How Rheumatoid Arthritis Affects the Whole Body

Rheumatoid arthritis (RA), an autoimmune inflammatory condition that causes pain, stiffness, and swelling, is most noted for its effects on the body’s joints. But rheumatoid arthritis is also a systemic disease, meaning it can affect the whole body, damage major organs, and even lead to a shortened life span.

The earlier you begin medication, the better your chances of halting joint damage, protecting your organs, and living a longer life without pain and disability, says Jonathan Greer, MD, a rheumatologist in Boynton Beach, Florida.

Here’s everything you need to know to protect various parts of your body if you have RA.

How Rheumatoid Arthritis Can Affect Your Eyes

Because of inflammation around the eyes, some people with rheumatoid arthritis may get either dry eye syndrome or episcleritis, a redness in the white part of the eye. These can generally be managed with over-the-counter or prescription drops, according to Johns Hopkins Medicine.

A more serious eye condition is scleritis, in which a deeper part of the white area, the sclera, is affected. Untreated, scleritis can lead to vision loss.

Uveitis can develop when the eye’s middle layer, the uvea, is inflamed. This brings on floaters (cobwebs or black spots in the field of vision), blurred vision, and pain, says Ana-Maria Orbai, MD, a rheumatologist and an assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.

Untreated uveitis can put a person at risk of glaucoma, a disease that causes pressure to build up in the eye that can ultimately damage the optic nerve and cause blindness. (This can also happen to people who take steroid medications for RA over a long period of time.) Treatment for both scleritis and uveitis involves corticosteroid eye drops, though this may not be enough to treat uveitis beyond the front of the eye, in which case oral and injected corticosteroids may be needed, according to the Mayo Clinic.

It’s also important to note that up to 30 percent of people with RA develop another autoimmune disease, Sjögren’s syndrome. This disease affects tear glands (as well as salivary glands), causing very dry eyes along with other symptoms.

Because of the risk of these eye diseases, regular eye exams by an ophthalmologist are critical to diagnosing these conditions early, which is why everyone living with RA should see this specialist every year.

RELATED: Rheumatoid Arthritis and Your Eyes: What to Know

How Rheumatoid Arthritis May Affect Your Mouth

Research shows that people who have rheumatoid arthritis may be more likely to develop periodontal disease, which usually starts with a gum infection.

They are also more likely to have dry mouth, which can predispose them to tooth decay. (This is especially true for people with coexisting Sjögren’s syndrome.)

The flip side of this may be true too: Poor oral health may lead to the onset or worsening of RA. Evidence suggests that bacteria in the mouth create autoantibodies that can attack the lining of the joints; according to the Arthritis Foundation, damaged gum tissue allows these bacteria to travel from the mouth into the bloodstream and affect other parts of the body.

Researchers have been working to better understand the mechanism behind this, but the takeaway is that treating gum disease and preventing unnecessary gum infections is good for your RA, as well. Schedule frequent dental checkups to catch minor issues before they become major problems. Some rheumatologists recommend a visit every three months, instead of the usual six, if you can afford it or your insurance covers it.

Rheumatoid Arthritis and Your Hands and Feet

Since RA is a condition of the joints, it’s obvious that it affects a person’s hands and feet. But beyond joint pain, RA can cause other distortions and deformities if it is not treated as early as possible with disease-modifying antirheumatic drugs (DMARDs).

Some of the most common symptoms affecting the hands include locking joints, ulnar deviation (also called ulnar drift — a weakening of tendons and ligaments that cause fingers to curve toward the pinkie), swan-neck deformities (distortions of the joints causing unusual bending and straightening), and even ruptured tendons, according to research published in the European Journal of Orthopaedic Surgery and Traumatology in 2020. All these effects can make basic life tasks such as writing, holding objects, and unscrewing lids difficult.

The hands can also be affected by muscle cramping, which can be relieved by gentle movements and warm compresses. More concerning, the inflammation of RA can affect the median nerve (which runs from the wrist to the fingers), causing numbness or carpal tunnel syndrome, notes CreakyJoints. See your doctor if you experience any of these.

In the feet, uncontrolled inflammation may lead to painful conditions like hammertoes (abnormal bending of the toes), bunion (a bony nodule on the outside edge of the big toe), a collapsed arch, and flatfoot deformity, notes the American Academy of Orthopaedic Surgeons.

