It is a generalized disease of the whole body which is mostly known for the pain and deformity it causes. It one of the diseases in which the body's immune system is mistakenly targeting itself. "Friendly fire".
It affects joints on both sides of the body at once most times and attacks more of small joints like finger, toe and wrist joints. The symptoms are worse in the morning with pain and stiffness and usually will last more than one hour. In other conditions that resemble rheumatoid arthritis the morning pain will last less than one hour. The pain of rheumatoid arthritis will gt better as the day gets on. But prolonged use of affected joints will worsen the pain. It weakens bones both around affected joints and other bones remote from the joint affected. It does so through a some substances that are part of the disease process and because of dis-use or reduced use of the joint, this therefore also affects muscle.
Organs affected include:
- the heart and/or blood vessels
- the skin
- the spinal cord
- the nerves
- the lungs.
- the blood
- the eyes
- joints and bones
How does rheumatoid arthritis come about?
It has been suspected that an infection sets it off. A germ that has a molecule on it resembling one that a person has infects the person. Large foreign molecules 'provoke a fight' when they enter the body. So the persons immune system takes a sample of this foreign molecule and carries it through a process that results in protective molecules called anti bodies being made. These are always made to specification to recognize that one particular molecule and neutralize it. Unfortunately the body is not aware it has it's own molecule that looks very much like the stranger, so it also ends up attacking itself even after the stranger is no more and most times will continue to do so for life.
It is not certain that this is exactly what happens but these are certain:
1. RA can start at any time in an individuals life, though is usually does not start below age 15.
2. It is three times more common in women than men.
3. If a family member is a sufferer the odds for suffering it doubles for every other member of the family. So there is a genetic component. One in every one hundred persons have it. In affected families two out every one hundred have it.
Joints and Bones
The tissue that is attacked in the joint is called the synovial membrane. A thin tissue-lining for the joint that produces the fluid that lubricates it. It becomes thickened and painful and excessive fluid is produced. The joint swells. If not stopped the process will spread to the slippery covering that allows bone to move on bone in joints, called cartilage, and to the bones themselves. Eventually cords that attach bones to the muscles that move them, called tendons, may be affected too. Hence there is joint destruction and disability.
The skin may be affected in many ways but commonly is the formation of nodules.
How is RA treated.
Drugs:
1. Pain killers. These are two groups of pain killers used to address pain in RA. Aspirin-like pain killers and steroids. They both can cause s stomach ulcers especially as they are used for extended periods. The steroids can cause multiple other problems including being prone to infections, poor wound-healing, abnormal weight-gain and distribution, weakened bones, poor blood pressure control and poor blood sugar control.
2. Biologics. Some of the worst problems in RA are the effects of substances the body produces. The biologics are used to block the actions of specific substances.
3.Disease modulating agents. These delay the development of damaging features like cartilage damage and bone deformity.
Non-drug treatments
1. Surgery: This may be used to remove the diseased synovial membrane to prevent other tissues getting affected or to replace a joint (altogether) with an artificial joint.
2. Exercise. Moderate exercise can reduce pain, stiffness and increase strength.
3.Physiotherapy and occupational therapy can be useful.
Drug treatment should follow proper medical assessment so to prevent abuse drugs are not mentioned by name here.
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