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Rheumatoid Arthritis

WHAT IS RHEUMATOID ARTHRITIS?

It is a crippling systemic disease mainly involving the membrane lining the joints and cartilages as well as affecting other parts of body like muscles, ligaments, blood vessels and eyes.

SEX OR AGE MOST AFFECTED

3 times more common in women. Usually begins between ages 20 and 60, with a peak incidence between ages 35 and 45.

SIGNS & SYMPTOMS

Slow or sudden onset of:

  • Morning stiffness in any or all-active, mostly small joints of the hands and wrists. It can also start in elbows, shoulders, feet and ankles.
  • Redness, pain, warmth and tenderness
  • Low-grade fever.
  • Nodules under the skin (sometimes).

CAUSES

It is an autoimmune disease.

RISK INCREASES WITH

  • Emotional or physical stress, as from accidents, childbirth, menopause or surgery.
  • Family history of rheumatoid arthritis or other autoimmune disorders.
  • Genetic factors, such as autoimmune-system defects.

HOW TO PREVENT

No specific preventive measures.

DIAGNOSTIC MEASURES

  • Observation of symptoms.
  • History and examination by a doctor, X-rays of joints.
  • Laboratory blood studies to detect a rheumatoid factor and other tests for immunity.

POSSIBLE COMPLICATIONS

  • Permanent deformity and crippling. This may develop rapidly, especially contractures (muscle shortening) or degeneration of muscles around an inflamed joint.
  • Impaired vision.

PROBABLE OUTCOME

The disease may be mild or severe. It is presently incurable, but pain relief, prevention of disability and an active, normal lifespan are usually possible with early diagnosis.

Conservative treatment relieves symptoms in 1 year in 75% of patients. About 5% to 10% are eventually disabled, despite treatment.

TREATMENT

GENERAL MEASURES

  • Splints at night may be helpful to support and protect a joint with active disease. Ask your doctor.
  • Relieve pain with heat, including hot soaks, heat lamps, heating pads
  • If you don't have a firm mattress, place 3/4-inch plywood between your bedsprings and mattress to support your back.
  • Dry climate favours and damp weather aggravates symptoms.

MEDICATION

Your doctor may prescribe: non-steroidal anti-inflammatory drugs, including aspirin and other salicylates; gold compounds; immunosuppressive drugs. Cortisone drugs usually relieve pain dramatically for short periods, but they are less effective for long-term use. They don't prevent progressive joint destruction, and they sometimes have hazardous side effects. Cortisone injections into joints can temporarily relieve pain.

ACTIVITY

  • Stay in bed, except to use the bathroom, until fever and other signs of an active flare-up disappear.
  • Remain active, but include daily rest periods. Sleep for 10 to 12 hours each night. Don't become overtired.
  • Stand, walk and sit erectly.
  • When able, exercise actively to preserve strength and joint mobility. Build up slowly to the amount suggested by your doctor.
  • Exercise disabled joints passively to help prevent contractures.

DIET

Eat a normal, well-balanced diet. Avoid arthritis diet fads, which are common. Lose weight if you are obese. Obesity stresses the joints.

CALL YOUR DOCTOR, IF

  • You notice symptoms of rheumatoid arthritis.
  • The following occurs during treatment:
    • Fever.
    • Symptoms appear in previously unaffected joints.
  • New, unexplained symptoms develop. Drugs in treatment may produce side effects.
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