Fundamental Insights for Rheumatoid Arthritis You Need to Know
Could rheumatoid arthritis be one of those diseases you dread or fear might ever occur to you? It is a dreadful disease.
Rheumatoid arthritis progresses gradually from its onset and eventually advances to the extent of affecting your mobility and activities.
Even though rheumatoid arthritis is a chronic autoimmune disease and not curable, you don't have to give up on treatment. Some medications or therapies can help slow the disease's progression and remain in remission by reducing pain and swelling.
Before rheumatoid arthritis progresses beyond pain and inflammation, you might take the condition lightly, not knowing how serious it is. You may not know that, as the disease progresses, it degenerates not only to the affected joints but also other body connective tissues and organs.
However, if you get treatment as early as possible, you can avert joint deformity and disability caused by the disease.What is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a chronic, inflammatory, and autoimmune disease that affects your body's connective tissues, including joints. Your immune system mistakenly turns against some healthy tissues, bones, and organs to attack and cause inflammation.Real Facts About Rheumatoid Arthritis
Rheumatoid arthritis is among more than 100 other rheumatic diseases, including lupus, fibromyalgia, gout, and many others.
The disease mostly affects the joints of the hands and feet, although it can affect other joints. RA is different from osteoarthritis, which attacks the joints of one side of the body, while rheumatoid arthritis affects the pairing joints on both sides of the body.
RA inflammation causes swelling and chronic pain in the affected area of your body.
Rheumatoid arthritis or RA is a progressive disease that gradually and severely deforms the affected joints, bones, muscles, connective tissues, and tendons. It is also a chronic systemic disease that can affect various body organs in the body.
Rheumatoid arthritis is a common condition in developed countries. Women are more prevalent to the disease than men with a ratio of 4 to 1.
Every year, about 41 people out of 100,000 are diagnosed with rheumatoid arthritis in America alone. The overall figure of those people with rheumatoid arthritis is about 1.3 million. According to the Arthritis Foundation, the disease has more than 54 million adults worldwide.
Rheumatoid arthritis does not spare the children either, and almost 300,000 have their rheumatoid arthritis known as juvenile idiopathic arthritis.
The rheumatoid arthritis prevalent age is between 20 and 60, especially for women, while men often get it later in life but with a lower number than women.
People used to regard rheumatoid arthritis as a "wasting disease" because it makes one lose weight. Also, doctors prohibited their RA patients from exercises fearing to damage the joints and eventually atrophy the muscles.
The autoimmunity in RA can also affect the body's primary organs, such as the heart and the lungs.How Rheumatoid Arthritis Occurs
As we mentioned earlier, rheumatoid arthritis is an autoimmune disease. The immune system mistakenly attacks the membranes or the tissue surrounding your joints, called the synovial.
At first, the disease can affect the joints of both hands or feet. It involves the joints in pairs.
Rheumatoid arthritis affects the synovial (the soft tissue which produces fluid that lubricates the joints). The effect leads to inflammation and gradually causing swollen and painful joints.
The continual attack on the immune system's synovial can eventually damage the cartilage and cause joint bone deformity.
As the disease progresses and continues to worsen, the inflammation flares up to cause intense pain and swelling of the joints. However, RA has its moments of relief when the pain lessens and the symptoms become manageable.
The pattern of rheumatoid arthritis flare up and remission more often happens in the early stages. Without treatment to control the disease progression, the RA intensifies to start deforming the joints.
Rheumatoid arthritis progresses and worsens through stages. Within ten years, as your rheumatoid arthritis continues to advance without treatment, you begin to become less active. The deformed joints and the inflammation can tremendously affect your mobility.
Stages of Rheumatoid Arthritis
You can avoid going through all the rheumatoid arthritis stages and the symptoms if you seek early treatment. Remember, it is not possible to revert any bone damage or deformity. Therefore, preventing the disease from progressing is essential to avoid such irreversible damages.
