Reality check: Every day is different with Rheumatoid Arthritis. Lucky
you if some days are good, else hard days can be really hard. What if you hack
a few ways through which you can simplify your day-to-day life? Time to bring
you glad tidings! Make a quick read to know the smart tips and tricks to manage
the disease well and have a normal life.
Mornings can be the
worst Because your joints can be immobile
during the night, you might feel extra pain and stiffness in the morning. Sadly,
it will throw off the rest of your day. On days when your pain is extra bad,
you can use heat therapy to decrease the pain and improve muscle flexibility. Heat
will warm the skin and deeper tissues, causing the blood vessels to dilate and
enabling more oxygen to the joints and muscles.
Some people feel pain in their hands
and wrists. To make things smoothers, sleeping in compression gloves can be a
savior for them. They reduce pain and keep your fingers flexible and supported.
Take your time to wake up and stretch in the first place. Just roll your body
from ankles to shoulders and pull your knees to your chest. Don’t rush yourself
in the morning.
Listen to your body
To make things easier, just listen to your body and work accordingly. You need to be present and mindful in every moment. Just aim for a medium pace and take lot of breaks. Don’t put much stress on your joints and set your feet slightly apart when you stand. You can take the support of a chair or wall when you have to stand for a long time in order to put less load on your body.
Manage the chores smartly Mopping, Sweeping and Laundry!! It’s all that over your mind when you wake up and want to start your day with it. Unluckily, it’s not your day today, thanks to rheumatoid arthritis. However, a smart management can work for you. Schedule laundry for today and mopping, sweeping for another. You need break these chores into several days to make things easier. Use easy to handle brooms and dusters to avoid any pressure on your joints.
Prefer a regular low-intensity exercise If you feel that exercise can make the things worst, you need to rethink. A low-intensity exercise can be beneficial in managing the disease. You can try walking as it can help reduce fatigue and prevent loss of muscle mass and bone density. A basic workout like walking can also prevent other diseases such as diabetes and heart disease that you are highly vulnerable of. Last but not the least, it can help you get through your day happily and avoid depression. Overall, movement is important to keep joint stiffness at bay.
Apart from these smart tips and tricks, keep it in your mind that dealing with rheumatoid arthritis is easier said than done. Sometimes, the pain can have a great impact on your mood, so much so that you have to turn down your plans and miss out on things that you are willing to do. It can increase the chances of depression and anxiety. Have someone by your side who can be a good listener for you and can help you sort out your feelings.
Rheumatoid Arthritis (RA) is a chronic autoimmune disease that’s progressive in nature, causes disabling pain and inflammation in and around the joints and, at times, damage to the skin, lungs, eyes, heart and blood vessels. It’s the most common form of autoimmune arthritis and is estimated to affect up to one percent of the global population.
Understanding Rheumatoid Arthritis
Rheumatoid arthritis is a systematic disorder caused when the body’s own immune system – the body’s defense against foreign bodies like viruses and bacteria – starts to malfunction, mistaking the body tissue for unwanted, foreign material. This causes the immune system to attack the joints, causing inflammation that leads to thickening of the synovium – the soft membrane that lines the insides of the joints.
The synovium’s primary goal is to supply the fluid that lubricates the joints and keeps them working smoothly. If the inflammation is left untreated, it can cause damage to the cartilage – the rubber like elastic tissue that covers and safeguards the ends of bones in the joint region. Over time, the loss of cartilage decreases the joint spacing in between the bones leading to painful joints and irreversible joint deformation.
The most commonly affected areas are the joints of hands and wrists, elbows, feet, ankles and knees. In addition to the joints, rheumatoid arthritis can also affect the respiratory, cardiovascular and other bodily systems.
Rheumatoid Arthritis – The Risks
The most obvious risks of rheumatoid arthritis are the destruction of the cartilage and the bone inside the joints. Left unchecked, rheumatoid arthritis can cause weakening and stretching of the joints to the extent that they lose their original form and alignment.Individuals affected by rheumatoid arthritis are also susceptible to formation of rheumatoid nodules (small lumps of tissue) around the lungs, elbows and other parts of the body.
