Rheumatoid Arthritis by Lisa Jimas

My mother was diagnosed at age 40, they sat me down in a room and said she would be crippled by the time she was 50. I must say, this year she is turning 62 and is not crippled. She does have rheumatic nodules on her elbows and the deformation of her hands and feet BUT she is still able to walk and get around. Rheumatoid arthritis is a disease. It is very painful and can affect anyone. We have more knowledge of rheumatoid arthritis today than ever before but it’s still not enough.


Rheumatoid arthritis is an auto-immune disease. An auto-immune disease is the immune response by the body against itself. Rheumatoid Arthritis (RA) is an autoimmune disease that is never-ending. It causes inflammation and deformity of the joints. The joints are a formation that holds two or more bones together (Gale Encyclopedia 2002). Inside the joints are synovial membranes. The synovial membrane becomes very inflamed. When you do not have rheumatoid arthritis the membrane is thin and delicate. However, in a person with rheumatoid arthritis, it is stiff and thick. This membrane is invaded with white blood cells. These white blood cells produce destructive chemicals. Eventually, the ligaments may erode because of the damage to the cartilage along the articular surfaces of the bones. These effects can interfere with the joint movement. The hands are more commonly destroyed due to rheumatoid arthritis. Eventually, the person can no longer close their hand to make a fist.

The body has over 200 bones. There are different types of bones for different needs. Bones are composed of four main sections. The first section is the periosteum. This is the outer membrane that protects the bone and contains blood vessels that help grow and nourish the bone. Secondly, the compact bone gives the body support. The compact bone is smooth and hard. Inside of the compact bone is a spongy inner structure called cancellous (chambered) bone. Cancellous bone contains the marrow that manufactures blood cells, and it also stores fat cells (Salem Health Magill’s Medical Guide 2011). Where the bones meet is called a joint or articulation.

Some of our joints move and some do not. Fixed joints are joints that cannot move such as our rib cage and our skull. Their primary function is to protect what is underneath such as the brain. We have two moving joints known as synovial joints and cartilaginous joints. Cartilaginous joints can move. However, the cartilaginous joints cannot move to the extent of the synovial joints. The synovial joints are filled with synovial fluid which is a liquid resembling the white of an egg. (Salem Health Magill’s Medical Guide 2011). In our bodies, we have six different types of synovial joints. They include ball and socket, ellipsoidal, hinge, pivot, saddle and gliding joints. Rheumatoid arthritis is commonly found in the area of the wrist which would include the ellipsoidal joints. The ellipsoidal joints are modifications of the ball and socket. In the ellipsoidal joints, the bones are oval instead of round. The synovial joints are the most complex joints and are the most mobile joints we have. This makes them most prone to diseases such as rheumatoid arthritis.

The onset of rheumatoid arthritis can be slow or it can appear very rapidly. Most often, the first signs of rheumatoid arthritis are pain and inflammation of the synovial joints. Each individual is different; therefore they might experience fatigue, weight loss and sometimes fever. When a person with rheumatoid arthritis wakes in the morning, the joints that have arthritis are typically stiff for at least one hour. These joints may become difficult to straighten such as the fingers. Eventually, the hands and feet may arch abnormally.

Research has not been adequate to prove what causes rheumatoid arthritis. There is still a lot of speculation as to how one person gets this disease. Some people feel that an outside event caused rheumatoid arthritis such as prolonged stress. While others believe it was caused by a bacteria or infection. Some research shows it’s genetic. There is still a need for additional research. What we do know is that for every three women, one man is diagnosed. It seems women have a greater chance for rheumatoid arthritis than men. Roughly, 80% of people are diagnosed with rheumatoid arthritis between the ages of thirty-five to fifty. This is not a disease that is diagnosed only in the elderly. The difference is you can see the effects of rheumatoid arthritis in a person who is eighty versus a person who is thirty-five years old. The older you get the more damage that is done. Rheumatoid arthritis is chronic.