RELATED: How to Relieve Rheumatoid Arthritis Related Foot Pain

In addition to seeing your rheumatologist and, if necessary, a podiatrist, you may also consult an occupational or physical therapist. These experts help you learn ways of moving that are less painful and that strengthen muscles, says Rebecca Manno, MD, a rheumatologist and adjunct assistant professor of medicine at the Johns Hopkins University School of Medicine in Baltimore.

Rashes, Ulcers, and Bumps: How RA Affects Your Skin

A skin rash or ulcers on the arms and legs sometimes occur in people with rheumatoid arthritis, especially if the disease has gone untreated for a long time, Dr. Greer says.

Up to 25 percent of people with RA develop rheumatoid nodules — knots of inflammatory tissue just under the skin near a joint. Most often appearing on the elbows, hands, and feet, they can be treated with a steroid injection if they become bothersome.

The conditions that affect the skin tend to resolve once RA is controlled with DMARD medications.

Rheumatoid Arthritis and Your Heart and Circulatory System

Higher levels of inflammation in people with rheumatoid arthritis increase the risk of heart disease, especially heart attacks and strokes, Greer says. Inflammation increases the buildup of plaque in the arteries, which narrows blood vessels and slows blood flow, notes the Arthritis Foundation, upping the chances of stroke and heart attack.

These heart conditions are also more deadly in those with RA. In people with systemic inflammatory diseases, heart attacks in those under 50 were found to be twice as likely to be fatal compared with heart attacks in people without an inflammatory condition, according to a study published in the European Journal of Preventive Cardiology in March 2021.

To lower your risk, you’ll want to get your RA under control and also reduce heart risk factors, such as high blood pressure and high cholesterol. A healthy diet like the Mediterranean diet can lower your risk of heart disease.

Another way to assist your heart and improve your RA: Don’t smoke; and if you do smoke, quit as soon as possible; in addition, avoid exposure to secondhand smoke.

Finally, know that certain RA medications themselves – including NSAIDs and steroids, per the Arthritis Foundation – have been linked to heart problems; JAK inhibitors may raise cholesterol levels, notes CreakyJoints. But these side effects are are not a reason to skip drug treatment. “The negative effects of not treating RA with medication are much, much worse than the side effects of RA drugs,” cautions Greer.

RA Can Trigger Anemia and Fatigue

A large percentage of people living with RA experience anemia, a shortage of red blood cells or the iron-rich hemoglobin in the red blood cells. Red blood cells carry oxygen from your lungs to all the cells in the body and organs, so when your organs aren’t getting enough O₂, you can experience weakness, fatigue, headaches, shortness of breath, dizziness, and more.

There are different types of anemia, and a common type in RA patients is called anemia of chronic disease. RA’s inflammatory molecules may interfere with the body’s ability to use iron, which in turn leads to anemia. Iron supplementation can help, but the best treatment is to keep the inflammation of RA under control with DMARD medication.

Another cause of fatigue: Autoimmune disorders like RA can trigger the release of inflammatory cytokines (proteins) in the blood, and the body undergoes stress as it tries to manage this, which leads to fatigue, notes the Arthritis Foundation. In addition, the depression and pain that may come along with RA continually sap energy.

RELATED: The Link Between Rheumatoid Arthritis and Anemia

Fever: A Full-Body Effect of Rheumatoid Arthritis

According to the American College of Rheumatology, low-grade fever is one of many common rheumatoid arthritis experiences. The Centers for Disease Control and Prevention (CDC) considers an adult to have a fever when their temperature is at least 100. 4 degrees F (37.8 degrees C), with symptoms of feverishness or chills.

Fever can occur as a result of your body’s autoimmune response. Once you start treating your RA, systemic symptoms like fever should improve, notes CreakyJoints, but some people may still develop low-grade fevers on occasion, depending on their disease activity.

How Rheumatoid Arthritis Impacts Organs

In addition to heart problems, RA can increase your risk of damage to other organs, such as the lungs and kidneys.

Rheumatoid Arthritis and Your Lungs

The most common RA-related lung complication is interstitial lung disease (ILD), a condition that causes inflammation and scarring of the lung tissue. This illness can be hard to detect but occurs when lung tissue becomes inflamed and eventually scarred.

It’s unclear exactly how many people with RA develop it, but French researchers presenting an abstract at the American College of Rheumatology (ACR) annual conference in 2020 found that the prevalence of subclinical (symptomless) ILD was 18 percent in people who had RA for a dozen years. Other research has detected ILD in up to 60 percent of patients with RA, with 10 percent of cases being clinically significant. People with RA are nine times more likely to develop ILD than the general population, according to a review published in May 2022 in Frontiers in Medicine.

