Rheumatoid arthritis is a chronic auto immune disease that damages the joints of the body. Inflammation of the tissue lining the joint damages the actual joints. In rheumatoid arthritis the body’s immune system mistakenly attacks the joints causing inflammation.Rheumatoid arthritis is often referred to as RA.
The major symptoms characterizing rheumatoid arthritis are joint pain, stiffness, and swelling due to inflammation. The inflammation affects other organs and systems as well. If the inflammation is not treated, it can permanently damage the joints and other tissues.
Rheumatoid arthritis most often affects the smaller joints, such as those of the hands and/or feet, wrists, elbows, knees, and/or ankles. The symptoms cause significant discomfort and disability in the patient.Many people with rheumatoid arthritis struggle to carry out the activities of daily living including sitting, standing and walking. Eventually many find themselves unable to work after being diagnosed with RA.
Rheumatoid arthritis affects all races, social and ethnic groups. Women are 2-3 times as likely to develop RA. It is most likely to strike people who are middle aged, but does occur in children through teen age, and the elderly population. The true cause of RA remains unknown. There are several factors thought to be involved in the immune systems faulty response. Heredity, hormones (perhaps why more women than men have RA) and bacterial or viral infection are suspected of causing the abnormal immune system activity toward the body.
There is currently no cure for rheumatoid arthritis; however with current treatments available the disease can be controlled in most people.
Therapy to stop or slow down inflammation in the joints can:
- Prevent or reduce symptoms of RA.
- Prevent or reduce joint destruction
- Prevent or lessen debilitating effects and associated complications.
Treatment options for patients with RA that will help halt the inflammatory reaction are:
Disease-modifying antirheumatic drugs (DMARDs): This group of drugs all have one thing in common: they interfere with the immune processes that produce inflammation in RA. DMARDs can stop or slow the progression of rheumatoid arthritis. The ability of the body to fight infection is compromised while on these medications. Precautions must be taken to avoid exposure to disease causing pathogens. Fever, cough, or sore throat needs early treatment to prevent more serious problems. This class of drugs includes methotrexate, gold salts and cyclosporine.
Biologic response modifiers act like substances produced normally in the body and block substances that are a natural part of the immune response. The process that leads to inflammation and damage of the joints is blocked. Examples of these medications are Enbrel, Remicade, and Humira. All of these are given intravenous or by injection.
Glucocorticoids such as prednisone, prednisolone and betamethasone are very potent agents that block inflammation and other immune responses. They better known as steroids. These can cause serious side effects and are given for the short durations if possible. They should never be stopped abruptly. Sometimes steroids are injected directly into the joint to relieve symptoms.
Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce swelling and pain but do not stop joint damage. They are not sufficient to treat rheumatoid arthritis by themselves.
- Agents that block only the COX-2 enzyme are called COX-2 inhibitors. They have fewer side effects than the other NSAIDs but have the same inflammation reducing properties. Precautions must be taken due to side effects of these medications.
Analgesic pain relievers such as ibuprofen, Tylenol and narcotic opioids are used to help with pain relief. Other treatment methods utilized for RA include acupuncture, massage, good nutrition and exercise as tolerated.