Autoimmune rheumatic diseases such as rheumatoid arthritis occur when the immune system mistakenly attacks the body's own tissues such as the joints, muscles, and connective tissues.
What causes Rheumatological Disease?
The exact cause of rheumatological disease is not fully understood, but it is likely related to a combination of genetic, environmental, and immunological factors.
What are the Common Autoimmune Rheumatic Conditions?
Some of the common autoimmune rheumatic conditions include the following:
- Rheumatoid Arthritis (RA)
- Psoriatic Arthritis (PsA)
- Ankylosing Spondylitis (AS)
- Juvenile Idiopathic Arthritis (JIA)
- Systemic Lupus Erythematosus (SLE)
- Vasculitis (e.g., Giant Cell Arteritis)
- Inflammatory Bowel Disease (Crohn’s & Ulcerative Colitis)
What is Rheumatoid Arthritis?
Rheumatoid arthritis is a chronic inflammatory disease in which the lining of your joints becomes inflamed, causing pain, swelling, and stiffness. It is an autoimmune disease because it occurs when your immune system, which normally fights against infection, starts destroying healthy joints. Severe rheumatoid arthritis can be very painful and even cause a deformity in a joint. It also affects your ability to perform routine activities.
Symptoms of Rheumatoid Arthritis
The symptoms of rheumatoid arthritis often affect the small joints of the hands and feet, and later spread to the larger joints such as the shoulders, elbows, hips, and knees. Both sides of the body are usually affected. Symptoms include:
- Swelling, warmth, and tenderness at the joints
- Joint stiffness that is worse in the morning, or after periods of rest or inactivity
- Fever
- Fatigue
- Weight loss
The symptoms may vary in severity. They sometimes flare up or worse, and at other times, are controlled (in remission). The joint deformity occurs at a later stage.
Rheumatoid arthritis may also affect other structures of the body such as the skin, eyes, salivary glands, lungs, heart, blood vessels, bone marrow, kidneys, and nerves.
Diagnosis of Rheumatoid Arthritis
To diagnose rheumatoid arthritis, your doctor will review your symptoms and medical history, and perform a physical examination of your joints as well as your reflexes and strength. Diagnosis is difficult in the early stages as there are no definitive tests or physical findings for rheumatoid arthritis, and symptoms may be common to other conditions
Your doctor may order:
- Blood tests that detect inflammation in the body
- Imaging tests such as X-rays, ultrasound or MRI to view the joints and check the progress of the disease
Treatments for Rheumatoid Arthritis
Several treatment modalities are available for the management of rheumatoid arthritis including
Medications: These include disease-modifying anti-rheumatic drugs (DMARDs), biologic agents (newer DMARDs), nonsteroidal anti-inflammatory drugs and steroids. The DMARDs reduce the body’s immune response against the joints whereas the NSAIDs and steroids reduce swelling and pain. Medications are combined for greater efficacy.
Physical therapy: Physical therapy exercises should be performed regularly to increase the strength of the muscles and flexibility of the joints. Transcutaneous electrical nerve stimulation (TENS) is a type of electrotherapy that is provided for pain relief.
Occupational therapy: Occupational therapy helps you to perform daily activities at home and at work independently. Stress on the joints is minimized by modifying your movements or using adaptive equipment. It also helps you adapt to your condition using relaxation and stress-management techniques.
Surgery: Surgical treatment is considered if you have severe rheumatoid arthritis and your symptoms do not improve with the conservative treatments. The benefits of surgery are pain relief and improvement in joint function. Surgical procedures include synovectomy (removal of the inflamed synovial membrane), joint replacement, joint fusion, and tendon repair.