This scarring makes it harder for oxygen in the lungs to enter the bloodstream and travel to other organs. The condition can cause breathlessness and coughing, but it can also be asymptomatic. If untreated, it can progress to pulmonary fibrosis, in which tissues are permanently scarred.

Research also shows that RA sufferers are at double the risk of chronic obstructive pulmonary disease, or COPD (which includes emphysema and chronic bronchitis), in which the air sacs can’t expand as easily and become clogged with mucus. There is no cure for COPD, although inhalers and steroids can help open airways.

Pleural effusion is another condition with increased risk. Here, the pleura — the tissue surrounding the lungs — becomes inflamed, which can lead to fluid buildup between the lung and the chest wall, according to the Arthritis Foundation.

People with RA may also develop nodules in the lungs, though they may not be bothered by them. (Nodules can also form on the throat and vocal cords, causing difficulty speaking.)

Being proactive and diligent about your RA treatment can address inflammation and minimize the risk for lung problems. And of course, if you smoke, quit.

Rheumatoid Arthritis and Kidney Function

People with RA have a greater risk of developing chronic kidney disease, though as RA treatment has improved — including the use of biologic medications and a decrease in chronic NSAID use — kidney problems have been reduced, according to an article published in Rheumatic Diseases Clinics of North America in November 2018.

Amyloidosis, a condition caused by the abnormal buildup of certain proteins that can impair kidney function, may occur in association with RA — usually in the later stages or if someone’s disease isn’t well-controlled with medication. The symptoms can be vague, such as weakness or swelling, and can include an enlarged spleen and gastrointestinal issues.

To screen for amyloidosis, rheumatologists will periodically check your kidney function.

To maintain healthy kidneys, you should also take care not to overuse nonsteroidal anti-inflammatory painkillers (NSAIDs), like ibuprofen and naproxen, as they can damage the kidneys, too.

RELATED: Protect Your Kidneys When You Have RA

Mental Health: Rheumatoid Arthritis and Depression

The fear that comes with living with any chronic illness, as well as dealing with daily pain and limited mobility, can take a toll on emotional wellness. But when it comes to RA, depression can be more than just an emotional response to the disease. “There is a clear link between RA and depression,” says Daniel Solomon, MD, MPH, the chief of the clinical sciences section in the division of rheumatology at Brigham and Women’s Hospital in Boston. “We don’t yet understand how much of the depression is from a reaction to the disease and how much is the inflammation of the disease, but they both contribute somehow. ”

What experts do know is that treatment for RA’s inflammation quells the inflammation associated with depression. The opposite may also be true: Treatment for depression (with talk therapy or medication, for example) may lessen the pain of the disease. As the Arthritis Foundation notes, while pain can incite depression, depression can also worsen pain. According to research presented at the 2021 annual congress of the European Alliance of Associations for Rheumatology (EULAR), catastrophizing about pain makes it worse, and it can actually impede RA remission.

RELATED: The Link Between RA, Depression, and Anxiety

Rheumatoid Arthritis Can Threaten Bone Health

RA can increase your risk of osteoporosis, a disease in which bones become less dense and more fragile, increasing the likelihood they will break.

According to a study in the August 2021 issue of Cureus, there are several reasons for this association: chronic joint inflammation, genetics, the role of estrogen, and the fact that certain RA medications, such as corticosteroids, can speed bone loss. Bone loss is most prevalent in areas that immediately surround joints affected by rheumatoid arthritis, notes the National Institutes of Health (NIH). Fractures most commonly occur at the spine, wrist, and hip, per the American College of Rheumatology (ACR), which notes that spine and hip fractures may lead to chronic pain, disability, and even death.

The best way to protect bones when you have rheumatoid arthritis? Eat calcium-rich and vitamin D–rich foods like eggs and fish, as well as D-fortified foods; do weight-bearing exercises (walking, stair-stepping) that your doctor approves; if you smoke, quit; and get a bone mineral density test so your doctor can consider whether you need medication.

RELATED: What to Eat and What to Avoid for Osteoporosis Prevention

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Rheumatoid Arthritis | Johns Hopkins Medicine

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is a long-term (chronic) disease that causes inflammation of the joints. The inflammation can be so severe that it affects how the joints and other parts of the body look and function. In the hand, RA may cause deformities in the joints of the fingers. This makes moving your hands difficult. Lumps, known as rheumatoid nodules, may form anywhere in the body.

