What is Rheumatoid Arthritis?

Rheumatoid arthritis is a chronic autoimmune disease. Unlike the other types of arthritis, rheumatoid arthritis involves your joints throughout your body so that you can experience symptoms on one or both of the following body parts:

Your fingers.
Your hands.
Wrists
Your knees.
Your ankles.
Your feet.
Your toes.

Uncontrolled inflammation hurts cartilage, typically a "shock absorber" in your joints. Eventually, it will deform your joints. Then your bone itself rots. This can lead to fusing your joint (an effort of your body to protect itself from constant irritation).

Specific cells in your immune system body's infection-fighting system the process along. The chemicals are released in your joints, but they also spread and cause symptoms throughout your body. Besides hurting your joints, rheumatoid arthritis sometimes affects other parts of your body, including your:

Skin.
Eyes.
Mouth.
Lungs.
Heart.

What are the symptoms of rheumatoid arthritis?

Rheumatoid arthritis develops differently in everyone. For some, symptoms will take years to develop, while others develop symptoms more quickly. Most people have periods with symptoms (flares) and times with no symptoms at all (remission).

Rheumatoid arthritis symptoms include:

More than one joint: Pain, swelling, stiffness, tenderness
Stiffness, especially after waking up or after a long period of inactivity
Pain or stiffness in the same joint on both sides of your body
Fatigue (severe tiredness)
Weakness
Fever

Do people with rheumatoid arthritis easily get tired?

Everybody's experience of rheumatoid arthritis is slightly different. However, most people with RA note that fatigue is among the worst symptoms of the disease.

Life with chronic pain can be very tiresome. It only gets worse to regain control over your pain if you get very tired. Pay attention and take action before you get too tired.

What are the symptoms of rheumatoid arthritis flare?

The symptoms of a rheumatoid arthritis flare aren't much different from the symptoms of rheumatoid arthritis. However, most people with RA have good days and bad days. A flare is a period when you are noticing symptoms after you have felt better for some time. You will probably go through periods of time when you feel better with treatment. Then stress, changes in weather, certain foods, or infections trigger increased disease activity.

Although you can't get rid of flares altogether, there are several things that can be done to simplify flare management. Keeping a journal of your symptoms daily and what is going on in your life may be helpful. Bring it with you to the rheumatologist so you both can find areas where triggers are lurking and work on those sources.

What causes rheumatoid arthritis (RA)?

The exact cause of rheumatoid arthritis is not known. However, experts believe that the disease is initiated by a contribution of genetic, hormonal, and environmental factors.

Ordinarily, your immune system keeps diseases away from your body. With rheumatoid arthritis, something triggers your immune system to attack your joints. A trigger may be an infection, smoking, or physical or emotional stress.

What are the risk factors for rheumatoid arthritis?

There are several predisposing causes of rheumatoid arthritis. These include;

Family History: You are more likely to develop RA if you have close relatives who have it
Sex: Women and people assigned female at birth are between two and three times more likely to develop rheumatoid arthritis
Smoking: Smoking raises a person's risk of rheumatoid arthritis and worsens the disease.
Obesity: You are more likely to get RA with obesity.

How is the diagnosis of rheumatoid arthritis performed?

Your doctor may refer you to see an arthritis expert who is called a rheumatologist. Rheumatologists are professional doctors specializing in diagnosing patients affected by the disease. A rheumatologist diagnoses the patients with rheumatoid arthritis using a set of criteria. They may examine you physically and ask about your medical history and symptoms that you're experiencing. Your rheumatologist will perform some blood test and imaging tests.

The blood tests check for inflammation and the blood proteins, also called antibodies, linked to rheumatoid arthritis. These include:

Erythrocyte sedimentation rate (ESR) or "sed rate" a proof of inflammation in your joint
C-reactive protein (CRP).
Some 80 percent of the patients who have been diagnosed with RA test positive for rheumatoid factor (RF).
About 60% to 70% of the patients with rheumatoid arthritis have antibodies to cyclic citrullinated peptides (CCP) (proteins).

Your rheumatologist may request imaging tests that look for signs your joints are breaking down. Rheumatoid arthritis is a cause the ends of bones on the inside of your joints can wear down. The imaging studies may be:

X-rays.
Ultrasounds.
Magnetic resonance imaging (MRI) scans.

In some cases, your provider may follow up with you over time before making a definite diagnosis of rheumatoid arthritis.

What are the diagnostic criteria for rheumatoid arthritis?

A provider will look for a pattern of signs, symptoms, and test results to declare that a patient has rheumatoid arthritis. They are based on years of research and clinical practice. Some people with RA do not have all of the criteria.In general, though, the diagnostic criteria for rheumatoid arthritis are:

Inflammation of two or more large joints: shoulders, elbows, hips, knees, and ankles.
Inflammation of smaller joints.
Positive tests for biomarkers, such as rheumatoid factor (RF) or CCP antibodies.
An elevated level of CRP or an elevated sed rate.
Your symptoms have lasted longer than six weeks.

What are the objectives of treating rheumatoid arthritis?

The primary objectives of treatment for rheumatoid arthritis are reducing joint pain and inflammation, which should help maintain or improve function in the affected joint. The ultimate long-term goal of treatment is to slow or stop the damage to the joint. Controlling joint inflammation reduces pain and improves your quality of life.