The progression of rheumatoid arthritis from the mild stage to the advanced stage can take about ten years. However, such duration can vary from one person to another, depending upon the immune system's condition.
The following are the progression stages of rheumatoid arthritis and the changes you may experience:
Stage 1: Stage 1 is the initial stage of RA that does not have many symptoms. The initial signs of RA at this stage are small joint stiffness, especially early in the morning. The stiff joints and particularly the knee can improve with movements.
Also, the joint tissue may swell at this stage due to inflammation. Both symptoms would be vague to you, making you less suspicious of the disease and therefore failing to seek treatment.
It may also be challenging for your doctor to clarify diagnosis with image testing such as X-ray, which might not clearly show any RA signs. But, images from ultrasound might show fluid formation in the joint, a symptom of rheumatoid arthritis.
Stage 2: From stage 1, your rheumatoid arthritis may progress to stage 2 if not diagnosed and treated. Since rheumatoid arthritis is an immune system disease, the antibodies may invade the joints causing synovial inflammation and swollen joints.
The synovial inflammation gradually damages the cartilage and hence affecting mobility, although not at this stage. The elbows at this stage may develop some rheumatoid nodules or lumps.
Diagnosing the disease at stage 2 through imaging would be much easier compared to the first one. The images in stage 2 have clear indications of RA.
Stage 3: Stage 3 is a severe stage whereby the symptoms are visible, which may not require more diagnostic procedures. At this stage, the joints and especially of the fingers are bent or crooked.
It is rare to see patients with deformed joints nowadays since most of them seek treatment early enough to prevent the disease from progressing beyond the first two stages.
Stage 4: Stage 4 is the last stage of rheumatoid arthritis. It is an advanced stage when the joints are no more. Rheumatoid arthritis can reach a point when the joints are entirely immovable. When you are at this last stage, your joints have fused and locked to cause total disability.
Again, just like stage 3, it is rare to find RA patients getting to this level. Years back, senior adults with stiff finger joints and deformities were a common thing. Not anymore, thanks to improved RA treatment.
Most RA patients seek early treatment and therefore avoid the disease from progressing to severe and advanced levels.
Symptoms of Rheumatoid Arthritis
Rheumatoid has two distinctive factors. It can at one time be on flare-up where the symptoms are rife and severe. Other times, the disease can have minimal symptoms, meaning it is in remission.
The following are some of the rheumatoid arthritis symptoms:
- Joints deformity
- Lock joints
- Rheumatoid arthritis in symmetrical joints
- Unsteady walk
- Weight loss
In its severity, rheumatoid arthritis can affect other body organs and structures such as:
- Bone marrow
- Nerve tissue
- Salivary glands
- Blood vessels
As you already know, rheumatoid arthritis is caused by the autoimmune system when it mistakenly attacks the synovial membrane. What leads to the immune system turning against some healthy body tissues and cells is not known yet.
However, researchers suspect some factors could trigger the abnormal immune system that attacks healthy joints and joint tissue. Such factors are:
Genetics: The cause of rheumatoid arthritis in about 60 percent of RA patients is genetic factors. Some genes, such as human leukocyte antigens (HLA) and other non-HLA, have a significant part in the body's autoimmunity, which may lead to RA.
Trauma or injury: The chronic inflammation from severe joint trauma can lead to the autoimmune system attacking the synovial tissue and causing RA.
What are Rheumatoid Arthritis Risk Factors?
Some factors can increase the risk of rheumatoid arthritis which include:
Family history: Rheumatoid arthritis can move in the family. If a member of your family has rheumatoid arthritis, you are at a high risk of having the disease as well.
Some genes are triggers of RA and especially if accompanied by smoking.
Age: The prevalent age for rheumatoid arthritis onset is 60, although it can occur at any age.
Gender: Women are at a high risk of developing rheumatoid arthritis than men by four times. Hormones are more the reason for RA in women than men. High levels of estrogen, such as from the birth controls and low testosterone, are likely to cause RA in women.
