Rheumatoid Arthritis (RA) — Autoimmunity Attacking Your Joints | Information on Rheumatoid Arthritis

Your body’s joints are where two bones meet, and it’s surrounded by a protective capsule. Obviously, putting two separate bones together so that they can move as needed and yet not damage each other through friction, is a bioengineering challenge that normally works remarkably well in people.

Cartilage is the rubbery substance which covers the bones at the joint so there’s no friction. It also acts as a sort of shock absorber. The joint’s capsule is lined with a thin layer of tissue named the synovial membrane. This produces clear fluid which acts as a joint lubricant. The synovium also acts as filter for nutrition coming from the blood, sending it into the joint and cartilage.

SONY DSC What is Rheumatoid Arthritis?

In rheumatoid arthritis, your immune system attacks the cells of the synovium. It produces extra fluid, so the joint becomes swollen, red, painful and inflamed. As the disease progresses, synovial cells grow and multiply abnormally, and the membrane becomes much thicker than it should, and new blood vessels form to feed a sheet called a pannus that spreads over the joint’s cartilage. This tears into the cartilage and damages the underlying bones. This leads to pain, stiffness and deformity.

Rheumatoid Arthritis Symptoms:

Warning signs of RA include: tender, warm or swollen joints; same joints hurt on both sides of your body; pain in the wrist and finger joints; pain in the neck, shoulders, elbows, hips, knees or feet; fatigue, occasional fevers, persisting morning pain and stiffness.

It often starts with morning stiffness or joint aches. In 90% of women, the first areas affected are the feet and hands. Sometimes the symptoms take years to appear, making an early diagnosis difficult, though important.

As with all autoimmunity diseases we don’t really understand why some people get rheumatoid arthritis and others don’t. More women than men get it. It could be combination of genes, hormonal influences, environmental triggers and maybe joint injuries.

Tests for RA include: Rhematoid factor (RF), Erthrocyte sedimentation rate (ESR or SED) rate, Antinuclear antibodies (ANAs), complete blood cell count (CBC), and x-rays to detect joint damage.

Most RA patients need pain medicine, and will usually be given nonsteroidal anti-inflammatory drugs (NSAIDs) first.

Other medicines include Disease-modifying antirhematic drugs (DMARDs) such as methotrexate (Rhematrex, Trexall) or MTX, azathioprine (Imuran), D-penicillamine (Caprimine, Depen), minocycline (Minocin), cyclosporine (Neoral), and gold salts (Myochrysine), sulfaxalazine, Leflunomide (Arava).

Etanercept and infliximab specifically target tumor necrosis factor alpha (TNFa), an inflammatory cytokine.

Also, corticosteroid such as predisone are used to reduce inflammation.

Joint replacement surgery can these days replace natural joints with constructs of metal and ceramic. Because of rheumatoid arthritis’ effects, tendon reconstruction may have to be part of the surgery. A synovectomy removes inflamed synovial tissue and is usually performed along with tendon reconstruction.

Experts also recommend that RA patients get adequate exercise, which may be prescribed for them by a physical therapist. Plus plenty of good rest. Splints and assistive devices should used as needed. Also, it’s important to manage your reaction to stress, since that can cause more inflammation. So meditation or other forms of relaxation are good. Yoga can perform double-duty of giving you exercise and stress reduction.