How is rheumatoid arthritis treated?

Joint damage commonly occurs within the first two years after diagnosis, so you must see your provider if you are experiencing symptoms. Initiating treatment of rheumatoid arthritis in that "window of opportunity" can also prevent long-term effects.

Medical treatments for rheumatoid arthritis include lifestyle changes, therapies, medication and surgery. Your provider weighs several factors and decides which treatment would be most beneficial to you based upon age, health, medical history, and the intensity of symptoms you are experiencing.

What are some medicines that treat rheumatoid arthritis?

Early treatment with certain drugs can improve the long-term prognosis. Combinations of drugs are often more effective and seem just as safe as single-drug therapy.

There are a variety of drugs to decrease the pain and stiffness of the joints and to halt or slow the disease. Examples of such drugs include the following:

Nonsteroidal anti-inflammatory drugs (NSAIDs)-

Nonsteroidal anti-inflammatory drugs decrease the pain and inflammation. They include such products as the following:

Ibuprofen (Advil®, Motrin®).
Naproxen (Aleve®).
Aspirin.

COX-2 inhibitors-

There are also NSAIDs called COX-2 inhibitors. Some examples include celecoxib (Celebrex®). Generally, COX-2 inhibitors are less likely than other NSAIDs to cause bleeding-type stomach side effects.

Corticosteroids, sometimes called steroids, are also drugs that may be prescribed to reduce pain and inflammation. Examples include prednisone and cortisone.

Disease-modifying antirheumatic drugs (DMARDs)-

Unlike the other NSAIDs, DMARDs can slow the disease process by altering your immune system. Your healthcare provider may prescribe DMARDs alone or in combination with steroids or other medications. Some common DMARDs include:

Methotrexate (Trexall®).
Hydroxychloroquine (Plaquenil®).
Sulfasalazine (Azulfidine®).
Leflunomide (Arava®).
Janus kinase (JAK) inhibitors

Another class of DMARDs is JAK inhibitors. Rheumatologists usually recommend JAK inhibitors for patients who are not improving on methotrexate alone. Available in the market:

Tofacitinib (Xeljanz).
Baracitinib (Olumiant).

Biologics

Your provider may prescribe biologic response agents if you do not do well on DMARDs. Biologics target the molecules that cause inflammation in your joints. Providers believe biologics are more effective because they can target cells at a deeper level. Examples of these products include:

Etanercept (Enbrel).
Infliximab (Remicade).
Adalimumab (Humira).
Anakinra (Kinaret).
Abatacept (Orencia).
Rituximab (Rituxan).
Certolizumab (Cimzia).
Golimumab (Simponi).
Tocilizumab (Actemra).

Biologics are relatively fast-acting—two to six weeks. They can be used alone or with a DMARD, such as methotrexate.

Is RA an inherited disorder?

Scientists have tested many genes in hopes of finding that one hidden cause. While it is true that there are many genetic variations and non-genetic causes that predispose you to RA, some important risk factors that have nothing to do with your genetic makeup include: gender; and exposure to irritants and pollutants in the environment.

Human leukocyte antigen (HLA) genes may affect an individual to develop rheumatoid arthritis. HLA genes aid your immune system in identifying the difference between proteins that your body produces and proteins from invading viruses and bacteria.

When is surgical treatment performed in rheumatoid arthritis?

Surgery may be necessary to restore movement in severely damaged joints. Your doctor also may consider surgery if your pain persists despite medication. Surgeries for RA include:

Knee and/or hip replacement.
Other surgeries to correct a deformity.

What is the prognosis for people who have rheumatoid arthritis?

Although rheumatoid arthritis cannot be cured, many treatments are available to reduce your pain and inflammation and slow your disease process. Early diagnosis and treatment are crucial.

What is early stage rheumatoid arthritis?

Doctors sometimes call the disease process in patients who have symptoms of rheumatoid arthritis for less than six months "early rheumatoid arthritis."

What are the four stages of rheumatoid arthritis?

Stage 1: Early-stage rheumatoid arthritis inflames the tissue surrounding your joint(s). You feel generally painful and stiff. Since your provider ordered X-rays, they wouldn't see any destructive changes in your bones.

Stage 2: Inflammation has begun to damage cartilage in your joint. You'll probably begin noticing stiffness and reduced mobility.

Stage 3: The inflammation becomes so intense that it damages your bones. You will feel more severe pain, you will have more stiffness, and reduced mobility compared to stage 2, and even physical changes can be seen.

Stage 4: In this stage, the inflammation reduces, but your joints worsen. You will experience intense pain, swelling, stiffness, and lost mobility.

Why Choose Tender Palm Super-Speciality Hospital for Rheumatoid Arthritis Treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Rheumatoid Arthritis treatment in Lucknow, India, at an affordable cost. We have a team of experienced rheumatologists and orthopedic specialists who provide accurate diagnosis with advanced imaging and laboratory testing, personalized medical care, and both medical and surgical treatment options. Our Rheumatology and Joint Care team has decades of experience in successfully treating Rheumatoid Arthritis in Lucknow, India.