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Rheumatoid Arthritis

by Charlene J. Nuble

A shooting pain in the knee. A burning sensation in the hand. Before you know it, you have rheumatoid arthritis.

Rheumatoid arthritis is a chronic inflammation of the joints. Rheumatoid arthritis is an autoimmune disease in which the immune system attacks normal tissues as if they were invading antibodies. Rheumatoid arthritis also causes inflammation of the tissues around the joints and other organs of the body. The hands and feet are the most affected areas of rheumatoid arthritis although it can also affect any joint lined by a membrane. Rheumatoid arthritis is referred to as a systematic illness and sometimes called rheumatoid disease.

 

Rheumatoid arthritis manifests itself over a period of a few months. However, for some, the disease appears overnight. Accelerated onset of rheumatoid arthritis does not mean the individual is at greater risk of the progression of the disease. Rheumatoid arthritis can lasts for years without symptoms. But rheumatoid arthritis is an illness that progresses and has the potential to cause joint destrution and functional disability. Usually, patients suffer cycles from severe to light symptoms. In terms of statistics, rheumatoid arthritis is three times more common in women than in men. It also besets people of all races equally. Rheumatoid arthritis can begin at any age but most often start in the early forties.

What causes rheumatoid arthritis? The truth is, its cause is still unknown. Viruses, bacteria, and fungi have long been suspected but none has been proven to be the cause. The cause of rheumatoid arthritis has been the focus of different research activities. There are some scientists who believe that the tendency to develop rheumatoid arthritis may be genetically inherited while others believe that certain factors in the environment might elicit the immune system to attack the body's own tissue components. This attack results to the inflammation in various organs such as lungs or eyes.

 

Drug Therapies for Rheumatoid Arthritis

 

Rheumatoid arthritis is a progressive disease that affects over two million Americans. Symptoms may include joint stiffness, muscle ache, and general discomfort. As a progressive disease, it is expected that most patients will experience a worsening of symptoms as time progress. Fortunately, there are many drug therapies available to patients that can help alleviate the patient's symptoms considerably. The primary goal of therapy consists of helping alleviate the symptoms associated with rheumatoid arthritis so that the patient can take part in all their normal activities with as little pain or discomfort as possible. Sometimes, the patient may have to learn to modify their activities in order to prevent damage or discomfort. For the most part, however, individuals with rheumatoid arthritis can lead healthy lives. Drug therapies are prescribed according to each individual's specific circumstances and symptoms. Many times, two or more drug therapies are used in conjunction with one another to achieve the best possible results.

 

Traditional drug therapies consist of anti-inflammatory drugs. These are often referred to as NSAIDs. NSAIDs are non-steroidal and are targeted at reducing mild to moderate symptoms associated with inflammation caused by rheumatoid arthritis. For more advanced cases of rheumatoid arthritis, doctors often prescribe a specific class of drugs, often referred to as DMARDs. These are also known as disease-modifying antirheumatic drugs, sometimes also referred to as glucocorticoids. DMARDs should ideally be prescribed at the early stages of treatment. Research has shown that DMARDs are most effective when indicated at the beginning of treatment. In fact, DMARD drugs tend to be avoided for advanced cases of rheumatoid arthritis because they have been shown to cause serious side effects. If prescribed early enough, DMARDs have been shown effective at relieving signs of joint damage.

 

The conventional approach to treating rheumatoid arthritis with drugs consists of prescribing DMARD drugs to the patients as early as possible after a positive diagnosis. Studies indicate that if a patient is treated approximately three to twelve moths after the symptoms of rheumatoid arthritis have been first noticed the patient has a considerably greater chance of going into remission. DMARD drugs are effective at fighting the inflammation associated with rheumatoid arthritis, and can slow the progress of the disease considerably when treatment is offered early enough. With their ability to ease the patient into remission, DMARD class drugs are generally regarded as the most effective treatment option for rheumatoid arthritis patients.

 

In general DMARDs can take up to two to three months to take maximum effect. DMARDs can be used in conjunction with other types of drug therapies. However, most patients find that the need for other anti-inflammatory drugs is greatly reduced or even eliminated. Although DMARDs are not a magical solution that works for everyone, they have proven effective in helping millions of rheumatoid arthritis sufferers enter remission or at least experiencing a substantial lessening of symptoms. For most patients, DMARDs are prescribed on a long-term basis. This is true of most drug therapies that are currently available to rheumatoid arthritis patients.

 

Researchers have also found that environmental factors may also play a role in the cause of rheumatoid arthritis. In fact, scientists reported that smoking tobacco increases risk in the development of rheumatoid arthritis.

The symptoms of rheumatoid arthritis depend on the degree of tissue inflammation. Rheumatoid arthritis is said to be active if the body tissues are inflammed. When the tissue inflammation subsides, rheumatoid arthritis is said to be in remission. Remissions may happen spontaneously or with treatment and can last for weeks, months, even years. During active rheumatoid arthritis, symptoms are felt. Symptoms may include fatigue, lack of appetite, low grade fever, and muscles and joint aches. Muscles and joint stiffness are usually felt during mornings and after a period of inactivity. During relapses (from inactivity to activity) of rheumatoid arthritis, joints become red, swollen, painful, and tender. This happens because the tissue lining of the joints become inflamed which results in the excess production of joint fluids.

Multiple joints are usually inflamed in symmetrical pattern and the joints of both hands and wrists are often affected. Simple tasks such as turning the door knob and opening the jars can be painful. Rheumatoid arthritis can also affect the joint responsible for the tightening of vocal cords to change the tone of the voice although rarely. But when this happens, it can cause hoarseness of the voice.

As mentioned before, rheumatoid arthritis is a systematic disease which can affect organs and areas of the body other than the joints. Sjorgen's syndrome is the inflammation of the glands of the eyes and mouth which causes dryness. Rheumatoid inflammation of the lung lining can cause chest pains because the lung tissue itself is inflamed and nodules of inflammation also develop within the lungs. Rheumatoid arthritis can also reduce the number of red blood cells which can result to anemia and white blood cells which can result to increase risk of infections. A rare, serious complication of rheumatoid arthritis is blood vessel inflammation which can impair blood supply to tissues and lead to death of tissues.

A rheumatologist is a doctor who specializes in arthritis and other related diseases. The rheumatologist reviews the history of symptoms, examines the joints, and the other parts of the body for the inflammation. The diagnosis is usually based on the pattern of symptoms, the distribution of the inflamed joints, and the blood and x-rays obtained.

Until now, there is no known cure for rheumatoid arthritis. Reducing joint inflammation and pain, maximizing joint function, and preventing joint destruction is the current goal in treating rheumatoid arthritis. Early medical intervention has been found to improve outcomes in treatment. Optimal treatment includes combination of medications, joint strengthening exercises, joint protection, and patient education. Treatment is customized according to many factors such as disease activity, types of joints involved, general health, age, and occupation. But treatment is most successful when there is close cooperation between the doctor and the patient.

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About the Author

Charlene J. Nuble 2005. For up to date links and information about arthritis, please go to: http://arthritis.besthealthlink.net/ or for updated links and information on all health related topics, go to: http://www.besthealthlink.net/