Rheumatoid Arthritis

Rheumatoid Arthritis woman

Last Updated December 20th, 2021

The most fundamental fact about rheumatoid arthritis is that it is an autoimmune condition, aka, it arises as a result of your body’s immune system attacking the healthy cells. Secondly, it is not a rare condition. RA affects more than 1.5 million people in the USA alone. Also, it has been observed that women develop RA more than men (3x times more!). This condition is not localized to a particular joint (unlike osteoarthritis), but is spread throughout the body.
Though RA doesn’t get passed on from parents to offspring everytime, having parent(s) with this autoimmune condition does increase the risk of developing the condition in the child. There are certain genes which influence the autoimmune processes within the body. These are - HLA, STAT4, PTPN22, etc.The presence of these can not only increase the risk of RA but also that of other autoimmune conditions such as multiple sclerosis.
Foods to eat in RA - Anti-inflammatory foods such as - fatty fish, fruits and vegetables, whole grains, nuts and seeds, olive oil. Foods to avoid in RA - Inflammatory foods such as - refined sugar, salt, processed junk, vegetable oil, alcohol, caffeine, tobacco etc.

Overview

Several diseases of the joints and bones occur at the onset of old age due to natural degeneration of the musculoskeletal system. Arthritis is a very common disorder after the age of 60 and affects men and women equally. According to statistics produced by the Arthritis Foundation, United States, nearly 350 million people suffer from arthritic conditions all over the world. A very common form of arthritis that affects mainly aged women is rheumatoid arthritis. The occurrence of rheumatoid arthritis is 1.06% in women and 0.6% in men. Recent research findings reveal that nearly 3,00,000 children have been diagnosed with juvenile arthritis in the past year, and many rheumatoid arthritis cases were reported among them. Thus clearly, Rheumatoid Arthritis is becoming a major cause of productivity and performance loss.

 

What is rheumatoid arthritis?

Rheumatoid Arthritis xrayRheumatoid arthritis is a systemic inflammatory disease which symmetrically affects the small bones and joints of the hand and feet. It is basically an auto-immune disease and produces systemic, articular and extra-articular effects. The reason rheumatoid arthritis is called “systemic” is if one knee gets affected with the disease the other knee starts showing similar symptoms as well. Inflammation, swellin, and stiffness of multiple joints (mainly the synovial joints) result in this conditions. This disease is usually incurable and the symptoms worsen with age. Rheumatoid arthritis typically peaks between the age of 40-50 and is at present one of the leading causes of disability on a global scale.

 

Difference between rheumatoid arthritis and osteoarthritis

Very often people get confused between the symptoms of rheumatoid arthritis and osteoarthritis, which may lead to misdiagnosis and improper treatment. The main difference is that osteoarthritis is the progressive erosion of the joints, while rheumatoid arthritis is the inflammation of the lining of the joints.

 

Pathogenesis of rheumatoid arthritis

The main pathological condition that leads to rheumatoid arthritis is the inflammation and thickening of the synovial membrane, caused due to autoimmune conditions. The synovial membrane becomes infested with inflammatory cells which causes joint pain and swelling. The vascular tissue (pannus) present in the synovial lining expands over the cartilage. Subsequent erosion of the articular cartilage and underlying bone occurs due to the presence of macrophages and osteoclasts (causes bone degeneration or resorption). Local inflammation is caused by two main immunoglobulin components synthesized by plasma cells in the subsynovium. Rheumatoid nodules form in the advanced stages and are surrounded by macrophages, fibroblasts, lymphocytes and plasma cells. Granuloma formation may also occur on the surface of pleura, endocardial valves, and pericardium.

