arthritis; once your condition has progressed to this stage the inflammation in your joints is eroding the cartilage and bone within your joint. This causes the ends of the bones to rub together as you move, causing increased pain and swelling. Your range of movement will be affected, causing you to experience loss of mobility and muscle strength. The joints may start to develop physical deformities such as painful lumps as well.

Stage 4: This is considered to be the end stage of the condition, where the inflammation stops but and your joints stop functioning. Chronic pain, swelling, stiffness and loss of movement occur in this stage; your muscles will become weak too.

What is the best treatment for rheumatoid arthritis?

The treatment options available to you depend upon what stage of rheumatoid arthritis you are experiencing. The earlier you can start treating your symptoms and condition the more effective it can be at limiting joint damage and slowing down the disease’s progression.

The main types of treatment include medication, lifestyle changes, physical therapy and surgery; however your doctor will be able to recommend the best treatment dependent on your symptoms.


Medication to treat rheumatoid arthritis

On being diagnosed with rheumatoid arthritis your doctor will explain the different types of medication available, these include disease-modifying anti-rheumatic drugs (DMARDs) and biological treatments. DMARDs help to ease symptoms and slow down the condition’s progression, by stopping the immune system attacking your body. Biological treatments for arthritis are newer and tend to only be used if you are not responding to other medication, they can be taken alongside DMARDs, and they are administered as an injection.

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Medication to help with pain

Alongside taking medication to control how quickly your rheumatoid arthritis is progressing, you may also want to take painkillers to help alleviate pain and allow you to live life as fully as possible. Your doctor may advise you to take over the counter painkillers including paracetamol or co codamol, which can help to relieve pain; however they do not treat the cause of the inflammation.

You can also take anti-inflammatory medication that you can buy in your local pharmacy, such as ibuprofen, for naproxen you will need a prescription from your doctor. These medicines belong to the group called non-steroidal anti-inflammatory drugs (NSAIDs); they work by reducing the inflammation and so reducing pain. Unfortunately they won’t stop the condition from getting worse but they can help to you continue doing the things you love.

There are also drug-free pain relief options, including TENS machines which help to alleviate pain by sending small electrical currents to parts of your body. These currents overpower the messages of pain being sent to your brain, as well as releasing feel good endorphins.

Lifestyle changes

Trying to keep as active as possible, while eating a healthy diet can also help you to keep feeling your best while improving your overall wellbeing. Physiotherapy can be used alongside medication to help improve your muscle strength, flexibility and overall fitness. There are tailored programmes available to help with particular areas of the body, for example if your wrists are most affected there are certain exercises you can do. A physiotherapist will be able to advise which movements are best for you. These can be built into your daily life, perhaps while you are watching television.

Surgery is sometimes needed if you have severe joint damage, and no amount of medication or treatments will help your joints or ease the pain. Surgery can help to restore your joints, in turn aiding you with mobility and function. You doctor will be able to advise whether joint replacement, or a procedure of removing the inflamed cartilage will be beneficial to you.

What foods should I avoid if I have rheumatoid arthritis? 

There is no specific diet that you should follow if you have rheumatoid arthritis; however there are certain foods, such as fish and olive oil that have been labelled by researchers as anti-inflammatory. However making sure that you eat a healthy diet, take regular exercise and get enough sleep will help you to feel better and improve your general wellbeing.

Can rheumatoid arthritis be cured?

No, at the moment there is no cure for rheumatoid arthritis (RA), however early diagnosis and treatment can help to reduce the impact of the condition has on your life, as well as slowing down the progress of RA.

What is the average age of onset of rheumatoid arthritis?

Typically rheumatoid arthritis develops in people aged between 30 and 50 years old, however the condition can occur before and after these ages.