Rheumatoid arthritis (RA) is the most common autoimmune type of arthritis. In RA, your body’s immune system begins to react against its own tissues, causing significant inflammation in your joints and various other organs. This can cause joint pain, stiffness, swelling and decreased flexibility of the joints. RA often strikes small joints in your wrists, hands and feet but can also affect larger joints and other organs such as the eyes and lungs. About 75% of RA patients are women. Symptoms usually start between ages 30 and 50 but can happen to people at any age. RA is a chronic condition and there is no cure currently however there are many ways to treat and manage symptoms. Early diagnosis and the right treatments can ease symptoms and prevent joint damage or disability.
Signs/Symptoms
Stiffness in your joints in the morning is a clue that you may have RA. It may last one to two hours (or even the whole day) but it usually improves as the day progresses. Swelling and pain in the small joints of the hands and feet which have lasted for more than 6 weeks. Diagnosing RA requires a physical exam, blood tests and scans like X-ray, MRI, or ultrasound. In patients with RA, affected areas may be irreversibly damaged or destroyed inflammation persists. Thus prompt diagnosis, early recognition of active disease and measures to quickly achieve and maintain control of inflammation and the underlying disease process, with the goal of remission or low disease activity are central to modifying disease outcome.
Treatment
Treatment of patient with RA by a rheumatologist is associated with better outcomes compared with care rendered by other clinicians. Non pharmacological measures, such as patient education, Physcial and occupational therapy, should be used in addition to drug therapy.
Immunization to decrease the risk of complications of medications.
We use antiimflammatory drugs including NSAIDs, Glucocorticoids, as bridging therapies to rapidly achieve control of inflammation.
Disease-modifying anti-rheumatic drug (DMARD) is usually the first treatment usually prescribed for RA. Common DMARDs include methotrexate, leflunomide, hydroxychloroquine, and sulfasalazine.
If DMARDs alone don’t control RA inflammation, a biologic may be needed such as abatacept, adalimumab, etanercept, tocilizumab, or medications such as tofacitinib or upadacitinib. No single treatment works for all patients, and many people may change their treatment at least once during their lifetime.
Regular follow up with your rheumatologist is key to proper disease control and reduced risk of joint damage. Take all medications as prescribed, and notify your doctor if drugs cause any side effects or problems. Do low-impact aerobic exercises, such as walking, and exercises to boost muscle strength. Smoking cessation is also highly important if you’re a smoker since there is a known association of tobacco use and rheumatoid arthritis. Certain supplements such as omega-3 have also been shown to improve pain in patients with RA.