The primary causes of pain in rheumatoid arthritis are-

  • Irritation of nerve endings due to chemicals produced by inflammatory cells
  • Excessive stretching of the capsules due to joint swelling

 

Joints affected

The joints primarily affected by rheumatoid arthritis are listed below-

  • Cervical spine: It can cause neck pain, stiffness, paraesthesiae or sensory changes.
  • Hands and wrists: Flexion contractures and ulnar deviation of fingers are observed.
  • Feet and ankles: Metatarso-phalangeal joints, talonavicular, subtalar and avicular joints are affected.
  • Shoulders: Inflammation of rotator cuffs occurs.
  • Elbows: Stiffness occurs.
  • Hips: Progressive loss of internal rotation occurs.
  • Knees
  • Temporomandibular joints: Pain, tenderness, and swelling occurs

 

Causes of rheumatoid arthritis

Rheumatoid Arthritis womanRheumatoid arthritis occurs due to multiple etiological factors which are described below-

  • Autoimmune diseases which cause a destruction of the joints and bones
  • The release of harmful chemicals such as cytokines (due to inflammatory response or existing pathological conditions) which directly affects the linings joints
  • Natural degeneration and weakening of body muscles and joints with age
  • Obesity or overweight conditions causing increased load on the knee
  • Joint inflammation due to rigorous physical activities or mechanical injury
  • Cigarette smoking can increase risks of joint damage
  • Diet deficient in Vitamin D
  • Accidental bending and twisting causing injured joints
  • Existing joint diseases such as gout, osteoarthritis or septic arthritis
  • Lifting excessively heavy loads
  • Genetic disorders causing degeneration of synovial tissues (mediated by Protein Tyrosine Phosphatase 22 gene)
  • Inflammation evoking food items such as artificial fats, processed meat, refined carbohydrates and alcohol
  • Toxicity due to chemicals present in the environment can affect the joints
  • Incorrect body postures

 

Symptoms of rheumatoid arthritis

Rheumatoid arthritis is manifested through the following symptoms-

  • Morning stiffness and joint pain lasting for more than 1 hour
  • Swelling of soft tissues of multiple joints
  • Symmetric joint swelling
  • Extreme tenderness and touch sensitivity of joints
  • Redness around the joint area
  • Erosion and decalcification (loss of calcium content) of joints in advanced stages
  • Formation of nodules in elbows and knees (rheumatoid nodules)
  • Fever and nausea
  • Extreme fatigue
  • General body weakness
  • Loss of appetite
  • Profuse sweating and few other flu-like symptoms
  • Anaemia
  • Dryness of eyes and mouth
  • Weight loss
  • Pain radiating to neighbouring regions (back)
  • Bone and joint deformities (at an advanced stage)
  • Throbbing pain in the joint and muscles after some activity
  • Joint pain during slight movements of hand and legs
  • Difficulty performing mundane activities such as walking, running or climbing stairs

 

Types of rheumatoid Arthritis

The International Classification of rheumatoid Arthritis is given below-

  • Seropositive rheumatoid Arthritis: It includes all categories of rheumatoid arthritis except arthritis of the spine and juvenile rheumatoid arthritis.
  • Felty’s syndrome: It is characterized by splenoadenomegaly and leukopenia.
  • Rheumatoid vasculitis: It is characterized by inflammation of the blood vessels.

 

Diagnosis

The following diagnostic tests are carried out to determine the cause and degree of rheumatoid Arthritis-

  • X-rays (to detect joint inflammation or cartilage destruction)
  • MRI scan (to examine joint injury if any)
  • Synovial fluid analysis ( to look for inflammatory cells)

 

Treatment and prevention

Rheumatoid Arthritis manTreatment

Medication 

  • Over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) can help in relieving pain and reducing inflammation. In case, OTC (over-the-counter) medications do not have much effect on the patient, stronger NSAIDs are prescribed by the doctor.
  • Medications to reduce joint pains, inflammation and joint degeneration are provided.
  • Certain medications can aid in reducing the progression of rheumatoid arthritis along with reducing degeneration of the surrounding tissues.
  • Medications that can target the part of the immune system that causes inflammation are called biological agents. These medications are prescribed to those who have been diagnosed with rheumatoid arthritis.

Therapy – Here the patient will have to undergo physiotherapy and occupational therapy. These therapies help the patient by reducing pain and by learning ways to manage their day-to-day activities with moderate to less pain.

Surgery 

  • Synovectomy – This surgery is performed on the knees, elbows, fingers, and hips to remove the inflamed lining of the joints.
  • Tendon repair – This surgery is done to repair the tendons around the inflamed joints.
  • Joint fusion – When the patient is unable to undergo a joint replacement, their joints are realigned to help bring back balance and reducing their pain.
  • Total joint replacement – Here the damaged joint is replaced with a prosthetic joint made of metal or plastic.

