Rheumatoid Arthritis

Introduction Rheumatoid arthritis (RA) is an autoimmune condition. In this condition, our body's immune cells assume its own synovial tissues are foreign substances and attack them. The synovium is the lining of the membranes surrounding your joints. In rheumatoid arthritis, synovial tissues of joints, cartilage, and bones get inflamed. This causes painful swelling that can eventually lead to joint deformity and bone erosion. RA can affect any joints, but it most commonly affects your fingers, hands, wrists, knees, ankles, toes, and feet. The inflammation of rheumatoid arthritis affects not only the joints but also other organs of the body, like the skin, lungs, heart, eyes, and mouth.

What are the stages of Rheumatoid Arthritis? Rheumatoid arthritis progresses in the following four stages: Stage 1

• Only inflammation of the synovial membrane is seen
• You might experience joint pain and stiffness
• Not visible on X-rays Stage 2:
• Tissue inflammation starts damaging the cartilage of the joint
• You might experience joint and mobility issues
• X-rays show early signs of bone erosion Stage 3:
• Damage to the bone, cartilage, and soft tissues is seen
• You might have joint pain, joint deformity, reduced functions, and muscle weakness
• X-rays show visible joint damage Stage 4:
• Inflammation subsides, but damage to the bone and cartilage worsens.
• You might experience severe pain and joint deformity

What are the symptoms of Rheumatoid Arthritis? Rheumatoid arthritis symptoms vary and come and go, often without warning. Some days are tougher, with more pain and swelling—these are called flares. On other days, the symptoms ease up or even seem to disappear for a while. That's remission. When symptoms appear, they include:

• Persistent pain in multiple joints
• Pain worsens in the mornings or after periods of inactivity
• Joint stiffness
• RA shows symmetrical behavior—if one side of the joint is affected, the other is likely to be as well.
• You might experience fatigue, a low-grade fever, and a general feeling of being unwell.
• In advanced stages, you might feel firm lumps of tissue (rheumatoid nodules) under the skin of the affected joint.

What are the causes of Rheumatoid Arthritis? The medical fraternity is still not able to pinpoint the exact cause of rheumatoid arthritis. However, they suggest that RA develops due to a complex connection of genetic and environmental factors: Genetic factors: Some people inherit certain genes, mainly in the HLA group, that make them more likely to develop rheumatoid arthritis. Hormonal factors: Women are more prone to RA Environmental factors: Cigarette smoke and dust exposure may trigger RA in genetically predisposed individuals Stress: Chronic stress may trigger RA

What are the Complications of Rheumatoid Arthritis? If not treated on time, RA can lead to serious complications. These include:

• Osteoporosis and increased risk of bone fractures
• Formation of the rheumatoid nodules around the bones, heart, and lungs
• Dry eyes and dry mouth
• Interstitial lung disease
• Pericarditis - inflammation of the heart lining
• Increased frequency of infections
• Carpal tunnel syndrome
• Lymphoma

How to Diagnose Rheumatoid Arthritis? Doctors perform the following tests to diagnose rheumatoid arthritis:

• Detailed medical history & physical examination of the affected joints
• Blood tests for inflammatory markers and autoantibodies
• Imaging studies (X-rays, ultrasound, MRI)
• Joint fluid analysis

What is the treatment of Rheumatoid Arthritis? Treatment of RA includes two primary goals:

• Reduce joint pain & swelling and improve mobility
• Slowing or stopping the progress of joint damage

Treatment modalities are: Medication

• Disease-modifying antirheumatic drugs (DMARDs): Slow disease progression and prevent long-term joint deformity.
• Corticosteroids: Help reduce inflammation and pain during flare-ups.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Provide relief from pain and inflammation.
• Biologics: Targeted treatments that address specific parts of the immune system.

Physical Therapy: Customised exercise programs to maintain joint flexibility and strengthen muscles

Lifestyle Modifications Diet: Anti-inflammatory foods like fruits, vegetables, whole grains, and omega-3 fatty acids are good for joints Regular exercise: Low-impact activities like swimming, walking, and yoga improve mobility without stressing joints. Stress management: Techniques such as meditation and deep breathing to manage stress, which may trigger flares.