Rheumatoid arthritis

Specialty of Rheumatology

What is it?

Rheumatoid arthritis is a chronic and degenerative disease that causes joint inflammation. There are certain areas that this type of rheumatic condition affects more often, they include the wrists, fingers, toes, elbows, shoulders, hips, knees, and ankles. Joint inflammation normally causes pain, deformity, and movement issues, as the cartilage wears out and the bones rub against each other.

The cause for this condition remains unknown and there is no known cure. Damage to the bone and cartilage is irreparable, which is why treatment seeks to relieve pain and disability, as well as avoid permanent joint damage.

What are the symptoms?

Rheumatoid arthritis affects joints on both parts of the body equally. Fingers, wrists, knees, feet, elbows, ankles, hips, and shoulders are the areas that tend to be most affected. The condition starts slowly, and the first symptoms tend to be: mild joint pain, stiffness, and fatigue.
 
Other symptoms include morning stiffness that lasts longer than one hour. The joints may feel hot, weak, or sensitive and rigid when they are not used for a while. Joint pain is often the same on both sides of the body. Joints may become inflamed. Over time, joints may lose their range of movement and become deformed.
 
Some of the most common symptoms include:

  • Chest pain when breathing (pleurisy)
  • Dry eyes and mouth (Sjögren syndrome)
  • Burning, itching, or discharge in the eyes
  • Nodules under the skin
  • Limb numbness or tingling
  • Difficulty sleeping.

Medical tests

There is no definitive test to diagnose if a patient has rheumatoid arthritis, but some can help in its indication.
 
Some of the main tests used to indicate rheumatoid arthritis include:

  • Full blood count
  • C-reactive protein
  • Erythrocyte sedimentation rate (ESR)
  • Joint X-rays 

What causes it?

The causes remain unknown. It is an autoimmune disease which involves genetic factors: a family history of the disease increases chance of developing it. Non-genetic factors also play a big role: such as infections, feminine hormones, smoking, stress, being overweight, and the type of diet you follow.

How can it be prevented?

There is no known way of preventing the disease, however, some risk factors have been identified such as smoking and chronic gum infections, which can really aggravate the condition. This is why it is important to not smoke and maintain good oral hygiene. Having a correct and personalised treatment can help prevent joint damage.

What is the treatment?

In most cases, this condition requires long-term treatment, which may include:
 
Different types of medication:

  • Antirheumatics
  • Anti-inflammatories
  • Antimalarials
  • Corticosteroids
  • Biological agents

 Physiotherapy:

  • Joint protection techniques
  • Hot and cold treatments
  • Splints or orthopaedic devices to support and align the joints
  • It is recommended to sleep between 8 to 10 hours a night, and to rest between activities

 Surgery:

  • Removal of the joint lining
  • In extreme cases, total arthroplasty, which may involve knee replacement or hip arthroplasty

 Exercise, education, and nutrition also play an integral role in the treatment of rheumatoid arthritis.

Which specialist should I see?

The specialists who treat rheumatoid arthritis are rheumatologists.

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