Here’s All You Need To Know About Rheumatoid Arthritis

Rheumatoid Arthritis usually affects the smaller joints in the hands and feet first, says an expert.

Symptoms of Rheumatoid Arthritis usually start between the ages of 40 and 60 years.

(Photo: iStockphoto)

For most people, the word ‘arthritis’ conjures up images of old relatives with joint pain, unable to move around much and largely confined to their homes and favourite chair. But arthritis is certainly not an “old person” condition.

In fact, there are certain types of arthritis that manifest in young and middle-aged people and one example of this is rheumatoid arthritis (RA).

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a chronic, autoimmune, inflammatory condition.(Photo: iStockphoto)

Rheumatoid arthritis (RA) is a chronic, autoimmune, inflammatory condition where the person’s own immune cells attack the membrane lining around the joints. This causes inflammation leading to pain. It also destroys the protective cartilage and results in erosion of the bone.

Over time, the ligaments that hold the joint together get weak and the bone shifts out of place and may also get deformed. RA usually affects the smaller joints in the hands and feet first. It may later spread to the wrists, elbows, ankles, knees, hips and shoulders and could even affect other parts of the body such as the eyes, heart, lungs and blood vessels.

Symptoms & Diagnosis

Symptoms usually start between the ages of 40 and 60 years.

The joints feel warm, appear red and the swelling may feel a little ‘squishy’. Stiffness and pain are worse after a patient has been resting for some time.

The symptoms can come and go, with alternating periods of disease activity called ‘flares’ and periods of relative symptom relief. This can make it a tricky condition to diagnose.

Diagnosis is done with the help of blood tests that detect a higher than normal erythrocyte sedimentation rate (ESR), anti-cyclic citrullinated peptide (anti-CCP) antibody levels or C-reactive protein (CRP) levels. Imaging with the help of X-ray, ultrasound and magnetic resonance imaging (MRI) also aids diagnosis.

Causes of Rheumatoid Arthritis

(Photo: iStockphoto)

We do not yet know what causes the body’s own immune system to attack itself. It is likely that genes play a role and make a person more susceptible to the condition. Women are more likely to develop RA than men. Cigarette smoking; exposure to asbestos or silica; viral infections with the herpes simplex virus, cytomegalovirus and the Epstein-Barr virus; and obesity are some other risk factors.

While we are yet to discover an effective cure for RA, we now know that there is a higher chance of symptom remission if a person is treated early on with certain type of drugs known as disease-modifying antirheumatic drugs (DMARDs). Of course, the patient’s doctor is in the best position to prescribe treatment, depending on disease severity and duration.

Living With Rheumatoid Arthritis in India

Effective treatment is only possible when patients learn to manage their symptoms.(Photo: iStockphoto)

Currently, an estimated 7 million Indians are living with RA. For them, RA can affect many aspects of their lives. Early morning pain and stiffness can make it difficult to start the day on time. On a ‘bad day’ when a patient has a disease flare, even simple chores like cutting vegetables, washing vessels, squeezing toothpaste on to a toothbrush, grabbing on to a bar or opening a bottle can seem difficult. The disease can affect work life as well, slowing down career progression or forcing a person into early retirement.

RA can often have a negative effect on important familial and social aspects of life, taking an emotional toll on patients and causing a lot of mental stress. For some patients who fear needles, even the regular treatment injections can become a source of stress.

Thankfully, we have effective treatment options available today that are available as oral drugs instead of injections. Patients with RA should check in with their doctor regularly to monitor their progress and evaluate how well the treatment is working.

Effective treatment is only possible when patients learn to manage their symptoms, adhere to prescribed treatment and communicate openly with their doctors.

(Dr. PD Rath is an Associate Director & Head – Rheumatology at Max Super Speciality Hospital, Saket, Max Multi Speciality Centre)