Rheumatoid Arthritis (Inflammatory Rheumatism): Causes, Symptoms, Treatment
Rheumatoid arthritis, popularly known as inflammatory rheumatism and generally seen in adults between the ages of 30-50, is one of the important chronic inflammatory diseases that directly affects the person’s quality of life. Although it is known to be associated with many factors such as smoking, stress, infection, hormonal changes and gender, genetic factors are largely responsible for the emergence of the disease. Early diagnosis directly affects the course of treatment and the patient’s response to treatment. Therefore, it is extremely important to have accurate information about rheumatoid arthritis and to be able to recognize the signs and symptoms of the disease at an early stage. You can find detailed information in the rest of our article.
What is Rheumatoid Arthritis and What Causes It?
Rheumatoid arthritis, also known as inflammatory rheumatism, is a chronic inflammatory collagen tissue disease that usually occurs in the small joints of the hand, wrist, foot and ankle, the joint structures of the knee and elbow, and less commonly in the joint areas affecting the shoulder and hip. Although important signs and symptoms associated with the disease are seen in the joints, other parts of the body are also considered at risk for inflammation.
Rheumatoid arthritis occurs with inflammation of the synovial fluid sacs in the joint structures of the body and tissue destruction in these areas, and is progressive as a result of complex interactions between these cell groups. The disease is staged in four different ways, depending on the severity of the complaints:
- Stage 1: Synovial fluid inflammation in the joints is still in its early stages and there is no limitation in the person’s vital activities.
- Stage 2: As synovial inflammation increases, pain and limitation of movement occur in the relevant joint areas, but the complaints are not severe enough to hinder the person’s vital activities.
- Stage 3: The inflamed tissue in the joints increases significantly and in this stage, patients have difficulty in performing daily living activities and work-related duties, and there is partial dependency.
- Stage 4: In this stage, joint limitation reaches its most severe state and the person is unable to even perform daily living activities on his own, complete dependency occurs.
Since rheumatoid arthritis is a progressive disease, the transition between stages can occur extremely quickly. Since the actual cause of the disease is not fully known, individuals from all age groups are considered at risk. However, it is possible to mention some risk factors such as genetics, age, infection, immune system functioning, smoking and family history, which are known to pave the way for the development of rheumatoid arthritis in a person. Accordingly, rheumatoid arthritis is considered an autoimmune disease whose cause is unknown. Like other autoimmune diseases, rheumatoid arthritis disease occurs in genetically predisposed individuals as a result of the influence of environmental factors, when the immune system functions abnormally and the body initiates a reaction against its own healthy tissue groups, causing damage to these tissues. Joints and other collagen tissues are damaged after a series of reactions actually initiated by the immune system.
What are the Symptoms of Rheumatoid Arthritis?
Rheumatoid arthritis is a disease with an insidious onset. For this reason, the first symptoms of the disease usually appear weeks or even months after the onset of the disease.
- The first symptoms noticed by the person are swelling in the joint areas, stiffness and the resulting pain. Joint areas of the hand, wrist, foot and ankle, as well as the knee and elbow, are often affected.
- Again, in the early period, general body fatigue, widespread muscle pain, mild fever and abnormal weight loss may be observed.
- Heat, swelling and pain may occur in the connective and muscle tissues surrounding the joint areas.
- The disease often affects bilaterally in small joint groups such as the hand and foot joints. For this reason, people whose hand area is affected experience rapid weakening of manual dexterity, and those whose foot area is affected experience foot pain even after walking a few steps.
- As the disease progresses, in addition to small joint groups, joint structures in areas such as knees, elbows, hips and shoulders are also affected, and complaints such as limitation of movement, pain and swelling may occur in the affected area.
- Muscle stiffness, also defined as morning stiffness, is one of the important findings associated with rheumatoid arthritis. When a person first wakes up from sleep or remains motionless for a long time, stiffness occurs in the joints that lasts more than 1 hour.
Rheumatoid Arthritis Complications
- After a while, the swelling in the wrist puts pressure on the nerves passing through this area, and as a result, carpal tunnel syndrome, characterized by numbness and loss of sensation in the hand, may occur.
- In the later stages of the disease, serious deformities occur, especially in the fingers and toes and the root joint structures in these areas.
- In cases of arthritis involving the knee area, a cyst filled with joint fluid (Baker cyst) may occur in the space behind the knee.
- In the later stages of severe disease, arthritis turns into widespread body inflammation, and as a result, inflammatory infection may occur in the tissues surrounding vital organs such as the heart and lungs. This condition is considered one of the most important complications related to rheumatoid arthritis.
- When the disease duration exceeds 10 years, there is a risk of inflammation in the vascular walls. This condition causes serious circulatory disorders, especially signs of gangrene in the fingertips, and wounds in the lower part of the body.
How to Diagnose Rheumatoid Arthritis?
There is no diagnostic test that allows a definitive diagnosis of rheumatoid arthritis. For this reason, the diagnosis of the disease is made based on some important data that are often seen together. Important findings that indicate the presence of rheumatoid arthritis in a person are:
- Stiffness and stiffness in certain joint areas that occur in the morning and last for at least 1 hour
- Soft tissue tenderness and swelling in 3 or more joints
- Joint inflammation occurring in the wrist, fingers and body of the hand
- Presence of symmetrical inflammation affecting both hands or both feet simultaneously
- Painless, painless, rheumatoid nodules and lumps under the skin
- Autoantibody positivity called rheumatoid factor (RF)
- Typical radiological data revealing rheumatoid arthritis
The presence of at least 4 of these findings at the same time and the patient’s complaints continuing uninterruptedly for at least 6 weeks is sufficient for the diagnosis of rheumatoid arthritis.
Rheumatoid Arthritis Treatment Methods
Rheumatoid arthritis is not a definitively curable disease, it is one of the chronic diseases that continue throughout life. However, it is possible to control the complaints of the disease with effective treatment interventions applied at the right time and to achieve complete remission with available drug options and advanced treatment strategies.
The types of drugs preferred for treatment are three different types: non-steroidal (non-cortisone) anti-inflammatory drugs (NSAIDs), also known as painkillers, cortisone/corticosteroid group drugs and disease-regulating antirheumatic drugs. While NSAIDs and corticosteroids are preferred to treat symptoms, antirheumatic drug types known as DMARDs and other biological agents are administered directly to treat the disease. In addition to these options, it is possible to say that physiotherapy is one of the most effective treatment methods. When determining which drug is suitable for the treatment of the disease, many personal factors such as the patient’s age, general health condition, presence or absence of comorbidities, severity of symptoms associated with rheumatoid arthritis, and the general course of the disease are taken into consideration. Therefore, effective treatment of the disease must be planned individually, and medical treatment must be supported by auxiliary treatment practices such as diet and exercise.