Smoking: Please quit smoking if you are a smoker. You are at a high risk of rheumatoid arthritis if you smoke. Developing rheumatoid arthritis among cigarette smokers has twice the risk factor as compared to non-smokers.
Smoking causes inflammation, oxidative stress, autoantibody formation, and epigenetic changes, leading to RA.
Smoking and rheumatoid arthritis can also interfere with RA treatment, especially the anti-TNF (anti-tumor necrosis factor).
Obesity: Although obesity is a controversial risk factor for rheumatoid arthritis, approximately two-thirds of RA patients are obese. It clearly shows that there is a link between obesity and rheumatoid arthritis.
The high rise of obese cases has impacted the increase of rheumatoid arthritis cases. Extra body fats could also interfere with rheumatoid treatment.
Rheumatoid Arthritis vs. Osteoarthritis
Rheumatoid arthritis and osteoarthritis are two different forms of arthritis.
The two are the most common among other types of arthritis. Most symptoms of the two conditions may appear the same, although the diseases differ extensively.
Osteoarthritis is a non-inflammatory disease, unlike rheumatoid arthritis. It occurs when the smooth joint cartilage starts to wear out. On the other hand, rheumatoid arthritis affects the synovial membrane to cause inflammation.
The cartilage cushions the joints from rubbing against one another. The synovial membrane is the soft tissue that lines the joints, bursae, and tendon sheaths. It lubricates and supplies nutrients to the joints' cartilages.
Osteoarthritis is a progressive arthritis that degenerates the joint cartilage. Between these two types of arthritis, osteoarthritis affects more people than rheumatoid arthritis. It mostly affects the knees, hands (wrist, fingers, and thumb), hips, and spine joints.
Some of the causing factors of these two types of arthritis are almost similar. Joint overuse, obesity, trauma or injury of the joint, and heredity are some of the contributing factors of osteoarthritis. (You can read more about osteoarthritis here).
You can have both osteoarthritis and rheumatoid arthritis simultaneously, although you are more likely to develop osteoarthritis as you advance in age. Therefore, if you have rheumatoid arthritis at a young age, you will likely develop osteoarthritis later in life.
Types of Rheumatoid Arthritis
When you know, or your doctor knows what type of rheumatoid arthritis you have, it could be easy to have the right treatment. Some types of rheumatoid arthritis are:
Seropositive RA: Seropositive RA is a type that has rheumatoid factor (RF) positive blood. It means that your blood has some antibodies which turn against your joints' synovial tissue leading to rheumatoid arthritis.
According to the blood test results, seronegative RA is rheumatoid arthritis with negative RF (rheumatoid factor). You may also have negative anti-CCP blood results after testing. Anti-CCP (anti-citrullinated protein antibody) are autoantibodies.
The antibodies protect you against foreign invaders such as bacteria and viruses.
However, negative RF does not mean you do not have rheumatoid arthritis. It means that the antibodies may be undetectable in the blood test due to low RF and anti-CCP.
As the RA progresses, your blood begins to have some RF in the blood and eventually may change to seropositive rheumatoid arthritis which has high levels of RF.
Juvenile idiopathic arthritis (JIA): Juvenile idiopathic arthritis is also known as Juvenile rheumatoid arthritis. It is the RA for children below 16 years. Although there are other types of juvenile arthritis, juvenile idiopathic arthritis is the most common.
JIA has various subtypes, which include polyarticular, systemic, and oligoarticular. Each type has varying symptoms, which makes them different.
Some of the symptoms of juvenile idiopathic arthritis are joint pain, stiffness, and swelling. It can cause severe complications such as joint damages, eye inflammation, or retard a child's growth.
Early diagnosis of all these types of rheumatoid arthritis can inhibit the disease's progression, improving symptoms, and the functionalities of the affected joints.Diagnosing Rheumatoid Arthritis
Diagnosing rheumatoid arthritis can be challenging, especially when at its initial stage. However, it is essential to get early treatment to avoid the disease's progression.