Sjogren’s syndrome – an autoimmune disease that causes dry eyes and mouth, disproportioned body mass and a range of infections round up the long list of health risks associated with rheumatoid arthritis.
Rheumatoid Arthritis symptoms
Tenderness and swelling of the joints
At the onset, rheumatoid arthritis usually causes tenderness and swelling in the smaller joints such as toes and fingers. As it progresses, the person affected begins to feel similar discomfort in the larger joints like the wrists, ankles, elbows, shoulders and hips.
Stiffness in the joints
Joint stiffness is a common symptom of rheumatoid arthritis. The stiffness is more severe at the morning time and after a period of inactivity such as after waking up from sleep.
Other common symptoms
A lasting feeling of fatigue, loss of appetite are other indicators of rheumatoid arthritis. The discomforts associated by rheumatoid arthritis can come and go periodically, the joint swelling and pain can significantly fade away for a while before returning.
Who all are at risk?
The exact cause of rheumatoid arthritis is still unknown, but there are several factors that have been known to increase the chances of an individual contacting the disease. These are:
Women are more susceptible to rheumatoid arthritis than men, with one in four women in the world being affected by the disease. In comparison, one in five men around the world are affected. It’s been discovered that women suffering from rheumatoid arthritis experience fewer or no symptoms when they’re pregnant. Breastfeeding has also been found to significantly reduce the risks of rheumatoid arthritis, with women that have breastfed for 2 years reducing their risks of contacting the disease to half.
While rheumatoid arthritis can affect people of all ages, it’s most common at the middle age.
Research has revealed that people who have a family history of rheumatoid arthritis are more at risk than those with no family history of the disease.
Overweight people, particularly women up to the age of 55 have been known to be at a greater risk of rheumatoid arthritis than any other demographic.
Smokers have been found to have a high risk of developing rheumatoid arthritis. The severity of pain and other symptoms is also higher in people who smoke regularly.
Rheumatoid arthritis diagnosis
Rheumatoid arthritis can be hard to diagnose early on as the same symptoms are shared by several other diseases. Usually, swelling in 3-4 or more different joints, pain and stiffness that lasts over 6 weeks, morning stiffness that lasts over half an hour, symmetrical symptoms on both sides of the body are factors that point towards rheumatoid arthritis.
In addition to carrying out a physical checkup of the joints, the doctor will also inquire about the patient’s past and family history of autoimmune and other diseases. The doctor is will recommend blood tests.
Imaging scans like X-ray, MRI and Ultrasound are also a common way of diagnosing rheumatoid arthritis. These scans can present a clear picture of cartilage and bone erosion and joint damage and help the doctor reach a diagnosis.
Rheumatoid Arthritis treatment
Treatment of rheumatoid arthritis varies with the severity of the patient’s symptoms. Based on the age of the disease and damage caused to the body, the doctor can recommend these courses of medication:
NSAIDs (Nonsteroidal anti-inflammatory drugs)
Over the counter NSAIDs can be effective in managing the pain and discomfort caused in the early stages of rheumatoid arthritis. In more serious cases, the doctor can give you stronger, prescription only NSAIDs.
Inflammation reducing steroidal drugs such as prednisone and other corticosteroids can help slow down joint damage and relieve acute pain.
DMARDs (Disease-modifying antirheumatic drugs)
DMARDs like methotrexate, hydroxychloroquine and sulfasalazine can effectively slow down the disease’s progression and prevent permanent damage to joints and tissue.
Biologic Response Modifiers
Biologic response modifiers are the new class of DMARDs that include the likes of abatacept, anakinra, baricitinib, certolizumab, etanercept, golimumab, infliximab, rituximab, sarilumab and tofacitinib. Also known as biologic agents, these DMARDs directly target inflammation causing parts of the immune system and are usually paired with non biologic DMARDs like methotrexate.
Physical therapy is beneficial in helping improve joint flexibility in rheumatoid arthritis patients. A trained therapist can help patients adapt to new ways of carrying out day to day tasks which have been made difficult by pain, swelling or loss of joint mobility. He/she may also recommend assistive devices and medical supplies like hand grips and buttonhooks to protect affected joint and body parts when carrying out simple tasks like working with tools and changing clothes.