Juvenile rheumatoid arthritis (JRA) is a form of arthritis in children ages 16 or younger. It causes inflammation and joint stiffness that last for more than 6 weeks. Unlike adult RA, which lasts a lifetime, children often outgrow JRA. But the disease can affect bone development in a growing child.

What causes rheumatoid arthritis?

The exact cause of RA is not known. RA is an autoimmune disorder. This means the body’s immune system attacks its own healthy cells and tissues. This causes inflammation in and around the joints. This may damage the skeletal system. RA can also damage other organs, such as the heart and lungs. Researchers think certain factors, including heredity, may be a factor.

RA most often occurs in people from ages 30 to 50, but it can occur at any age. It happens more in women than in men.

What are the symptoms of rheumatoid arthritis?

The joints most often affected by RA are in the hands, wrists, feet, ankles, knees, shoulders, and elbows. The disease often causes inflammation in the same areas on both sides of the body. Symptoms may begin suddenly or slowly over time. Each person’s symptoms may vary, and may include:

• Pain
• Stiffness, especially in the morning
• Swelling over the joints
• Decreased movement
• Pain that is worse with joint movement
• Bumps over the small joints
• Trouble doing activities of daily living (ADLs), such as tying shoes, opening jars, or buttoning shirts
• Trouble grasping or pinching things
• Tiredness and lack of energy (fatigue)
• Occasional fever

These symptoms can seem like other health conditions. Always see your healthcare provider for a diagnosis. 

How is rheumatoid arthritis diagnosed?

Diagnosing RA may be difficult in the early stages. This is because symptoms may be very mild, and signs of the disease may not be seen on X-rays or in blood tests. Your healthcare provider will take your medical history and give you a physical exam. Tests may also be done, such as:

• X-ray. This test uses a small amount of radiation to create images of internal tissues, bones, and organs onto film.
• Joint aspiration. For this test, a small fluid sample is taken from a swollen joint. It is done to look for signs of infection or gout.
• Nodule biopsy. Tiny tissue samples are taken to look at under a microscope. This helps to check for cancer or other abnormal cells.   
• Blood tests. These tests are done to find certain antibodies, called rheumatoid factor, cyclic citrullinated antibody, and other signs of RA.
• Ultrasound or MRI. These imaging tests can look for bone damage and inflammation. 

How is rheumatoid arthritis treated?

Your healthcare provider will figure out the best treatment for you based on:

• How old you are
• Your overall health and medical history
• How sick you are
• How well you handle certain medicines, treatments, or therapies
• If your condition is expected to get worse
• Your opinion or preference

There is no cure for RA. The goal of treatment is often to limit pain and inflammation, and help ensure function. You may have 1 or more types of treatments. Treatment may include:

• Medicines. Some medicines may be used for pain relief. Some are used to treat inflammation. Others can help to slow the disease from getting worse. Medicines should be managed by a rheumatologist. This is a doctor who specializes in arthritis and rheumatic diseases. You may need regular blood tests to check how the medicines affect your blood cells, liver, and kidneys.
• Splints. Splints may be used to help protect the joints and strengthen weak joints.
• Physical therapy. Physical therapy may be used to help increase the strength and movement of the affected areas.

In some cases, surgery may be an option if other treatments don’t work. Surgery does not cure RA. It helps correct the deformities caused by the disease. After surgery, RA can still cause problems. You may even need more surgery. Joint repair or reconstruction can be done in many ways, including:

• Surgical cleaning. This surgery removes inflamed and diseased tissues in the hands to help increase function.
• Joint replacement (arthroplasty). This type of surgery may be used in cases of severe arthritis of the hand. It may be done on older adults who are not so active. Joint replacement may reduce pain and help increase joint function. During the surgery, a joint that has been destroyed by the disease is replaced with an artificial joint. The new joint may be made out of metal, plastic, or silicone rubber. Or it may be made from your own tissue, such as a tendon from another part of your body.
• Joint fusion. For this surgery, a joint is removed, and the two ends of bones are fused together. This makes one large bone without a joint. This is usually done on patients with advanced RA. After the bone fusion, the fused joint can’t move.

Complications of Rheumatoid Arthritis

Because RA damages joints over time, it causes some disability. It can cause pain and movement problems. You may be less able to do your normal daily activities and tasks. This can also lead to problems such as depression and anxiety.

RA can also affect many nonjoint parts of the body, such as the lungs, heart, skin, nerves, muscles, blood vessels, and kidneys.  These complications can lead to severe illness and even death.

