Rheumatoid Arthritis: A story of Auto Destruction


To defend our body, an army of defence cells called White Blood Cells secretes antibodies to counter incursions of harmful contaminants. This is called immune response. In an autoimmune disease these antibodies mistakenly start targeting body’s own tissues, leading to inflammation. In Rheumatoid Arthritis, joints are attacked by antibodies resulting in inflammation of nearby tissues. If inflammation goes uncontrolled, it can irreversibly damage cartilage and elastic tissue covering joint surfaces as well as bones. Gradually there is loss of bones and cartilage resulting in reduction of joint space. Joints become painful with reduced mobility over time.

You might be wondering why me? Well medical science presently does not know precise cause which triggers the autoimmune damage in some people. So doctors blame genes, some viruses and bacteria for leading to autoimmune reaction. Nevertheless, people with following risk factors have been found to be associated with more chances of developing Rheumatoid Arthritis.

1. Women are more likely to develop rheumatoid arthritis, due to influence of female hormones.
2. It can occur at any age, but it most commonly begins between 40 and 60 years of age.
3. Family history of rheumatoid arthritis may increase the risk of the disease.
4. Cigarette smoking increases risk of developing Rheumatoid Arthritis, especially in genetically predisposed individuals. Smoking also has been found to be associated with greater disease severity.
5. It is debatable if exposure to asbestos, silica, mineral oil or insecticides increases the risk for developing rheumatoid arthritis.
6. Obesity, emotional trauma may aggravate the symptoms of Rheumatoid Arthritis.

The resulting deformity and pain cannot be reversed. Studies show that early treatment adopters feel better and are more likely to lead active life. Control of Rheumatoid Arthritis at early stage might also prevent joint damage requiring replacement. We should know when to visit a doctor for ruling out rheumatoid arthritis. Following signs and symptoms are clues to Rheumatoid Arthritis.

1. Rheumatoid arthritis starts with smaller joints like those between your fingers and hands, and between toes and foot. It gradually involves knees, wrists, shoulders, elbows, ankles and hips. It affects symmetrical joints on either side. Usually multiple joints are affected simultaneously.
2. Pain, tenderness, swelling or stiffness in joint for six weeks or longer
3. Joint stiffness usually worse in morning and after inactivity. Joint stiffness lasting for more than 30 minutes
4. Signs and symptoms may show periods of flare and remission.
5. Over time, rheumatoid arthritis can cause joints to deform
6. Many people may experience fever, fatigue, loss of appetite

You should see your doctor to rule out Rheumatoid Arthritis, if have persistent or repetitive episodes of multiple joint pains and swelling.

Your blood test may show increased C-Reactive Protein and ESR (Erythrocyte Sedimentation Rate). 80% of patients with Rheumatoid Arthritis test positive for Rheumatoid Factor in their blood. But it can be present in many inflammatory conditions and is not a specific disease. But an antibody known as anti-cyclic citrullinated peptide (anti-CCP) is found specifically in patients with RA.Thus a positive anti-CCP test is a stronger clue to RA. X Ray, MRI can show the extent of joint erosion, but a normal test does not rule out RA.

Rheumatoid Arthritis can also represent as systemic disease or following complications

a. Dry Eyes and Mouth: Dryness, irritation or infection of eyes and mouth, known as Sjogren’s syndrome
b. Skin: Small lumps under the skin over bony areas called Rheumatoid nodules
c. Lungs: Shortness of breath
d. Blood Vessels: Hardening of blood vessels leading to atherosclerosis
e. Blood: Anaemia
f. Osteoporosis: Rheumatoid Arthritis or medicines for its treatment can itself lead to weak bones vulnerable to fracture

You might want to know what should you do if you have Rheumatoid Arthritis

1. Whenever RA flares up, you need rest to reduce swelling, pain and stiffness in joints.
2. During all other times of disease, you need to exercise regularly as advised by your doctor. Low impact, aerobic, muscle strengthening and flexibility exercises are beneficial.
3. Hot packs or steam batch soothes stiff joints and cold pack is best when you have acute pain.
4. Deep breathing exercise help in relaxation and feeling of well-being.
5. Some studies have shown turmeric and omega-3 fish oil to reduce pain and morning stiffness in rheumatoid.
6. Follow medical advice of your doctor

Objective of treatment for Rheumatoid Arthritis are to

• Stop inflammation and provide longer remission cycles by aggressive treatment
• Relieve joint pain, tenderness and swelling
• Improve joint mobility
• Improve feeling of well-being
• Prevent further joint and organ damage
• Reduce long-term systemic complications

If joint is damaged or pain is unbearable despite treatment, it may need replacement in minuscule percent of patients. In fact, Osteoarthritis is most common indication of Knee Replacement in 97% of cases, followed by Rheumatoid Arthritis in 2% of cases. In next article, we will enlighten ourselves in depth about joint pain and Osteoarthritis.

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