The pain of rheumatoid arthritis

RHEUMATOID arthritis is a chronic inflammatory autoimmune disorder in which the body’s immune system mistakenly attacks itself. Internist Dr Samantha Nicholson says this disease, like regular arthritis, can cause pain and stiffness in the joints; however, rheumatoid arthritis affects the lining of the joints, causing painful swelling that can eventually result in bone erosion and joint deformity.

The Mayo Clinic says rheumatoid arthritis can affect more than just your joints. In some people, the condition can also damage a wide variety of body systems including the skin, eyes, lungs, heart and blood vessels.

Although doctors don’t know specifically what causes rheumatoid arthritis, a genetic component seems likely. Dr Nicholson explained that autoimmune diseases such as lupus, vitiligo and thyroid disease in general might run in your family. While your genes don’t actually cause rheumatoid arthritis, they can make you more susceptible to environmental factors — such as infection with certain viruses and bacteria — that may trigger the disease, according to the Mayo Clinic.

As rheumatoid arthritis progresses, the affected person can experience:

•Swollen joints.

•Joint stiffness.

•Swan neck – this is a deformity in the fingers, where the finger is bent into the shape of a swan on water.

•Subluxation – A subluxation is a partial slip-out of a joint.

•Weakened bones around the joints. This can leave tears/ fractures on the joints.

•Because of the inflammation, there is an increased risk of heart attack and stroke.

Factors that may increase your risk of rheumatoid arthritis include:

• Your sex. Women are more likely than men to develop rheumatoid arthritis.

• Age. Rheumatoid arthritis can occur at any age, but it most commonly begins between the ages of 40 and 60.

• Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of contracting the disease.

• Smoking. Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity.

• Environmental exposure. Although uncertain and poorly understood, exposure to such materials as asbestos or silica may increase the risk for developing rheumatoid arthritis.

•Obesity. People who are overweight or obese appear to be at somewhat higher risk of developing rheumatoid arthritis, especially women diagnosed with the disease when they were 55 or younger.

According to Dr Nicholson, when patients are diagnosed with this disease, doctors start them on disease-modifying anti-rheumatic drugs. Two of the common drugs in this group are hydroxychloroquine and methotrexate.

She pointed out, however, that there are risk factors with these medications, as they can cause liver and kidney disease and ulcers. Sometimes steroids are used for treatment. Steroids themselves come with complications including diabetes, weight gain and stretch marks.