The common surgical procedures for treating rheumatoid arthritis:
The goal of this surgery is to remove the synovium – the inflamed membrane lining the insides of the joint.
This procedure involves surgically fusing an affected joint with the aim of realigning or stabilizing it. Joint fusion is usually carried out in cases where the doctor has ruled out joint replacement surgery.
Tendon Repair Surgery
At times, the joint damage and inflammation caused by rheumatoid arthritis can rupture or loosen the tendons around the joints. In such cases, the surgeon will operate on the affected areas and repair the tendons.
Total joint replacement
In this procedure, the damaged parts of the joint are surgically removed and replaced by prosthesis composed of plastic and metal.
Early diagnosis and the Right treatment can reduce the damage and help the patient lead an active, pain free life.
Frozen shoulder, also known as adhesive capsulitis is a disorder that cause stiffness thereby resulting in pain in the shoulder joint. This condition leads to the loss of normal range of motion of the shoulder, leaving the affected individual unable to perform even simple physical activities like reaching for objects placed on an overhead shelf. A frozen shoulder can get significantly worse if left untreated. In most cases, the problem deteriorates, and then goes away over the course of time, usually over a period of 1 to 2.5 years.
Dull, lingering pain in one of the shoulders or in the muscles of the outer shoulder and upper arm region accompanied by stiffness of the shoulder joint are common symptoms of frozen shoulder. The pain may worsen at night in some cases. Most patients will experience pain at the slightest movement of the shoulder.
Who all are at risk?
For reasons yet unclear, women are more likely to develop a frozen shoulder than men. People belonging to the age group of 40-60 years old and those recovering from a stroke, mastectomy and other medical conditions that restrict the movement of arms are most likely to be affected by a frozen shoulder.
Individuals suffering from heart and thyroid related issues (hyperthyroidism/ hypothyroidism), tuberculosis, cardiovascular disorders, Parkinson’s disease and diabetes too have a high susceptibility to developing a frozen shoulder.
In addition, individuals recovering from tendinitis or injuries that cause them to wear a sling for several days are also at the risk of getting a frozen shoulder in absence of regular stretching. An estimated 10 percent of people suffering from rotator cuff disorders are affected by frozen shoulder.
A physical examination is required for diagnosing a frozen shoulder. This involves active and passive movement tests. In the ‘active’ part, the doctor will have the affected individual move the shoulder on his/her own to get a measure of pain and stiffness. In the ‘passive’ leg of the examination, the doctor will move the affected individual’s shoulder to gauge the differences in discomfort and range of motion.
In some instances, the doctor can administer anesthesia to numb the shoulder in order to carry out the physical examination. In addition, imaging tests such as X-ray, MRI or ultrasound may also be required if the doctor suspects a torn rotator cuff, arthritis or a similar condition to be the underlying cause of shoulder distress.
In some cases, non-steroidal anti-inflammatory drugs are prescribed to alleviate the pain, especially if there’s noticeable swelling in the affected shoulder. If there is significant inflammation or pain, the doctor can prescribe different, more potent medications.
Physiotherapy has been found to be effective in improving mobility of the shoulder and is often recommended. In severe cases wherein oral medication fails to bring relief, the doctor can revert to administering a corticosteroid injection into the shoulder joint.
Some rare cases may call for a shoulder surgery. The surgery is an arthroscopic or keyhole procedure.
knees are one of human body’s most utilized joints — they bear approximately
3-4 times the body weight with each step. The staggering amount of work the
knees perform means that most people will invariably face knee pain at some
point of their lives. This could be short term discomfort, inflammation and
dislocations caused by trauma or age and weight related issues like
of knee pain depends upon the underlying cause and the degree of damage to the
joint and surrounding tissue. Inflammation and pain in the knee region can be
self-managed by RICE therapy—Resting it to allow proper healing, Icing the swollen area for 20-30
minutes, 4-5 times a day, Compressing
the knee using a wrap and Elevating
the knee to prevent fluid buildup in the affected region. Joint deformation,
puncture wounds, suspected fractures, excessive redness and swelling, fever and
lack of relief from RICE therapy are
indicative of conditions that require medical attention.
