A chronic inflammatory condition, rheumatoid arthritis, is a type of arthritis that affects more than just your joints. In some cases, this condition gets so severe that it can hamper a bunch of body systems, including blood vessels, lungs, skin, heart, and eyes. It is primarily a form of an autoimmune disorder that occurs when the immune system attacks certain tissues in the body. This type of arthritis is different from osteoarthritis, which is caused by the damage caused by regular wear and tear. In rheumatoid arthritis, there’s damage to the joint’s lining. Consequently, you’ll experience painful swelling, which can either lead to joint deformity or bone erosion. It is the inflammation of rheumatoid arthritis that tends to have a damaging impact on the other parts of the body, too. Though the new medications have paved the way for better treatment, if the condition escalates to a severe stage, it can lead to physical disabilities.

Symptoms

The primary symptoms of rheumatoid arthritis are:

• Swollen, warm, or tender joints
• Stiff joints, which are severe in the mornings, and aggravates after a bit of inactivity
• Not feeling hungry
• Fever
• Fatigue

In the early stages, rheumatoid arthritis starts at smaller joints. It includes the attaching joints, ones that attach your toes to the feet, or those that annex your fingers to the hands. With the progression of the disease, these symptoms spread to the ankles, knees, elbows, shoulders, hips, and wrists. Usually, the symptoms are noted in the same joints towards both sides of the body. In approximately 40% of people suffering from rheumatoid arthritis, the symptoms aren’t associated with joints. So, some non-joint symptoms affect:

• Lungs
• Skin
• Heart
• Eyes
• Nerve tissue
• Salivary glands
• Kidneys
• Blood vessels
• Bone marrow

Typically, the symptoms vary from person to person in terms of their severity. Often, the symptoms even come and go. There will be flares in the symptoms, followed by a long period of absence. It all varies. Over time, because of this disease, the joints might either move from their place or develop deformities.

Causes

You experience rheumatoid arthritis when the body’s immune system mistakenly attacks the synovium, which is the lining of the membrane enveloping the joints. Because of the inflammation, the synovium thickens and can have a severe effect on the bone and cartilage inside the joint. It stretches and weakens the ligaments and tendons, which keep the joint together. As a result, the joint has alignment issues or loses its shape.

There’s no information on what possibly causes the commencement of rheumatoid arthritis. However, there’s a belief that genetics does have a role to play here. Though genes do not directly cause rheumatoid arthritis, they certainly make you vulnerable to environmental factors, like bacteria or the virus that could be the triggers of the disease.

Risk factors

Some known risks of rheumatoid arthritis are:

• Age
  Though rheumatoid arthritis can develop at any age, the onset is usually noted in middle-age.
• Sex
  Women are more susceptible to rheumatoid arthritis than men.
• Family history
  People who have rheumatoid arthritis in their family are more prone to develop the disease.
• Smoking
  People who smoke have a higher risk of rheumatoid arthritis.
• Obesity
  People who are overweight are more vulnerable to developing rheumatoid arthritis compared to others.
• Environmental factors
  Exposure to silica or asbestos heightens the risk of rheumatoid arthritis.

Complications

Because of rheumatoid arthritis, you might be more susceptible to other complications. These include:

• Heart problems
  Rheumatoid arthritis might lead to blocked or hardened arteries. It might also lead to inflammation in the sac that envelopes your heart.
• Osteoporosis
  Rheumatoid arthritis medications, along with the disease, increase your chances of developing osteoporosis. It is a condition in which your bones weaken over time, making them vulnerable to fractures.
• Dryness in mouth and eyes
  Those suffering from rheumatoid arthritis might develop Sjogren’s syndrome. It is a condition in which the moisture of the eyes and the mouth diminish.
• Lung disease
  Scarring or inflammation of the lung disease is also common in those who have rheumatoid arthritis.
• Infections
  Rheumatoid arthritis and its medications have a deteriorating effect on the immune system, which puts you at a higher risk of developing infections.
• Carpal tunnel syndrome
  When the disease impacts your wrist, it can lead to a compression in the nerves, which serve your fingers and the hands.
• Rheumatoid nodules
  It is a complication that causes a few bumps of tissues to develop around the pressure points, like in the elbows or lungs.
• Lymphoma
  The risk of lymphoma, which is a type of cancer of the lymph system, is more prevalent in rheumatoid arthritis.
• Unhealthy body composition
  Usually, the people who suffer from rheumatoid arthritis have a higher composition of fat to lean mass.

Diagnosis

Often, it is not easy to diagnose rheumatoid arthritis when it is in its early stage. It is because the symptoms of the disease are usually similar to the symptoms of multiple other diseases. Furthermore, there’s no particular blood test or a physical examination that can ascertain the presence of rheumatoid arthritis.

• Physical examination
  In a physical examination, the doctor will try to see through the redness, swelling, or warmth in the joints. It would also involve an analysis of the muscle strength or the body’s reflex action.
• Blood tests
  Those that develop rheumatoid arthritis might have a high C-reactive protein or the erythrocyte sedimentation rate. These two are signs of inflammation in the body. However, there will be other blood tests that will be performed to check for the rheumatoid factor in the body. Some are also done to check the anti-CCP antibodies.
• Imaging tests
  Imaging tests, such as X-rays, ultrasound, and MRI, will be performed to ascertain the impact and severity of rheumatoid arthritis.

