Rheumatoid Arthritis

This content is for informational and educational purposes only. It is not a diagnosis and does not replace consultation with a healthcare professional. If you experience symptoms of rheumatoid arthritis, consult a doctor for timely diagnosis and treatment.

Does Rilassáre's complementary medicine replace traditional medicine?

No. Our complementary medicine protocols (nutrition, psychological support, and general medicine) are designed as an adjunct to the treatment a patient may already be receiving, never as a substitute. Every case is individually assessed by our medical team, since no intervention is free of risk and its suitability depends on each person's clinical history.

What is rheumatoid arthritis?

Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just the joints. In some people, the condition can damage various body systems, including the skin, eyes, lungs, heart, and blood vessels.

Rheumatoid arthritis is an autoimmune disorder that occurs when your immune system mistakenly attacks your own body's tissues.

Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

The inflammation associated with rheumatoid arthritis is what can also damage other parts of the body. Although new medications have greatly improved treatment options, severe rheumatoid arthritis can still cause physical disabilities.

Symptoms of rheumatoid arthritis

Signs and symptoms of rheumatoid arthritis may include:

• • Tender, warm, swollen joints.
• • Joint stiffness that is usually worse in the mornings and after inactivity.
• • Fatigue, fever, and loss of appetite.

In its early stages, rheumatoid arthritis tends to first affect smaller joints, particularly the joints that connect your fingers to your hands and your toes to your feet.

As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips, and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.

About 40% of people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Areas that may be affected include:

• • Skin
• • Eyes
• • Lungs
• • Heart
• • Kidneys
• • Salivary glands
• • Nerve tissue
• • Bone marrow
• • Blood vessels

Signs and symptoms of rheumatoid arthritis may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission, when swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place.

Causes of rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease. Normally, your immune system helps protect your body from infection and disease. In rheumatoid arthritis, the immune system attacks healthy tissue in the joints. It can also cause medical problems in the heart, lungs, nerves, eyes, and skin.

Doctors don't know for certain what starts this process, although a genetic component appears likely. While genes don't by themselves cause rheumatoid arthritis, they can make a person more likely to react to environmental factors, such as infection with certain viruses and bacteria, that may trigger the disease.

Risk factors

Factors that may increase your risk of rheumatoid arthritis include:

• •Sex. Women are more likely than men to develop rheumatoid arthritis.
• •Age. Rheumatoid arthritis can occur at any age, but it most commonly begins in middle age.
• •Family history. If a family member has rheumatoid arthritis, you may have an increased risk of the disease.
• •Smoking. Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition. Smoking also appears to be associated with greater disease severity.
• •Excess weight. People who are overweight appear to be at a higher risk of developing rheumatoid arthritis.

Diagnosis of rheumatoid arthritis

Rheumatoid arthritis can be difficult to diagnose in its early stages because the early signs and symptoms mimic those of many other diseases. There is no single blood test or physical finding that can confirm the diagnosis on its own; it must always be established by a doctor.

During the physical exam, your doctor will check your joints for swelling, redness, and warmth. The doctor may also check your reflexes and muscle strength.

Blood tests

People with rheumatoid arthritis often have an elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP), which may indicate the presence of an inflammatory process in the body. Other common blood tests look for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies.

Imaging tests

Your doctor may recommend X-rays to help track the progression of rheumatoid arthritis in your joints over time. MRI and ultrasound tests can help your doctor judge the severity of the disease in your body.

Complications of rheumatoid arthritis

Rheumatoid arthritis increases your risk of developing:

• •Osteoporosis. Rheumatoid arthritis itself, along with some medications used to treat it, can increase your risk of osteoporosis, a condition that weakens bones and makes them more prone to fracture.
• •Rheumatoid nodules. These firm bumps of tissue most commonly form around pressure points, such as the elbows. However, these nodules can form anywhere in the body, including the heart and lungs.
• •Dry eyes and mouth. People who have rheumatoid arthritis are much more likely to develop Sjögren's syndrome, a disorder that decreases the amount of moisture in the eyes and mouth.
• •Infections. Rheumatoid arthritis itself and many medications used to combat it can impair the immune system, leading to increased infections. Protect yourself with the vaccines recommended by your doctor.
• •Abnormal body composition. The ratio of fat to lean mass is often higher in people with rheumatoid arthritis, even in those with a normal body mass index (BMI).
• •Carpal tunnel syndrome. If rheumatoid arthritis affects your wrists, the inflammation can compress the nerve that serves most of your hand and fingers.
• •Heart problems. Rheumatoid arthritis increases your risk of hardened and blocked arteries, as well as inflammation of the sac that encloses your heart.
• •Lung disease. People with rheumatoid arthritis have an increased risk of inflammation and scarring of lung tissues, which can lead to progressive shortness of breath.
• •Lymphoma. Rheumatoid arthritis increases the risk of lymphoma, a group of blood cancers that develop in the lymphatic system.

Treatment for rheumatoid arthritis

There is no cure for rheumatoid arthritis. But clinical studies show that remission of symptoms is more likely when treatment, always directed by a doctor, begins early with medications known as disease-modifying antirheumatic drugs (DMARDs).

Medications

The type of medication your doctor recommends will depend on the severity of your symptoms and how long you've had rheumatoid arthritis. All of these medications require a prescription and medical follow-up.

• •NSAIDs. Nonsteroidal anti-inflammatory drugs can relieve pain and reduce inflammation. Side effects may include stomach irritation, heart problems, and kidney damage.
• •Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning bones, weight gain, and diabetes.
• •Conventional DMARDs. These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Side effects vary but may include liver damage and increased risk of infections.
• •Biologic DMARDs. This class of DMARDs is usually most effective when paired with a conventional DMARD. These drugs also increase the risk of infections.
• •Targeted synthetic DMARDs. These are used when traditional DMARDs and biologics have failed. Some of these medications can increase the risk of blood clots and serious cardiac events, so their use requires close medical supervision.

Therapy

Your doctor may refer you to a physical or occupational therapist who can teach you exercises to keep your joints flexible, as well as new ways to do daily tasks that ease the strain on your joints.

Assistive devices can help avoid straining painful joints.

Surgery

If medications fail to prevent or slow joint damage, you and your doctor may consider surgery to repair damaged joints. Surgery can help restore your ability to use your joint, reduce pain, and improve function.

Rheumatoid arthritis surgery may involve one or more of the following procedures, always determined by the treating physician:

• •Synovectomy. Surgery to remove the inflamed synovium (lining of the joint).
• •Tendon repair. Repair of tendons around the joint that have loosened or ruptured.
• •Joint fusion. To stabilize or realign a joint and relieve pain.
• •Total joint replacement. The damaged parts of the joint are removed and a prosthesis is inserted.

Surgery carries risks of bleeding, infection, and pain, which should be discussed with your doctor.

Regenerative medicine and supportive protocols

Stem cells are being researched as a possible supportive therapy for various orthopedic and autoimmune conditions, including arthritis. Research in this area is still developing and results vary from person to person.

At Rilassáre Clinic, these protocols are offered exclusively as a supportive adjunct under individual medical evaluation, never as a substitute for diagnosis or for the treatment prescribed by the treating physician. They do not diagnose, cure, or guarantee cartilage regeneration or disease remission.

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