By David Perz, D.O.
This article is a follow up to the Osteoarthritis article published in the February-March 2005 issue of Healthy Times.
What Is Rheumatoid Arthritis?
Rheumatoid arthritis (rue-ma-TOYD arth-write-tis) involves inflammation in the lining of the joints and/or other internal organs. RA typically affects many different joints. It is typically chronic, which means it lasts a long time, and can be a disease of flare-ups.
RA is a systemic disease that affects the entire body and is one of the most common forms of arthritis. It is characterized by the inflammation of the membrane lining the joint, which causes pain, stiffness, warmth, redness and swelling. The inflamed joint lining, the synovium, can invade and damage bone and cartilage. Inflammatory cells release enzymes that may digest bone and cartilage. The involved joint can lose its shape and alignment, resulting in pain and loss of movement.
What Are the Symptoms?
Symptoms include inflammation of joints, swelling, difficulty moving and pain. Other symptoms include loss of appetite, fever, loss of energy, and anemia.
What Causes It?
The cause of RA is not yet known. However, it is known that RA is an autoimmune disease. The body's natural immune system does not operate as it should, resulting in the immune system attacking healthy joint tissue and causing inflammation and subsequent joint damage.
What Are the Effects?
Early in the disease, people may notice general fatigue, soreness, stiffness and aching. Pain and swelling may occur in the same joints on both sides of the body and will usually start in the hands or feet. RA affects the wrist and many of the hand joints, but usually not the joints that are closest to the fingernails (except the thumb). RA also can affect elbows, shoulders, neck, knees, hips and ankles. It tends to persist over prolonged periods of time, and over time, inflamed joints may become damaged.
How Is It Diagnosed?
Physicians diagnose RA based on the overall pattern of symptoms, medical history, physical exam, X-rays and lab tests including a test for rheumatoid factor. Rheumatoid factor is an antibody found in the blood of about 80 percent of adults with RA. However, rheumatoid factor may be seen in other conditions besides RA.
Treatment
Current treatment methods focus on relieving pain, reducing inflammation, stopping or slowing joint damage, and improving patient function and well-being.
Early treatment is critical. Treatment most often involves some combination of medication, exercise, rest, joint protection, and physical and occupational therapy.
Will exercise really help me? Yes. Exercise keeps your muscles strong and helps you stay flexible. Exercises that don't strain your joints are best. To avoid pain and injury, choose exercises that can be done in small amounts with rest time in between. Try tightening your muscles and then relaxing them a number of times. You can do this with all of your major muscle groups. You could also try an "aquacise" program available through your local swimming pool or community center. These programs involve special movements in the pool, with much of your body's weight held up by water.
David Perz, D.O. is a Family Physician in Hemet. He can be reached at (951) 766-8403.