Low FODMAP diet for rheumatoid arthritis

Consuming high FODMAP foods cause common gastrointestinal problems such as bloating, gas, constipation, and diarrhea. This is because it is difficult for the gut enzymes to break these foods down and digest it, causing the intestines to bloat and absorb water while releasing gases such as carbohydrate, hydrogen and methane.

FODMAP stands for:

F – Fermentable. 

O – Oligosaccharides.

D – Disaccharides.

M – Monosaccharides.

A – and

P – Polysaccharides.

According to certain studies foods such as red meat (chorizo), wheat bread, barley induced flour, rye, sausages, milk products such as cow milk, goat milk etc. which are high in FODMAPs, can increase the symptoms of rheumatoid arthritis. Foods such as walnuts, tuna, salmon, baby spinach, kale etc. consist of low FODMAPs, and are said to help reduce the symptoms of rheumatoid arthritis.

Following a low FODMAP diet can help reduce consumption of artificially sweetened foods and fats. Consuming a low FODMAP diet can help in relieving the symptoms of rheumatoid arthritis.

Prevention – Since there are no sure shot prevention methods, there are certain risk factors that can help in maintaining the condition.

  • Exposure to certain harmful minerals such as silica and or asbestos may increase the chances of developing arthritis.
  • Those who are overweight seem to be at a higher risk of developing rheumatoid arthritis. This is why it is important to maintain a healthy weight.
  • Cigarettes tend to contain nicotine, which has bone degenerative properties, which is why it is important that people do not smoke. If they do smoke, then quitting is the best option for a healthier lifestyle.
  • Knowing your family history is necessary to understand the chances of developing rheumatoid arthritis.

Facts

  • Rheumatoid arthritis (RA) can be diagnosed in people of any age. It is not a disease that is found only among the elderly.
  • Though osteoarthritis and rheumatoid arthritis both affect the joints and cause pain, they are not the same. That is because they have different causes.

Facts

  • 3 million people in the USA have been diagnosed with rheumatoid arthritis.

Facts

  • Those who live on a higher altitude (within ages of 15-30 years) tend to have a higher risk of developing rheumatoid arthritis.

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The most fundamental fact about rheumatoid arthritis is that it is an autoimmune condition, aka, it arises as a result of your body’s immune system attacking the healthy cells. Secondly, it is not a rare condition. RA affects more than 1.5 million people in the USA alone. Also, it has been observed that women develop RA more than men (3x times more!). This condition is not localized to a particular joint (unlike osteoarthritis), but is spread throughout the body.
Though RA doesn’t get passed on from parents to offspring everytime, having parent(s) with this autoimmune condition does increase the risk of developing the condition in the child. There are certain genes which influence the autoimmune processes within the body. These are - HLA, STAT4, PTPN22, etc.The presence of these can not only increase the risk of RA but also that of other autoimmune conditions such as multiple sclerosis.
Foods to eat in RA - Anti-inflammatory foods such as - fatty fish, fruits and vegetables, whole grains, nuts and seeds, olive oil. Foods to avoid in RA - Inflammatory foods such as - refined sugar, salt, processed junk, vegetable oil, alcohol, caffeine, tobacco etc.

 

Dos and Don'ts

Dos
  • Exercise regularly. This helps in making sure that the joints are not stiff.
  • Soak the affected joints in warm water.
  • Partake in water-based exercises as they help in blinding up muscle strength and aid in easing the pain.
Don'ts
  • Lift anything that is heavy, including weights. This could make the pain worse.
  • Make any sudden movements; this can increase the symptoms of arthritis.
  • Forget to take your medications on time or delay going for physiotherapy.