The following are some of the procedures you will undergo when having your rheumatoid arthritis diagnosis:Health History. Your doctor might want to know about your health history and your family health history. While at that, your doctor may ask you to define how you are feeling.
Such information is necessary to lay the foundation for other diagnostic procedures such as:Physical Examination. Your doctor may examine the affected joint to see whether it is swollen, twisted, red, and also touch to feel whether it is warm, an indication of inflammation. The doctor may also examine you to check for rheumatoid nodules, especially at the elbows.
The examining doctor may ask you to move your joints to check whether you can feel any pain or experience motion limitation. Your joint reflex action and muscle strength can also tell much about the condition of the joint.Laboratory Test. Some of the lab examination your doctor may require, especially if in suspicion of rheumatoid arthritis after a physical examination, are:
Rheumatoid Factor Blood Test: Checking for the presence of autoimmune protein in the blood.
Antinuclear antibody (ANA): It is a test to check for autoantibodies present in the blood.
Erythrocyte sedimentation rate: it is a test to check the presence of inflammation in the body.
C-reactive protein level: C-reactive protein is a test to check the presence of trauma, severe infection, or any chronic disease.
Radiography: Radiography is the principal imaging diagnosis for rheumatoid arthritis. It checks the bone joint structure.
Ultrasonography: Ultrasonography uses sound waves to produce ultrasound images showing the extent of damage caused by RA.
MRI (magnetic resonance imaging): An MRI produces more exact images for joint bone structure and the synovium.
We do DNA health testing, which could help detect this potential and many others. If you are concerned that you might have the possibility, then give us a call, and we can set up a DNA health assessment test. There is a particular Gene involved in promoting bone health. The Gene VDR is a critical factor in Bone Health, especially with creating new bone formation.
Key Genes: VDR
Vitamin D Receptor Gene or VDR rs2228570
WHAT IS THE PURPOSE OF THE VDR GENE?
The VDR gene ("Vitamin D Receptor") produces a protein receptor that plays a key role in effectively utilizing Vitamin D. For our body to use Vitamin D effectively requires that protein produced by VDR Gene.
Vitamin D works in concert with Vitamin K and Calcium to optimize bone density. Our bodies are constantly creating new bone (formation) as well as breaking down bone (resorption). Formation outpaces resorption until peak bone mass (maximum bone density and strength) is reached around age 30, when resorption slowly begins to exceed bone formation. One of Vitamin D's most important roles is to maintain skeletal calcium balance by promoting calcium absorption in the intestines.
Live Blood Testing
We do Live Blood Analysis and look at dry blood samples specifically.
PPPs: Heinz Bodies in PPP
Black spots, roughly the size of a RBC inside the white open areas in a sample. Heinz bodies are associated with high levels of toxicity, acidity, and possible cellular damage. These black spots indicate the possibility of Bone Degeneration.
Rheumatoid Arthritis Treatment
If you can remember, we mentioned that rheumatoid arthritis has no cure. However, you can manage your condition to prevent its progression.
The following are some of the ways you can manage your RA:
Steroids: Steroids or corticosteroids can help reduce inflammation and pain during rheumatoid arthritis flare-ups. However, the treatment can thin your bones and cause weight gain, which can result in diabetes.
NSAIDs (nonsteroidal anti-inflammatory drugs): It is a standard RA treatment for its potential in easing inflammation, stiffness, and pain.
DMARDs (disease-modifying antirheumatic drugs): DMARDs is one treatment you wouldn't want to miss. It slows the condition's progression and saves your bone joints and body tissues from any degenerative damage.
Topical Medications: When you apply some pain relief gels, creams, and patches can help ease your pain almost instantly. SoMme of the products contain capsaicin, an ingredient in chili peppers, which may cause some burning sensation.
Surgery. Surgery is inevitable when other treatments have failed to manage your condition. Your doctor can suggest surgery and or other treatments. The surgery can not only help manage the disease but also restore your joint's functionality.