It seems that diagnosing rheumatoid arthritis is difficult. There is no such test to determine if someone has this disease. There are certain factors that doctors look for to help in diagnosing this disease. The American College of Rheumatology uses a list of criteria. One of the signs of this disease is stiffness in and around your joints first thing in the morning for an hour or more. Also, there will be swelling or fluid in three or more joints simultaneously. There must also be at least one swollen joint on your wrist, hand, or fingers. Second to last, the doctors look for rheumatoid nodules. Typically these nodules are in pressure points of the body, most commonly the elbows. Lastly, a blood test can be done to check for rheumatoid factor in the body. Some doctors will also perform an x-ray to look for changes in the hands and wrist due to the destruction of bone around the involved joints (WebMD 1988).

You cannot cure rheumatoid arthritis; you can only treat the symptoms. There are numerous ways to treat this disease. Some of the treatments can obtain without a prescription. One of the best ways to treat rheumatoid is with exercise. It is commonly known that exercise is for the body, however, the more mobile you stay the less stiff your joints will be. The notion is to exercise daily when inflammation and fever are less severe. Yoga is a great exercise for those with arthritis; it keeps your body agile and easy on your joints. Those who have rheumatoid arthritis usually do low-impact exercise, as not to flare their symptoms. On days that fever and low grade pain arise, you may use over-the-counter treatments such as ibuprofen, or acetaminophen. Cold packs work well for swelling of the joints, whereas heat works well for stiffness.

There are numerous prescriptions you can obtain from your doctor, preferably a rheumatologist. A rheumatologist is a physician who specializes in this disease. Some of the medicines involved with rheumatoid arthritis are methotrexate. This is used to suppress the immune system. Sulfasalazine also works by suppressing the immune response that is active in rheumatoid arthritis, and it is an anti-inflammatory agent. Celebrex is a COX-2 inhibitor. It had been recalled and it is now back on the market for use. This medicine can treat pain and inflammation and has a low risk of bleeding or stomach ulcers. Besides taking medicine orally, you can also inject TNF Inhibitors (Tumor Necrosis Factor). “Tumor necrosis factor-alpha (TNF) is a pro-inflammatory cytokine produced by macrophages and lymphocytes. It is found in large quantities in the rheumatoid joints and is produced locally in the joint by synovial macrophages and lymphocytes infiltrating the joint synovium” (John Hopkins website 2011). Even with all of our medical advancements, bed rest can still be just what the doctor ordered.

Rheumatoid Arthritis is a chronic painful inflammation of our joints. It affects our joints and causes bone deformation and swelling. This disease is not just a disease for the elderly; it can affect the young as well. If someone has arthritis, see a doctor for treatment. The sooner the treatment the sooner you can slow the growth of rheumatoid. There is no magic number as to how fast or slow your body will react.
References
2006. Effect of Regular Exercise of Pain, Fatigue, and Disability in Patients with Rheumatoid Arthritis. Family & Community Health. Vol. 29 pages 320-327.
2008 American Society For Surgery of the Hand. Developed by the ASSH Public Education Committee. www.assh.org/public/hand.conditions/pages/ArthritisRheumatoidArthritis.aspx
Levesque, M. January 25, 2009. Diagnosing Rheumatoid Arthritis. WebMD. www.webmd.com/rheumatoid-arthritis/guide/diagnosing-ra
Matsumoto, Alan. Bathon, Joan. Clifton, O. Bingham III. Rheumatoid Arthritis Treatment. John Hopkins. www.Hopkins-arthritis.org/arthritis-info/rheumatoid-arthritis/rheum_treat.html
Salem Health: Magill’s Medical Guide. 6th Edition. Vol. 5 pages 2596-2603. 2011.
The Gale Encyclopedia of Medicine. Second Edition. Vol 4 N-S. Pages 2899-2902.
Wikipedia, the free encyclopedia. November 2, 2011. Synovial Joint. https:/en.wikipedia.org/wiki/SynovialJoint