In a recent interview with Dr. Vishnu Sharma MD(Med) DNB(Rheumatology) Consultant Rheumatologist Shalby hospital, Ahmedabad, Best Doctor Team got the answers for the condition “Rheumatoid Arthiritis” for our readers: Rheumatoid Arthritis (RA)
Arthritis is a broad term that describes tenderness and swelling in the joints. Rheumatoid arthritis is a particular form of arthritis. It is chronic inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints.
Symptoms of Rheumatoid Arthritis
Common symptoms include:
Joint pain, stiffness (specially in the morning or after rest), swelling predominantly involving small joints of hand and feet as well as large joints like wrist, shoulder and knees.
Other symptoms are easy fatiguability, depression, feeling of unwell.
Less commonly RA can cause inflammation in other organs of body like eyes, lungs, heart.
Treatment options for Rheumatoid Arthritis
The goal of treatment in rheumatoid arthritis is to reduce joint inflammation and pain, maximize joint function, and prevent joint destruction and deformity.
There are diffrent types of drugs used to treat RA
– NSAIDs ( Non steroidal anti inflammatory drugs)
– DMARDs ( Disease modifying anti rheumatic drugs): These are medicines that ease symptoms but also reduce the damaging effect of the disease on the joints. They work by blocking the way inflammation develops in the joints. They do this by blocking certain chemicals involved in the inflammation process.
DMARDs include: methotrexate, sulfasalazine, leflunomide, hydroxychloroquine, azathioprine, ciclosporin, and penicillamine.
Biological medicines: These medicines have been introduced more recently and also have a disease-modifying effect against RA. They are sometimes called cytokine modulators or monoclonal antibodies. Biological therapies include: adalimumab, certolizumab pegol, etanercept, golimumab, infliximab, anakinra, abatacept, rituximab and tocilizumab.
Medical tests done for rheumatism
Blood tests include:
Test to measure inflammation: ESR and CRP
Tests for antibodies: Rheumatoid factor and Anti CCP antibodies
Tests for anemia
Other test includes: X ray, Ultrasound, MRI
As per the doctor, the disease is painful as the joints are very painful specially during active disease.
When asked, whether a person with past history of RA have any bad effects in his health in future?, Dr. Sharma suggested that the risk of developing certain other conditions is higher than average in people with RA. These include: cardiovascular disease (such as angina, heart attack and stroke), anaemia, infections (joint infections and non-joint infections), and osteoporosis (thinning of the bones).
Here are some measures to control RA as suggested by the doctor:
Although there is no cure for RA yet, however, treatments can make a big difference to reduce symptoms and improve the outlook.
Measure to control RA includes DMARDs, biologics and other treatment options like NSAIDs and corticosteroids, Physiotherapy or regular exercises, surgery in few cases, by treating extraarticular symptoms of RA and by reducing risk of developing other diseases like cardiovascular diseases, osteoporosis.
The other question we had for the doctor was about hyper mobility and if it is connected with RA, and here is what our doctor answered, “Hypermobility means joints that stretch more than normal. Children or young adults with hypermobility usually have joint pain and occasionally mild swelling during the late afternoon, at night, or after exercise or activity. The pain is more common in the lower extremities, such as the calf or thigh muscles. It most often involves large joints such as the knees or elbows, but can involve any joint. It is not related with RA”
As per Dr. Sharma, if your doctor suspects that you have RA, you will usually be referred to a joint specialist (a rheumatologist). This is to confirm the diagnosis and to advise on treatment. It is very important to start treatment as early as possible after symptoms begin. This is because any joint damage done by the disease is permanent. Therefore, it is vital to start treatment as early as possible to minimise or even prevent any permanent joint damage
Special Thanks to: Dr Vishnu Sharma MD(Med)DNB(Rheumatology) Consultant Rheumatologist Shalby hospital, Ahmedabad Visiting Rheumatologist BJ MC and civil hospital, Ahmedabad Appt: 079-40203146, 8511555477 Email: firstname.lastname@example.org, email@example.com
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