1Overview

Rheumatoid arthritis (RA) is a chronic inflammatory disorder that can affect many parts of the body, including the joints. It could cause severe damage to other areas of the body like the eyes, skin, lungs, heart and blood vessels.

It is an autoimmune disease, a condition wherein the body’s immunes system, mistakenly attacks the joints, particularly the joint linings. The immune system regards the tissues in the joints as foreign bodies, leading to inflammation.

The World Health Organization (WHO) reports that this chronic systemic disease that attacks the joints, muscle, tendons, fibrous tissue and connective tissues occur between the ages of 20 and 40. These years are considered the most productive time of one’s life. Since RA is a disabling condition, it can cause deformity, pain and mobility issues.

The prevalence rate of RA is between 0.3 percent and 1 percent worldwide. Women are more likely to develop this condition than men. For people who have RA, within ten years of onset, about 50 percent of them in developed countries can’t maintain a full-time job.

2Signs and Symptoms

The signs and symptoms of rheumatoid arthritis differ in severity and may come and go. This means that the condition is intermittent wherein the patient will experience flares, acute bouts of the symptoms. These eruptions occur alternately with periods of remission when the pain and swelling fade or disappear.

In the early stages, people suffering from RA may not see any redness or swelling in the joints. However, they may experience pain and tenderness. The signs and symptoms may include:

  • Tender, swollen and warm joints
  • Fatigue, weight loss, and fever
  • Joint stiffness which is usually worse early in the morning and after inactivity
  • More than one joint is affected (polyarthritis)
  • Small joints in the wrists, hands, and feet are affected
  • Signs and symptoms affect both sides of the body (symmetrical)
  • Limping
  • Loss of a wide range of motion
  • Loss of joint function and deformity

As the diseases worse, the symptoms often spread to other joints of the body. An estimated 40 percent of those with RA will experience other signs and symptoms that are not related to the joints.

  • Dry, painful, red eyes
  • Impaired vision
  • Sensitivity to light
  • Dryness of the mouth
  • Gum infection
  • Formation of rheumatoid nodules, which are small lumps under the skin on bony areas
  • Inflammation of the blood vessels
  • Inflammation of the lungs, leading to difficulty of breathing
  • Anemia or reduced number of red blood cells

3Causes

The exact cause of rheumatoid arthritis is still unknown, just like any other autoimmune disease. However, many health experts blame autoimmunity in the development of this chronic inflammatory disease.

The immune system is supposed to protect the body by attacking foreign bodies in the body such as viruses and bacteria. As a result, inflammation happens. In an autoimmune disease, however, the immune system erroneously attacks the body’s tissues, which will lead to inflammation. If the inflammation is present for an extended period, it may result in joint damage, which is irreversible.

Another theory of some doctors who are studying the disease is that viruses and bacteria may trigger the autoimmune response. However, none has been proven as the culprit. Some experts have linked genetics as the cause of autoimmune disorders like rheumatoid arthritis.

4Effects On The Body

Ongoing and prolonged inflammation can cause problems throughout the body. RA can affect some organs and parts of the body in various ways.

Skeletal System

There are many tissues in the body that rheumatoid arthritis can affect. Since RA affects the joints in the body, you can expect pain, swelling, and stiffness in all joints in the body like the knees, shoulders, elbows, ankles, and hips.

Individuals who have RA are more likely to have claw toes, hammertoes, and bunions. As the disease worsens, the bones can become damaged, including supporting cartilages, tendons, and ligaments.

Circulatory System

Aside from the bones and muscles, the disease can also affect the circulatory system. People with RA have a heightened risk of developing anemia, wherein the number of red blood cells is below normal. Moreover, they can suffer from blocked or hardened arteries, which may eventually lead to heart disease.

Respiratory System

Rheumatoid arthritis may lead to the inflammation and eventually, scarring of the lungs. Termed as pleurisy, this scarring is permanent and may interfere with normal lung function. In the long run, chronic inflammation may damage the lung tissues, called rheumatoid lung. A person with RA may also suffer from other respiratory problems including blocked airways, pleural effusion or fluid in the lungs, pulmonary hypertension and pulmonary fibrosis.