Living with Rheumatoid Arthritis

There is no cure for RA. But it is important to help keep your joints working well by reducing pain and inflammation. Work on a treatment plan with your healthcare provider that includes medicine and physical therapy. Work on lifestyle changes that can improve your quality of life. Lifestyle changes include:

• Activity and rest. To reduce stress on your joints, switch between activity and rest. This can help protect your joints and lessen your symptoms.
• Using assistive devices. Canes, crutches, and walkers can help to keep stress off certain joints and to improve balance.
• Using adaptive equipment. Reachers and grabbers let you extend your reach and reduce straining. Dressing aids help you get dressed more easily.
• Managing the use of medicines.  Medicines for this condition have some risks. Work with your healthcare provider to create a plan to reduce this risk.
• Seeking support. Find a support group that can help you deal with the effects of RA.

When should I call my healthcare provider?

Tell your healthcare provider if your symptoms get worse or you have new symptoms.

Key Points about Rheumatoid Arthritis

• RA is a long-term (chronic disease) that causes joint inflammation.
• RA can also affect many nonjoint areas such as the lungs, heart, skin, nerves, muscles, blood vessels, and kidneys.
• RA may cause deformities in the joints of the finger, making movement difficult.
• The joints most often affected by RA are in the hands, wrists, feet, ankles, knees, shoulders, and elbows.
• Symptoms may include joint pain, stiffness, and swelling; decreased and painful movement; bumps over small joints; and fatigue or fever.

Rheumatoid arthritis – symptoms, causes and treatment of rheumatoid arthritis

Rheumatoid arthritis

Rheumatoid arthritis is a chronic systemic connective tissue disease. Considered as an autoimmune disease. Affects mainly peripheral small joints. Rheumatoid arthritis has an infectious and inflammatory origin. The disease is characterized by:

• progressive course;
• immobility in the joint;
• destruction of articular tissue.

Causes of rheumatoid arthritis

Among the causes of rheumatoid arthritis are:

• hereditary predisposition;
• infectious diseases (herpes, rubella, hepatitis B, Epstein-Barr, etc.).

Trauma, food allergy, history of surgical interventions are provoking factors.

Symptoms of disease

Rheumatoid arthritis is a systemic disease that can affect not only the joints, but also various organs and systems. The severity of the clinical picture depends on many factors: the severity of the disease, the presence or absence of complications, the localization of the pathology. According to statistics, 70% of cases of exacerbation of rheumatoid arthritis occur in the cold season.

The disease mainly affects the small joints of the hands and feet. As the pathological process progresses, other organs and systems are involved. The latent period of the disease is expressed by weakness, fatigue, weight loss, muscle pain, fever, sweating.

• Subacute onset is more typical for rheumatoid arthritis. It is accompanied by the following symptoms:
• Joint pain. Aching, undulating current. Stopped by taking anti-inflammatory drugs. It is localized more often in the small joints of the feet, hands, wrists, knees and elbows.
• Muscle pain. They are aching in nature, persist for a long time.
• Fever. The level of increase in body temperature depends on the activity of the inflammatory process.
• Morning stiffness. Continues for 30-60 minutes.

Extra-articular manifestations of rheumatoid arthritis

Rheumatoid arthritis affects not only the joints, but also other organs and systems:

• Skin. The main symptoms are dryness and thinning of the skin, brittle nails, small subcutaneous hemorrhages. Also, the disease is characterized by rheumatoid nodules – subcutaneous formations, up to 2 cm in diameter.
• Gastrointestinal tract. It is expressed in a decrease in appetite, the appearance of flatulence, rarely abdominal pain, heaviness in the epigastric region.
• Respiratory system. Rheumatoid arthritis affects the pleura and interstitial tissue. This is expressed by dry or exudative pleurisy.
• Cardiovascular system. The rheumatoid process can affect all layers of the heart.
• Urinary system. The lesion manifests itself in the form of glomerulonephritis.
• Nervous system. The rheumatoid process, which has spread to the nervous system, is expressed by impaired sensitivity, paralysis, impaired sweating, and thermoregulation.

Diagnosis of rheumatoid arthritis

Laboratory diagnosis

Diagnosis of rheumatoid arthritis begins with a blood test.

In the general blood test, close attention is paid to the level of hemoglobin, leukocytes, ESR. This examination allows you to assess the severity of the inflammatory syndrome.

