Rheumatoid Arthritis: A Painful and Debilitating Illness

Feb 23, 2020 Dr Zulfikar Bux, Features / Columnists

By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine

Have you ever had or seen someone who has Chikungunya? It’s a terribly painful and debilitating time. The joint pains and stiffness are sometimes unbearable. Now imagine having to live like that.
The reality is that patients with Rheumatoid Arthritis have to live with similar joint pains and immobility. Over one percent of the world’s population suffers with Rheumatoid Arthritis. Some are undiagnosed and are left to suffer without proper treatment.
Today we will shed some light on this incurable condition.

WHAT IS RHEUMATOID ARTHRITIS?

Rheumatoid arthritis is a disease that causes pain, swelling, and stiffness in the joints. It is one of many different types of arthritis. Doctors do not know what causes it. But they do know that it happens when the body’s infection-fighting system, called the immune system, “attacks” the joints.

HOW CAN I TELL WHETHER I HAVE RHEUMATOID ARTHRITIS OR ANOTHER TYPE OF ARTHRITIS?

You cannot tell. Only a doctor can tell you that. But there are some clues to look for. For instance, rheumatoid arthritis usually starts by affecting the small joints in the fingers, the balls of the feet, and the wrists. It usually affects both the left and the right side at the same time. (Other types of arthritis tend to first affect larger joints, like the knees or hips. And they might affect one side much more than the other.)

ARE THERE SYMPTOMS TO LOOK FOR?

Yes. Symptoms include:
• Pain, swelling, limited motion, warmth and tightness around affected joints, which most commonly include the hands and wrists, feet and ankles, elbows, shoulders, neck, knees and hips, usually in a symmetrical pattern. Over time, joints may develop deformities.
• Fatigue, soreness, stiffness and aching, particularly in the morning and afternoon (described as morning stiffness and afternoon fatigue)
• Lumps or rheumatoid nodules below the skin
• Weight loss
• Low-grade fever and sweats
• Trouble sleeping
• Weakness and loss of mobility
• Depression from unbearable pains and stiffness

WHAT HAPPENS AS RHEUMATOID ARTHRITIS GETS WORSE?

Even though it might start in the fingers and toes, rheumatoid arthritis can affect any of the joints. Sometimes it damages the joints forever. Plus, rheumatoid arthritis can cause problems in other parts of the body, such as the heart, lungs, or eyes. Doctors have no way of knowing which people will get which symptoms or how bad the effects will be.

WHAT ARE THE TREATMENTS FOR RHEUMATOID ARTHRITIS?

If your doctor tells you that you have rheumatoid arthritis, start treatment right away. Do not wait until your symptoms get worse. Getting treated early can help prevent a lot of the damage the disease can do to your body.
There are dozens of medicines for rheumatoid arthritis. The right one for you will depend on:
• How bad your symptoms are
• How many of your joints are affected
• How your disease has changed over time
• What side effects you feel with the medicines you try
• What your X-rays look like
• The results of certain blood tests
In general, the treatment options include:
• Medicines called “nonsteroidal anti-inflammatory drugs,” also known as NSAIDs
• Medicines called steroids
• Medicines called “disease modifying anti-rheumatic drugs” also known as “DMARDs”

People who have severe pain that does not get better with the medicines listed above sometimes get narcotic pain medicines.

IS THERE ANYTHING I CAN DO ON MY OWN TO FEEL BETTER?

Yes. It is very important that you stay active. You might want to avoid being active because you are in pain. But that can make things worse. It will make your muscles weak and your joints stiffer than they already are. A physical therapist can help you figure out which exercises will do the most good. An occupational therapist can help you figure out how to keep doing the everyday tasks you need to do—even with arthritis.
Another thing you can do to on your own is to eat a healthy diet. People with rheumatoid arthritis are at risk for heart disease, so avoid fatty foods. Instead, eats lots of fruits and vegetables

WHAT IS LIFE LIKE WITH TREATMENT?

Early, effective treatment can help you live well with rheumatoid arthritis, although the severity of the disease and its response to therapy are highly variable. Eating healthy, regular checkups, and using your medications as prescribed by your doctor, are your best options with this debilitating illness.

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Rheumatoid Arthritis: A Painful and Debilitating Illness

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