Non-Surgical Knee Pain Treatment: –
medicine of various kinds can be effective against knee pain. Depending on the
diagnosis, a physician may prescribe a course of analgesics for pain relief,
nonsteroidal anti-inflammatory drugs for pain and inflammation or oral
This procedure involves the use of a needle to remove
joint fluid from the knee, primarily for lab tests. The removal of excess
fluid, however, can alleviate pain and reduce inflammation by itself.
Injecting Hyaluronic Acid Supplements
Hyaluronic acid is the substance that helps absorb shocks and lubricates the knee joint, ensuring proper and safe motion. People with Osteoarthritis (a condition that alters the shape or structure of the joints) often suffer from a breakdown of hyaluronic acid. Supplementing by injecting hyaluronic acid directly into the knee joint can significantly ease pain.
Injecting corticosteroids directly into the knee joint can bring immediate relief to swollen, aching knees. The effect of these injections can last from several days to over six months. Continuous knee injections, however, can cause cartilage breakdown so this procedure should not be relied upon for long-term pain management.
Using patient’s blood PRP is prepared & injected into the knee joint. It is one of the safest procedures available.
Surgical Option: –
surgery is usually a last resort option for when all other procedures have
failed to cure knee pain. The degree of invasiveness involved varies with the
extent of damage and structural modification required.
minimally invasive surgery performed for removal or repair of torn menisci,
trimming pieces of joint cartilage, repairing torn cruciate ligament and
removing inflamed joint lining or loose bodies from the knee. The surgery
entails making small incisions in the knee to insert a lighted scope and small
instruments to carry out the procedure.
surgery entails reshaping and repositioning the bones to take the load off the
damaged area of the knee. Performed in cases where the damage in limited to one
section of the knee or wherein the patient is unwilling to undergo total knee
Total knee Replacement
damage is substantial and irreparable by means of other procedures, it requires
the removal of the top of the tibia (shin bone) and the damaged part of the
bone at the end of femur (thigh bone), and/or of the patella (knee-cap). The
surgeon will then replace the removed parts with prosthetic components
typically made from metal alloys and high-grade plastic.
Tender, swollen joints that ache when you move – you could be suffering from Bursitis, a painful medical condition wherein bursae – the small, fluid filled sacs that work as cushion between the bones, muscle and tendons around the joints have become inflamed.
The human body has 150 plus bursae. Their primary function is providing lubrication to reduce friction between the tissue during physical activity. Joints like hips, shoulders and elbows that engage in frequent physical activity are the most commonly affected by Bursitis.
Bursitis too can affect other joints, like the knee and the base of the big toe. Bursitis of the knee is commonly called “Housemaid’s knee” or “Clergyman’s knee”.
Bursitis is marked by easy to spot visual and physiological cues. These include –
Stiffness and ache in the joint region.
Swelling and redness in the affected joint.
Experiencing increased pain when moving or putting pressure on the affected areas.
Bursitis is usually caused by repetitive movements that wear out or stress the bursae. Athletes and laborers whose daily routine involves lifting objects over their heads or kneeling for long durations are at a high risk of developing bursitis.
Something as seemingly innocuous as leaning on your elbows for long when studying or reading can also lead to bursitis. Ageing, rheumatoid arthritis, gout, infections and injuries suffered to the joint region are other common causes.
Diagnosis of Bursitis involves an examination of the affected joint and inquiry into recent physical activities and injuries. In some cases, swelling and soreness in the joint can be accompanied by fever. In such an event, the doctor will draw a small quantity of fluid from the bursa close to the affected joint which will be tested.
You might have to undergo an X-ray if the doctor suspects a break or a fracture or MRI in case of torn tendons. If the doctor suspects rheumatoid arthritis, you might have to undergo some blood testing.
Minor discomfort and inflammation can be managed and cured by ice packs and rest. Raising the affected joint to reduce the blood flowing into it can also sometimes help to reduce swelling.
If you experience a sharp pain in the joint, are unable to move, develop a rash and/or a fever, consult your doctor. Based on the underlying cause and diagnosis, the doctor may administer steroid injections at the site of the pain and/or prescribe a course of antibiotics. Some cases may require intravenous administration of antibiotics and surgical draining to reduce fluid buildup.