In a biochemical blood test, the level of fibrinogen, CRP, haptoglobin, sialic acids is studied. Specific markers of rheumatoid arthritis are the following indicators:

• Rheumatoid factor in the blood. Increases in 60% of cases.
• ACCP (antibodies to cyclic citrulline peptide). One of the most sensitive methods for early diagnosis of the disease. Detected in 80-90% of cases.
• Antinuclear antibodies. They are determined in 10% of cases.
• Analysis of synovial fluid. The study evaluates its transparency, color, number of leukocytes.

Instrumentation

Arthroscopy is a modern, informative and less traumatic method for diagnosing various joint diseases. The examination is carried out using a special optical device – an arthroscope. Thanks to the procedure, it is possible to assess the prevalence of pathology, to conduct a differential diagnosis of rheumatoid arthritis with other diseases (tuberculosis, sarcoidosis). During arthroscopy, it is possible to take material for histological examination.

X-ray of the joints is the main method of instrumental diagnosis of rheumatoid arthritis. There are several methods for assessing the stage of radiological changes in the joints. Doctors of the multidisciplinary clinic “Health” can apply any technique that is most suitable in each case.

Joint scintigraphy is a test that involves the use of a radioactive substance – technetium. Depending on its content in the joint, the activity of the pathological process is assessed.

Joint synovial biopsy is rare. The procedure is prescribed for the purpose of differential diagnosis with other diseases.

MRI is a highly accurate method of instrumental diagnostics. Allows you to assess the degree of deformation of the joints, the prevalence of the pathological process, its localization.

Ultrasound of the joints and internal organs is prescribed for severe progressive disease. With the help of ultrasound, it is possible to assess the condition of the heart, liver, spleen, pancreas and other organs.

Criteria for diagnosis

Diagnosis of rheumatoid arthritis is made when 4 or more of the following criteria are present:

• morning stiffness;
• damage to small joints;
• symmetrical lesions of the joints, their swelling;
• presence of rheumatoid nodules;
• the presence of rheumatoid factor in the blood;
• characteristic radiological changes in the joints and bones.

Drug treatment of rheumatoid arthritis

There are 2 stages in the treatment of rheumatoid arthritis:

1. Relief of exacerbation.
2. Maintenance therapy.

Non-steroidal anti-inflammatory drugs are prescribed to eliminate the acute phase of the disease. Thanks to them, it is possible to reduce the severity of the pain syndrome, relieve swelling and inflammation, and local redness of the tissues. Among the features of drugs in this group are:

• onset of effect after 3-4 days of administration;
• sequential drug selection;
• drug substitution if no effect;
• undesirable combination of two or more drugs of the NSAID group;
• the need to take strictly after meals;
• strong irritant effect on the mucosa of the gastrointestinal tract.

Selective COX-2 inhibitors target an enzyme involved in inflammation. They have fewer side effects compared to non-steroidal anti-inflammatory drugs. They can be prescribed in the presence of diseases of the gastrointestinal tract, liver and other internal organs.

Glucocorticosteroids are hormones of natural or synthetic origin. They have anti-inflammatory and immunosuppressive effects. Corticosteroids are used when non-steroidal anti-inflammatory drugs are ineffective. When prescribing glucocorticosteroids, the doctor takes into account the age and gender of the patient, the state of the immune system, blood pressure indicators, and the state of the electrolyte balance.

It is necessary to take GCS in a strictly defined dose. Treatment begins with small dosages with a gradual increase in the amount of the drug. Gradual dose reduction is carried out after achieving a therapeutic effect.

Pulse therapy

Pulse therapy is a treatment method based on the administration of large doses of drugs. A severe acute inflammatory process cannot be stopped with the usual doses of drugs. Therefore, pulse therapy for rheumatoid arthritis is one of the methods of treatment.

Therapy should be carried out in a hospital under the supervision of a physician. This is due to the fact that taking high doses of drugs can contribute to the development of adverse reactions that must be quickly eliminated. Pulse therapy can be used with the following drug groups:

• Glucocorticosteroids. The effect of the treatment can be noticeable as early as 3-5 days. As a result of therapy, the severity of pain and edematous syndromes decreases. After achieving the desired effect, the treatment is transferred to maintenance doses of the drug.
• Cytostatics. The frequency of reception is selected individually. Cancellation of drugs is carried out one year after reaching a stable remission.

Biological therapy

Biological therapy is considered a new treatment for rheumatoid arthritis. The task of therapy is to uncouple the pathogenetic chain responsible for the occurrence of an inflammatory reaction. Thanks to modern technologies, biologically active substances have been created that show good results in the treatment of various autoimmune diseases.

