Rheumatoid arthritis is a chronic inflammatory autoimmune disease that affects joints along with other organs of our body. Every one of us has an immune system which protects our body from foreign invaders like bacteria and virus. The immune system keeps those invaders out or seeks out and destroys them. When the immune system hits the wrong target, it can unleash a stream of disorders, including allergic diseases, arthritis and so on. Autoimmune diseases are those where immune system abnormally acts and destroys own tissues instead of fighting with foreign materials.
Among various types of arthritis, rheumatoid arthritis is one kind affecting around 1% of people worldwide. In rheumatoid arthritis, the immune system produces antibodies (a protein produced primarily by plasma cells which are used by the immune system to neutralize pathogens) that attach to the linings of joints. Immune system cells then attack the joints, causing inflammation, swelling, and pain. In other words, the immune system attacks synovium — the lining of the membranes that surround our joints. The resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint and with time the joint loses its shape and alignment. The disease is symmetrical (appears on both sides of the body) and can lead to severe deformity in few years if not treated.
Rheumatoid arthritis can affect body parts besides joints, such as eyes, mouth and lungs and is different from osteoarthritis, common arthritis that often comes with older age.
Risk Factors for Rheumatoid arthritis
Though exact causes are unknown, many cases are believed to result from an interaction between genetic factors and environmental exposures.
- Sex: The incidence of rheumatoid arthritis is two to three times higher in women than men.
- Age: Though, it can occur at any age, the most common age of onset is between forty and sixty.
- Genetics: Certain genes like HLA-DRB1, PADI4, PTPN22 are associated with the disease. Age, sex and genetic factors cannot be modified or changed.
- Smoking: Smoking is associated with a mild to moderate (1.3 to 2.4 times) increased the risk of the disease onset. It may increase the severity of disease as well. Besides, if one has a genetic predisposition, smoking further augments the risks of disease development.
- Obesity: People who are overweight or obese appear to be at somewhat higher risk of developing rheumatoid arthritis than those of normal weight.
- Live Birth History: Most studies have found that women who have never had a live birth have a slight to a moderately increased risk of RA.
- Breastfeeding: Almost all recent population-based studies have found that rheumatoid arthritis is less common among women who breastfeed.
- Early Life Exposures: Early life exposures may alter the risk of developing the disease in later life. For instance, a study found that maternal smoking doubled the risk of children developing rheumatoid arthritis as adults.
Symptoms and complications
Symptoms of rheumatoid arthritis may include tender, warm, swollen joints, stiffness, tiredness, fever and irritation, loss of appetite, weight loss etc. At an early stage, it affects smaller joints particularly the joints that attach fingers to hands and toes to feet. As the disease develops, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. Many people who have rheumatoid arthritis also experience signs and symptoms that don’t involve the joints. That is, it can affect many non-joint structures, including skin, eyes, lungs, heart, kidneys, salivary glands, nerve tissues, bone marrow, and blood vessels. The symptoms may disappear from time to time. Above mentioned, joint involved symptoms may last up to six weeks or even longer.
If anyone has those symptoms, care seeking should not be delayed as the early diagnosis and prompt treatment improves the disease outcome. If not treated early, it severely damages bones along with inviting more non-joint complications. Rheumatoid arthritis itself, along with some medications used for treating it, can increase the risk of osteoporosis — a condition that weakens our bones and makes them more prone to fracture. The impaired immune system leads to increased susceptibility to infection as well. Another complication of the disease is a development of rheumatoid nodules. These tissues most commonly form around pressure points, such as the elbows. Yet, these nodules can form anywhere in the body, including the lungs. Furthermore, people who have rheumatoid arthritis are more likely to experience Sjogren’s syndrome, a disorder that reduces the amount of moisture in eyes and mouth. Besides, heart and lungs are also affected. The risk of hardened and blocked arteries is increased. There is also increased the risk of inflammation and scarring of the lung tissues, which can lead to progressive shortness of breath. Other complications may include blood cancers, compression of nerve serving hands and fingers due to inflammation.
Prevention, treatment and self-care
As the exact causes are unknown, we cannot prevent the disease but we can surely reduce our risks by modifying factors like obesity and smoking. Regular exercise is beneficial to prevent the disease. There is no cure for the disease, yet we have treatments and various medications. The medications include non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief and inflammation reduction, steroids for reducing inflammation and pain and slowing down joint damage. Other medications include disease-modifying anti-rheumatic drugs (DMARDs) and biologic agents. In rheumatoid arthritis, there is the huge significance of self-care or self-management. Eating healthy diets, balancing activities with rest, taking the heat and cold therapies etc help a lot. A positive family support directly influences victim’s attitude. A positive attitude and emotional support are very important.