Over 100 different forms of “arthritis” exist. Osteoarthrits is the most common form that you are most likely aware of. It involves the breakdown of cartilage in the joint, which causes “bone on bone” rubbing. This type of arthritis comes with “old age,” causes bone spurs to form in joint, which results in “creaking and cracking” that worsens with activity. Rheumatoid arthritis differs greatly.
Rheumatoid arthritis (RA) is an autoimmune disease in which your body’s immune system attacks it’s own joints. Specifically, RA attacks the tissue, or lining, that surrounds all of the joints in your body. The lining becomes inflammed and can cause damage to the cartilage and bone in the joints. It can involve almost every joint in the body, except the joints at the ends of your fingers. Women between the ages of 20-40 are more predisposed than men. The cause is not certain, but may be linked to a type of viral infection. You must have a genetic predisposition to have RA, it is not contagious.
Signs and Symptoms
Joint swelling is the most common sign. As mentioned earlier, it can involve almost every joint in the body. Pain with motion and touch is common and generally worse in the morning and improves as the day progresses. Weight loss, fatigue, dry mouth, vision problems, chest pain and shortness of breath are associated symptoms.
RA has distinctive hand features, described as Boutonniere Deformities and Swan Neck Contractures seen in this picture.
The course of RA varies into four classes: 1) you may have one acute attack that never happens again, 2) you may have a period of relapses and remission, 3) you may have relapses and remissions, but remissions are still associated with symptoms, 3) finally, you may have a course that continues to progress.
Tests to Expect
In order to properly diagnose RA, you doctor will need to run blood tests, perform X-rays of your affected joints and possibly perform an x-ray of your neck. Blood tests can confirm and suggest the severity of the disease. X-rays will determine if cartilage is still alive in the joint and if erosions of the bone have occurred.
The earlier that RA can be treated, the better the outcome will likely be. Every RA patient does not require the same treatment. Some medications may work better for some than others. NSAIDs and corticosteroids are the best to treat your symptoms. In most cases, treatment with these medications is only needed for the short-term, but may be needed for a longer period. In addition, disease-modifying drugs are needed to keep RA in remission. The most common is methotrexate. 80% of patients on methotrexate have moderate to excellent benefit after 6 weeks. However, side effects may occur including, upset stomach, ulcers in the mouth, hair loss and damage to the liver, lungs or kidneys. Therefore, making your follow up visits with your doctor is essential to make sure your organs are not being damaged. Other medications, such as hydroxychloroquine or sulfasalazine may also be used and also require close follow up. Again, I cannot stress the importance of making your appointments.
Role of Exericse
There is strong evidence suggesting that exercise from low to high intensity of various modes is effective in improving disease-related characteristics and functional ability in RA patients. (Rheumatology, 2008)
Based on the evidence, aerobic capacity training combined with muscle strength training is recommended as routine practice in patients with RA. (Cochrane Database, 2009)
Walking, moving, lifting, biking, swimming, etc, are of utmost importance in improving your symptoms and quality of life. Learn how to perform the Fast Pace cardiovascular workout to improve your symptoms. You may also try resistance training workouts, such as the 20 Minute Weight Loss Workout, Back to the Basics- 500 Rep Workout, or, Exercise Menu workouts.
Staying on top of this disease is key to keeping it under control!