Topical treatment

Topical treatment involves the use of ointment and cream. The main objective of this method is a directed action on inflamed tissues around the affected joint. The most commonly used drugs are non-steroidal anti-inflammatory drugs.

Physiotherapy

Physiotherapeutic procedures are prescribed as part of complex therapy for rheumatoid arthritis. The main tasks are to relieve pain, increase activity, eliminate morning stiffness. Physiotherapy for rheumatoid arthritis may include galvanic currents, ultrasound, paraffin or ozocerite applications, infrared radiation.

Despite the positive effect of this method, physiotherapy procedures cannot be used as an independent method of treatment.

Drug treatment of rheumatoid arthritis during remission

During remission, treatment consists of taking cytotoxic drugs. Cytostatics are drugs whose action is aimed at inhibiting the vital activity of body cells, mainly those capable of intensive division. The drugs have anti-inflammatory, antitumor, immunosuppressive effects. Apply with extreme caution.

There is a huge variety of groups of drugs and methods of their use. Self-medication can lead to the development of complications. Therefore, the appointment of therapy should be done by an experienced doctor. This takes into account complaints, the results of laboratory and instrumental studies.

Doctors of the multidisciplinary clinic “Health” select an individual treatment plan for each patient. This approach allows you to achieve results in a minimum amount of time.

Prevention of rheumatoid arthritis

To help reduce your risk of developing or getting worse with rheumatoid arthritis, doctors recommend doing the following:

• Exercise therapy. To maintain the range of motion in the joints, it is enough to perform light exercises.
• Muscle massage. It is prescribed in the presence of ankylosis (complete immobility of the joint). Massage allows you to maintain normal muscle tone and mass.
• Sanatorium treatment. In rheumatoid arthritis, balneotherapy has a positive effect. However, this method of treatment is recommended for mild disease.
• Taking prescribed therapy. If necessary, the doctor prescribes methotrexate. The dosage is selected individually.
• Sanitize chronic foci of infection. It implies timely treatment of tonsillitis, pneumonia, pyelonephritis, sinusitis and other diseases.
• Use of orthopedic splints, supporting devices. They allow you to prevent further deformation of the joint with its existing instability.

If rheumatoid arthritis is diagnosed, it is necessary to visit a rheumatologist once every 6 months for routine follow-up.

Qualified rheumatologists conduct appointments at the multidisciplinary clinic “Health”. The doctors of our center have many years of experience in this field. Specialists regularly improve their professional skills and knowledge at specialized courses. This is evidenced by numerous diplomas and certificates. On the territory of the clinic there is the largest open-type express laboratory in Russia. All examinations are carried out as soon as possible. For diagnostics, modern equipment from a European manufacturer is used.

Rheumatoid arthritis is a serious disease that requires timely diagnosis and correct treatment. Therefore, when the first signs of illness appear, make an appointment with a doctor. We are glad to see you at any time convenient for you. You can make an appointment, as well as ask any questions of interest, by phone.

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Rheumatoid arthritis is a so-called systemic disease that affects the connective tissue of the body, which entails a lot of negative consequences. Small joints are severely affected, which collapse, change their size and shape. About 1% of people worldwide suffer from this disease.

The difficulty is that no one knows the exact causes of the disease. There is only a set of moments that contribute to the development of the disease, and therefore it cannot be avoided. The disease itself leads to the loss of a person’s ability to work, greatly reduces the quality of his life.

Rheumatoid arthritis is diagnosed at an average age of 30-35 years, then the disease gradually develops and by old age it has the maximum effect on a person’s life. Women suffer from this disease 3 times more often than men.

Possible causes of the problem

The medical community assumes that many factors influence the development of the disease at once, and not just one. Possible causes of rheumatoid arthritis include:

• genetic predisposition. The point is that at the genetic level, a person has a tendency to various disorders in the development of immunity;
• certain infectious agents. There are several “candidates” here, but the researchers of this problem have not yet decided to the end;
• set of triggers: hypothermia, hyperinsolation, intoxication, bacterial infections, taking certain medications. This group also includes disorders of the thyroid gland and even stress.

There is information that breastfeeding for two years is a factor that reduces the risk of developing the disease (on average, twice).