Natural Remedies for Rheumatoid Arthritis
Many doctors may not recommend natural remedies, probably because some can interfere with the prescribed treatment. However, some alternative therapies do not interfere with rheumatoid arthritis treatment, which includes:
Acupuncture: Acupuncture therapy is an old Chinese therapy for various ailments. Acupuncture is useful for relieving pain from joint inflammation. It has a unique treatment procedure that follows particular body pathways called meridian that connect with acupoints for energy stimulation.
Acutherapy. Acutherapy differs from Acupuncture. It simultaneously produces mechanical, thermal and electrical stimuli which work together to create a chain of electro-chemical reactions. This sets off a chain of electro-chemical reactions that stimulates the production of neuro-transmitters. Then, messages are sent to the brain to organize the proper peptides to restore the body to its homeostatic (physical and chemical) state.
Tai Chi: Tai Chi, also called Tai Chi Chuan, is another ancient Chinese therapy that uses martial art to relieve some arthritis symptoms. One review on Tai Chi for treating rheumatoid arthritis concludes that it improves joints' range of motion, especially for the ankle.
Massage and Acupressure: Massaging by acupressure can bring relief and improve the range of motion to people with rheumatoid arthritis. An acupressurist can recognize the pressure points to use depending on the affected joints.
Cold and Heat: Cold or heat compresses could ease your RA symptoms. For instance, a cold compress on an inflamed joint can reduce the inflammation pain and the swelling during flares. On the other hand, applying heat pressure on an affected joint can help relax stiff muscles and improve blood flow.
Exercises: No matter how you feel, activities are useful not only for your RA but for your entire health. However, you may need to be selective with the kind of exercises necessary for you.
You can discuss your condition with a physical therapist to develop a customized exercise plan that can help improve your situation and keep fit.
Diet: You can control rheumatoid arthritis flare-ups by eating the right food, such as whole grains, fruits, vegetables, healthy fats, fatty fish, nuts, and legumes. You should avoid food that can exacerbate flare-ups, such as fried food, gluten, salt, alcohol, dairy products, and refined carbohydrates.
Rheumatoid Arthritis Complications
Rheumatoid arthritis can advance beyond what it is and cause other health complications. Some of the RA complications are:
Carpal tunnel syndrome: Most people with RA develop carpal tunnel syndrome. It is a disease that compresses the median nerve, a nerve that controls hand movement and sensations. Carpal tunnel syndrome can make you develop tingling fingers and the thumb.
Rheumatoid nodules: Some nodules can develop on the hands, wrist, elbow, feet, ankles, and lungs. The nodules may appear when you have rheumatoid arthritis flare-ups.
Pulmonary fibrosis: Pulmonary fibrosis is permanent scarring of the alveoli, which would cause other complications such as difficulty breathing. Pulmonary fibrosis is also called interstitial lung disease (ILD).
Osteoporosis: Rheumatoid arthritis can lead to osteoporosis. When you have rheumatoid arthritis, your doctor may prescribe some pain and inflammation management drugs such as corticosteroids.
One of the corticosteroid side effects weakens the bones and, therefore, may cause osteoporosis.
How to Prevent Rheumatoid Arthritis
So far, rheumatoid arthritis is unpreventable. However, you can lower some of the risk factors by doing the following:
- Quitting smoking
- Observe a healthy diet with additional supplements such as vitamin D and calcium
- Changing your lifestyle to a healthy one by exercises and avoiding a sedentary lifestyle
- Drink alcohol moderately
- Maintain a healthy weight
Remember that rheumatoid arthritis is a chronic disease with no cure. But it is still undergoing more research to discover what might cure it. It is also a progressive disease that can worsen as time passes.
The moment you start receiving the right treatment, the disease is likely to stop progressing. You can also improve your symptoms since the disease flare-ups would be no more if you follow your prescription according to your doctor's directions.
If you have any concerns over your rheumatoid arthritis, please talk to our Natural Health Practitioner and Master Herbalist, Yvonne Dollard Perc.
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