 

 

 

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Surgery or home-remedy; what is the right way to treat a burn The treatment of a burn injury depends on its severity. You can save a life by offering the…
Poop chart: Top things you didn’t you your poop could reveal about you Bristol poop chart was designed during the 1990s in order to help doctors identify various types of poops…
Ear pain model
Easy and safe tips for ear wax removal you can do at home Cerumen impaction generally occurs when an external object like cotton swabs are used to remove the ear wax.…
TSH test
TSH Test – Thyroid Stimulating Hormone TSH test measures the level of thyroid secreting hormone in the blood. The level of this hormone is…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
EEG
Electroencephalogram – EEG EEG or electroencephalogram is a diagnostic tool used to access the functioning of neurons and brain activity to…
beta 2 glycoprotein 1 IgG
Beta 2 Glycoprotein 1 IgG Beta 2 glycoprotein 1 antibody test involves detecting and measuring the presence of the IgG class of beta…
cystatin C
Cystatin C Test Cystatin C is a specific single-chain protein that is found in body fluids and is a biomarker for…
copper serum test
Copper Serum Test Copper serum test checks for abnormal levels of copper in the body. Both high and low levels of…
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
carrageenan seaweed
Carrageenan: How a simple seaweed extract could better your gut health & immunity Eat more ice cream to prevent cold and flu? –With carrageenan you get one simple seaweed extract that…
occupational hazards types
Occupational Hazards: How to vouch for your health at your workplace Occupational hazards affect millions worldwide. Chemical spills, faulty wires, deadly pathogen, and work-stress can happen anytime. Follow these…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
Garlic health benefits cloves
Garlic: Nature’s white pill as an effective home remedy What are the secrets hidden in these tiny white pills? Find out the immense health benefits of using…
Cordyceps: How the Caterpillar fungus works as a proven cancer-shield Strange as it may sound, but cordyceps or "caterpillar fungus", a fungus variety native to the Himalayas may…
GM Diet: The fastest way to lose weight or yet another hoax diet? General Motors started this trend of extreme dieting for 7 straight days to ensure its employees were able…
waterchestnut
Water Chestnuts: The tastiest ways to include this healthy tuber in your diet Water chestnut is not a nut after all. It is a tuber (much like the potatoes) growing close…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
Sciatica pain relief: Get rid of the pain with these easy daily tips Researchers have claimed that not only heat but icing the area too helps relieve sciatica pain. Find out…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
HSV-IgM test
Herpes Simplex Virus (HSV)-IgM Test The HSV-IgM class antibody is produced by the body a few days after an initial HSV infection and…
apolipoprotein a1 test
Apolipoprotein -A1 (APO-A1) Test Apolipoprotein A-I (Apo-A1) constitutes 70% of protein content in high-density lipoprotein (HDL) and helps in lipid metabolism.
calories healthy
Calories: How to keep a check on these for faster weight loss Did you know you can burn calories while sleeping? Calorie-burning is what causes weight loss. How much should…
hYdroxycut pills
Hydroxycut: How safe are these so-called weight loss supplements? Hydroxycut is a blend of several different ingredients formulated to promote weight loss; powered by a key weight…
Anhedonia: Does the chronic inability to feel joy affect you too? How often do you feel dragged down by an invisible force? Do you feel an inexplicable emotional numbness…
Plexus Slim: Is this pink slimming drink the ultimate one-stop fat burner? How effective is Plexus Slim in helping people lose weight? What are its ingredients? Can it be safely…
Ear infections check up
Troubled with ear infections? Find easy and instant home remedies here Ear infections are common in both children and adults and may lead to hearing loss if left untreated.…
Appendix pain: Recent findings on this not-so vestigial organ The exact function of the appendix is still not clear. Some consider it as an organ that once…
Top reasons why you need to pay attention to your vitamin B6 intake Vitamin B6- An essential water-soluble vitamin. Its deficiency leads to physical changes such as sores & glossy tongue…
liver cleanse detox
14 go-to foods that are best for a complete natural liver detox Liver cleanse can be achieved by just choosing or avoiding certain types of food. Liver itself is a detoxifying…
PROSTATE-SPECIFIC-ANTIGEN
Prostate-Specific Antigen (PSA) Test Prostate specific antigen test is a blood test used to determine the presence of prostate cancer or any…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
dhea adrenal
Androstenedione Test Androstenedione is produced by the adrenal gland, the test of the levels of Androstenedione helps in the evaluation…