Symptoms

Symptoms of rheumatoid arthritis include:

• stiffness in the morning. That is, during awakening and within an hour after sleep, a person cannot move actively, in his usual mode – it can be difficult to perform even simple actions, for example, shift a pillow, a blanket;
• pain in the joints, which can be repeated at different intervals. If the joints are palpated, the pain intensifies. With the development of the disease, reduced joint mobility is manifested. The temperature of the skin in the area of ​​the folds may be higher than in the rest of the skin;
• the presence of rheumatoid nodules. Dense subcutaneous formations are palpated in the joints;
• general feeling unwell. It can be manifested by a decrease in appetite, unreasonable weight loss, a constant feeling of fatigue.

With an aggressive course of the disease and a long period of illness, other internal organs can be damaged, which is not so common.

Forms of arthritis

The disease in its purest form suggests that only the joints are affected, without affecting other organs. If we are talking about a disease with systemic manifestations, then in this case, autoimmune processes affect the heart, lungs, kidneys, nervous and other systems. The development of the disease is associated with the deposition of a protein of a pathological type in the organs.

Can reveal the diagnosis of rheumatoid arthritis and other additional diseases. It is sometimes combined with osteoarthritis, rheumatism.

There is also the so-called juvenile variant of the disease – this is a severe form of the disease that affects children and adolescents. It can also capture only joints or joints together with internal organs.

Varieties of the disease depending on the course

Slowly progressive rheumatoid arthritis suggests that the disease develops over many years, gradually affecting the joints. The joints themselves do not suffer very much. Here treatment helps and you can maintain a fairly comfortable standard of living.

The rapidly progressive type is characterized by frequent and severe exacerbations, severe joint damage, and treatment helps little. The quality of human life is deteriorating significantly.

The simplest and easiest type for the patient is a disease without noticeable progression. With it, you can live to a ripe old age, not particularly suffering from symptoms.

Stages of development

The degree depends on how much the insufficiency of the musculoskeletal system manifests itself. There are 4 steps, taking into account the zero:

• zero. The patient takes care of himself, his life practically does not change;
• first. Due to problems with the joints, not all movements are available to the patient. Some professional activities are already excluded;
• second. At this stage, a person loses his professional ability to work;
• third. The most difficult degree assumes that the patient does not have the opportunity to independently serve himself even in everyday life for one hundred percent.

Obviously, when combined with other diseases, the situation at each stage becomes much more complicated.

Diagnostics

Different methods are used to diagnose rheumatoid arthritis:

• laboratory. They involve immunological, biochemical studies and the study of a complete blood count;
• instrumental. Joint puncture, radioisotope examination, x-rays are common diagnostic options;
• biopsy. It also belongs to the instrumental ones, but it is taken out separately, since of all the listed solutions it is used most rarely.

Diagnosis begins with an appointment with a doctor and examination. To make an appointment, you need to contact a rheumatologist.

Treatment in Moscow

For those forms when the treatment of rheumatoid arthritis can give a good result, a whole set of different medicines is used:

• non-steroidal anti-inflammatory drugs;
• basic preparations. They are made on the basis of several active components;
• hormonal substances. In this case, glucocorticoids are used in different forms: tablets, ointments, injections;
• biological agents: monoclonal antibodies, regulators of lymphocyte differentiation, etc.

In addition to the main treatment, patients are offered physiotherapeutic procedures, therapeutic exercises (only at the time of remission). Prevention of osteoporosis is mandatory. And rheumatoid arthritis, if it greatly reduces the quality of life, may involve surgical correction of “difficult” joints.

Prevention of complications

If the symptoms of rheumatoid arthritis were detected at an early stage, then timely treatment in many situations can significantly slow down the pathological processes and avoid complications. The following preventive measures should be added to effective treatment:

• maintaining a healthy lifestyle. Patients are also recommended a special diet;
• giving up bad habits;
• regular physical activity without undue stress;
• increased attention to the treatment of other diseases – even common colds.

Such prevention of rheumatoid arthritis gives a good chance that a person will be able to live life in fairly comfortable conditions.

Related Q&A

How is arthritis different from rheumatoid arthritis?

Arthritis is the collective name for diseases of the joints. It also includes the characteristic symptoms of other diseases. Rheumatoid arthritis is a specific diagnosis and a dangerous disease that requires mandatory treatment.

Can the disease be permanently cured?

This is a chronic disease that cannot be cured forever and completely. But with the help of treatment it is possible to keep it in remission for a long time or significantly reduce the number and intensity of exacerbations.

Is it possible to sunbathe with rheumatoid arthritis?

Since excessive insolation is one of the triggers in the development of this disease, it is obvious that sunbathing with such a diagnosis is unacceptable – complications of rheumatoid arthritis will not keep you waiting.