Rheumatoid Arthritis: The Painful and Debilitating condition

Sep 04, 2022 Dr Zulfikar Bux, Features / Columnists

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By Dr Zulfikar Bux

Assistant Professor of Emergency Medicine

Kaieteur News – I saw two patients this week with a history of Rheumatoid arthritis and their condition has worsened because they chose to not follow up as required. I am seeing this condition more often than when I started to practice medicine, and I think the time is appropriate to remind readers of the debilitating and painful nature of this disease. The joint pains and stiffness are often unbearable and lifelong and cases are on the increase. Over one percent of the world population suffers with Rheumatoid arthritis with women two times more likely to be affected than men. Today, I will shed some light on this incurable condition as treatment and awareness can prevent life threatening complications.

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. The immune system basically malfunctions and treats joints as foreign entities thereby attacking them causing inflammation and slow destruction.

How can I tell whether I have rheumatoid arthritis or another type of arthritis?

There are some clues to look for; 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. Overtime, 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 causing joint defects. 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 their symptoms 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. Often, they have to be on treatment for the rest of their life.

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 on your own is to eat a healthy diet. People with rheumatoid arthritis are at risk for heart disease, so avoid fatty and preserved foods. Instead, eat lots of fruits and vegetables and naturally occurring foods. Studies have shown that a diet rich in Vitamin D and sunlight will help persons with Rheumatoid arthritis.

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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