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Monday, May 9, 2016

rheumatoid Arthritis

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average age of onset mid- to late-fifties

More than 50 million Americans have arthritis, making it the No. 1 cause of disability in the country.

There are more than 100 types of arthritis. Rheumatoid arthritis is a chronic inflammatory disorder that manifests itself in multiple joints throughout the body.

While RA can occur at any age, the average age of onset ranges from the mid- to late-50s. It most commonly begins in the 40- to 60-year-old age group and is more common in women than in men.

The cause of RA is not fully understood, although we know that an abnormal response of the immune system causes it to mistakenly attack the body’s own tissues.

While rheumatoid arthritis affects everyone differently, the following joint symptoms are clues to RA: -Joint pain, tenderness, swelling or stiffness for six weeks or longer, -Morning stiffness for 30 minutes or longer, -More than one joint is affected, -Small joints (wrists, certain joints of the hands and feet) are affected, -The same joints on both sides of the body are affected, -Along with pain, many people experience fatigue, loss of appetite and a low-grade fever.

The symptoms and effects of RA may come and go. A period of high disease activity is called a flare. A flare can last for days or months. Some people may have rheumatoid arthritis for a short time and then go into remission when the swelling and pain disappear.

Ongoing high levels of inflammation can cause problems throughout the body involving the eyes, mouth, skin, lungs, kidneys, heart and blood vessels.

The good news is that advances over the last 25 years have dramatically improved treatment options for patients.

The goals of RA treatment are to stop inflammation and put the disease in remission, relieve symptoms, prevent joint and organ damage, improve overall wellbeing, and reduce long-term complications.

Early, aggressive treatment to reduce or stop inflammation as quickly as possible is the key to prevent disability and increase the chance to attain remission. The earlier, the better.

There are different medications used in the treatment of rheumatoid arthritis. Some are used primarily to ease the symptoms of RA; others are used to slow or stop the course of the disease and inhibit structural damage.

Getting disease activity to a low level and keeping it there can prevent or slow the pace of joint damage.

There are several things individuals with RA can do on a daily basis to take a proactive role in their treatment. Taking steps to promote good overall health makes a big difference. There are several ways you can help manage your RA symptoms and promote overall health: (Check with your doctor first.)

• Incorporating a healthy diet with foods rich in antioxidants helps control and reduce inflammation. I recommend the Mediterranean diet, which emphasizes fish, vegetables, fruits and olive oil, among other healthy foods. It’s also important to eliminate or significantly reduce processed and fast foods that fuel inflammation.

• Exercise is so beneficial it’s considered a main part of RA treatment. Exercise programs featuring low-impact aerobics, muscle strengthening and flexibility are recommended. Programs should be tailored to fitness level and capabilities, and be mindful of any joint damage that exists. Physical therapists can help plan a personalized fitness routine that works best for you.

Keep in mind that it is important for patients with RA to be active but pace themselves regarding rest and exercise. When RA is active and joints feel painful, swollen or stiff, rest helps reduce inflammation and fatigue that can come with a flare. Taking breaks throughout the day conserves energy and helps protects joints.

Heating pads or warm baths help to soothe stiff joints and tired muscles. Cold is best for acute pain. Cold packs can be used two or three times a day at 20-minute intervals to help numb painful areas and reduce inflammation.

Topical treatments such as creams or patches can be applied directly to the skin over the painful muscle or joint.

Relaxation techniques can help train painful muscles to relax. Consider methods like deep breathing, guided imagery and visualization, or mindfulness. Research shows massage can help reduce arthritis pain, improve joint function and ease stress and anxiety. Acupuncture may also be helpful.

Supplements like turmeric and omega-3 fish oil may help with rheumatoid arthritis pain and morning stiffness. However, consult a doctor before taking any supplement regarding side effects and potential interactions.

Many studies have proven that maintaining a positive attitude makes a tremendous difference in dealing with a chronic condition like RA. The support of friends, family members and co-workers provides vital emotional support.

All these things can help a patient with RA cope well with life changes and symptoms.

Dr. Robert E. Goodman is a board-certified rheumatologist in Shreveport with more than 30 years of specialized rheumatology experience in the diagnosis and treatment of musculoskeletal disease and systemic autoimmune conditions. Contact him at The Arthritis & Rheumatology Clinic at 424-9240. www.arthdoc.com

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