Treatment

There’s no way to cure rheumatoid arthritis. However, certain medications can reduce the impact and severity of the symptoms. Few even assure the symptom remission for a long period.

Medications
The doctor will recommend a few medications to overcome rheumatoid arthritis. However, the type of medications recommended will mostly depend on the symptoms and the duration of rheumatoid arthritis.

Some common medications to treat rheumatoid arthritis include:

• Steroids
  There are steroids like prednisone, which are known to reduce joint pain and inflammation. It is also known to slow down the damage to the joint. In this case, a corticosteroid is prescribed to overcome acute symptoms. However, it has its share of side effects and might lead to diabetes, thinning of bones, and weight gain.
• NSAIDs
  NSAIDs are anti-inflammatory medicines that are used to reduce inflammation and provide instant relief from pain. Some prescribed NSAIDs include naproxen sodium and Ibuprofen. If the pain is severe, you can opt for stronger NSAIDs, which are strictly available with a prescription. However, there are a few common side effects of NSAIDs. These include heart problems, stomach irritation, and kidney damage.
• DMARDs
  It is a type of medication that stops the progression of the disease and keeps the tissues and the joints protected from permanent damage. It includes hydroxychloroquine, methotrexate, and sulfasalazine. They have some side effects, such as lung infections, liver damage, or suppression of bone marrow.
• Biologic agents
  These are nothing but a newer type of DMARDs. It includes adalimumab, tofacitinib, abatacept, tocilizumab, baricitinib, sarilumab, anakinra, rituximab, etanercept, and infliximab. These are target-specific medicines that target the immune system responsible for inflammation. It also reduces the progression of the disease.

Therapy

At times, your doctor will send you an occupational or a physical therapist who will teach you a couple of exercises that will improve the flexibility in your joints. They will also give you ideas and new ways to perform your day-to-day tasks with ease.

Assistive devices

To prevent the stressing of your joints, you might also be recommended a few assistive devices. You can head to a medical store to find some assistive devices for yourself.

Surgery

In case medicines aren’t successful in providing relief, the doctor will recommend surgery. With surgery, you might be better able to use the affected joint. It can also better the functionality of the joint and reduce pain.

Some common surgeries for rheumatoid arthritis include:

• Joint fusion
  In this, a joint is surgically fused to realign or stabilize the joint. It also provides relief from the pain.
• Tendon repair
  Because of joint damage or inflammation, you might experience a rupture or loosening of the tendons. This might be cured with surgery.
• Synovectomy
  To help you get rid of the lining of the joint that is inflamed, a surgery called synovectomy is performed. It is a common surgery for hips, elbows, knees, fingers, and wrists.
• Joint replacement
  It is a replacement surgery wherein the damaged joint is replaced, and plastic or metallic prosthesis is inserted in its place. It has a risk of pain, infection, and bleeding. You should be certain of the pros and cons of this surgery before opting for it.

Lifestyle changes

People who have rheumatoid arthritis must make some lifestyle changes to take better care of them. These help in better management of symptoms.

Some lifestyle changes to make include:

• Be physically active
  Try to do gentle exercises every day. These will strengthen your muscles and joints. It will also help you be fatigue-free.
• Use cool or hot pads
  The cool pads will have a numbing effect and fade away the pain. They also help you get rid of the swelling. On the other hand, the cool pads relax the tense muscles.
• Relax
  Stress can aggravate the pain. So, try to relax.

Diet and rheumatoid arthritis

Certain changes in your diet can also help you deal with rheumatoid arthritis better. However, before you add or eliminate a particular food item in your diet, it is best to try out an elimination strategy. Certain food items might aggravate or flare-up symptoms in one but might not do you anything for another. So, it is best to consult your doctor before making any changes to your diet.

Food and substances to include:

• Beans
• Berries, like raspberries and blueberries
• Citrus fruits, like grapefruits, oranges, and limes
• Broccoli
• Green leafy vegetables, such as kale, Brussel sprouts, bok choy, Swiss chard, and spinach
• Nuts like walnuts
• Canola oil
• Soybeans, edamame, and tofu
• Ginger
• Green tea
• Olive oil
• Turmeric
• Whole grains including whole-wheat pasta, brown rice, and bread

Food and substances to avoid:

• Dairy
• Red meat
• Grain-based desserts
• Corn oil
• Processed food
• Fried food
• Fast food
• Excessive salt and sugar
• Too much alcohol
• Grilled food

Please note that these foods should not be eliminated from your diet. Instead, you can still consume them in moderation. However, if they are causing a symptom flare-up, try to restrict as much as possible.

Prevention

There are a few ways that can help you prevent or reduce the risk of rheumatoid arthritis. These include:

• Quit smoking
  Smoking not only increases the risk of rheumatoid arthritis but also causes the symptoms to flare-up when you already have the disease.
• Get fitter
  People who are overweight are more susceptible to developing rheumatoid arthritis. So, try to make a conscious step towards getting fitter. For this, you should eat a healthy and nutritious diet and include a bit of workout or physical activity in your routine.
• Stay away from environmental pollutants
  People who are exposed to environmental pollutants have a heightened risk of developing rheumatoid arthritis. So, try to avoid your exposure to these pollutants as much as possible. If you work in a chemical factory, do not ever step in without safety gear.
• Try and seek help in the earlier stages
  If you notice any minor pain in your joints, visit a doctor. Seeking help earlier reduces the severe progression of the disease.