5Risk factors

Risk factors may increase your risk of developing rheumatoid arthritis.

Age

Though this disease can occur at any age, it mostly begins at the age of 40 to 60.

Sex

Women are at a higher risk of developing RA than men

Genetics

Your family history has something to do with RA development. If a family member has rheumatoid arthritis, you may have an increased risk of the disease.

Smoking

Cigarette smoking may increase the risk of RA, especially if you have a family history of the disease. Smoking may even worsen one’s outlook or prognosis. It has been linked to greater disease severity.

Obesity

People who are overweight and obese face a higher risk of having RA. The risk is higher for women who are obese.

Environment

Several studies have associated the exposure to some chemicals like asbestos or silica with a higher risk of developing RA.

Testosterone

Males with low levels of testosterone are at a greater danger of suffering from RA later in life.

6Complications

Rheumatoid arthritis can cause widespread inflammation in the body. Some of the complications of this condition may include:

Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) results from the compression of the nerve that controls movement and sensation in the hands. The common symptoms include pain, numbness and tingling in the thumb and fingers.

Joint Damage

Because of the chronic and long-term inflammation in the joints, RA can cause joint damage. When the joints get damaged, it may lead to permanent disability.

Cervical Myelopathy

Cervical myelopathy is a condition wherein the dislocated joints at the top of the spine put pressure on the spinal cord. This causes pain and mobility issues. In the long run, this condition may even cause permanent cord damage, if it’s left untreated.

Cardiovascular Disease

Cardiovascular disease (CVD) can occur because of widespread inflammation. When the blood vessels become inflamed, it may lead to an impeded blood flow. When there is limited blood flow to the vital organs like the heart and brain, it may result in life-threatening conditions such as heart attack and stroke.

7Diagnosis

Rheumatoid arthritis can be hard to diagnose, especially in its early stages. The signs and symptoms of the disease are the same as other conditions. Since there is no one blood test to confirm the disease, here are methods to help diagnose RA.

Blood Tests

Individuals who are suffering from RA have an increased erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP). These blood tests detect if there is an active inflammation in the body.

Imaging Studies

Imaging tests like radiologic examinations computed tomography scan (CT-scan), and magnetic resonance imaging (MRI) is the most commonly used methods to help the doctor determine the illness and its severity.

8Treatment

There is no cure for rheumatoid arthritis, but the treatment involves targeting the symptoms and discomforts.

Medicines

Pain relievers and anti-inflammatory drugs are the most commonly used treatment to relieve pain and swelling.

NSAIDs (Nonsteroidal anti-inflammatory drugs)

NSAIDs are pain relievers that are used to relieve pain and to swell in the joints. For mild pain killers, they are bought directly from the pharmacy. However, stronger dosages are prescribed by a licensed doctor to prevent addiction and dependence.

Steroids

Steroids or corticosteroids are used to relieve inflammation. Side effects of these drugs may include thinning of the bones, weight gain, and immunosuppression.

DMARDs (Disease-modifying Antirheumatic Drugs)

DMARDs or disease-modifying antirheumatic drugs work to change the course of the disease. It slows the progression of the disease by acting in the immune system.

Surgery

Surgery will only be done if there is due damage on the joints that limits mobility. Surgery can relieve the pressure and inflammation in the joints and at least, alleviate the patient’s pain. Joint replacement surgery can restore joint function and mobility.

9Prognosis

Rheumatoid arthritis does not have a cure, and it’s progressive. This means that as time passes by, the joints will be damaged by the inflammation. Persistent joint inflammation may take a toll on their function and ability to move. Disability is a serious complication of RA if it’s not treated early and appropriately.

Thus, adherence to the treatment regimen is essential. You must slow down the progression of the disease to prevent joint damage and immobility. People with RA have an increased risk of a shorter life expectancy, but with the right medicines and treatments, the quality of life of patients with RA will be improved.