Rheumatoid Arthritis Treatment

July 12, 2013

RA Present, Past and Future

Not so long ago, rheumatoid arthritis (RA) patients ended up bedridden. Their joints mangled, they were unable even to care for themselves. There were no joint replacements for the 17-year-old with Juvenile RA. The only treatment was aspirin, the first NSAID, and it was hailed as a miracle drug.

Think about how little pain and inflammation relief an aspirin gives you and how desperate our forebears must have been that they hailed it a miracle and were thankful.

In the last few decades, research by U.S. Department of Health and the drug companies have given us a comparative large array of treatment choices to make with our doctors.
NSAIDs
Non-steroidal anti-inflammatory drugs have helped millions of RA sufferers. The brand names include aspirin, ibuprofen, Naprosyn, and others. They work by reducing the production of prostaglandins, which are the chemicals that cause your inflammation, fever and pain.
Corticosteroids
Steroids have been used for some time to reduce inflammation. They are given by pill, cream or injection. The synthetic cortisol decreases inflammation the same way your body does. They are also known as triamcinolone, cortisone and prednisone.
Methotrexate
Methotrexate is a disease-modifying anti-rheumatic drug (DMARD), immunosuppressive drug or slow-acting anti-rheumatic drug (SAARD). It actually interferes with the production of DNA. It is not known exactly how it works in rheumatoid arthritis, but the effect is to reduce moderate to severe inflammation. This may be a good choice for a patient with limited insurance or financial means.
Biologicals
These newest drugs are weekly injections given by the patient. If the patient is not helped by a DMARD drug, biologicals such as Humira, Enbrel or other brand names can be used. The treatment is quite expensive but effective.
Joint Replacement
Orthopedic surgeons routinely replace the joints of rheumatoid arthritis patients. The development in surgical techniques to replace any joint, from knees to hips, shoulders or fingers has been rapid and successful. Surgeons probably have done as much to save patients from becoming crippled by destroyed joints as medications.
Pain Management 
Physicians called “physiatrists” are experts in rehabilitation and the management of pain. These doctors should be practicing at major medical centers, not a store front! They are indispensable to the RA patient. The doctor can properly prescribe all the pain medications the patient takes, leaving the rheumatologist to take care of inflammation. Every RA patient should see one of these specialists regularly.
Physical Therapy
Physical therapy can help stretch involved muscles and keep joints from stiffening. Much physical therapy can be done at home with stretch bands, chair yoga, yoga for seniors, Tai Chi DVDs or water therapy. There is a solution for every pocket and every ability.
Future Therapies
There are many treatments in the pipeline, some in early mouse experiments and others ready for human trial. Many seem to replace the current biologicals with pills rather than injections that will eliminate many of the biological side-effects. Some are combined with methotrexate. There is a lot of hope for the future, working toward a day when RA is remembered as distant history.

Symptoms of Arthritis

July 12, 2013

The initial symptoms of arthritis are often confused with an acute joint injury. You do not remember injuring yourself, but you think that you twisted or strained a joint without knowing it. You may suffer from morning pain and stiffness for up to thirty minutes. A classic symptom of arthritis is pain in your feet when you get out of bed. Besides joint stiffness and pain, there could be redness or warmth around the joint and a limited range of motion in how far you can extend or bend the affected joint of your arm or leg. You might have a persistent pain and tenderness around an affected joint. The joint could also contain fluid or be swollen. Fatigue or fever may accompany these symptoms. The joints are complex structures and hold the bones together in order to move the skeleton. When you experience joint pain, you are less likely to exercise and engage in physical activities from a fear of increased joint damage and pain. Unfortunately, this is the worse thing that you can do for your arthritis since daily exercise and physical activities keep your joints mobile thus preventing stiffness and reduce deformities.

If your symptoms persist, you should consult your medical doctor. Early diagnosis and treatment are essential to help you manage your arthritis. There is not a cure for arthritis, but it can be well managed with appropriate medications, a healthy weight, stop smoking if you smoke, some type of physical activity and protecting your joints. Your medical doctor will listen as you describe your symptoms and give you a physical exam. Based on the doctor’s finding, you may be referred to a rheumatologist who specializes in arthritis and related diseases.

There are over one hundred types of arthritis and related diseases, the rhematologist will need to determine what type you have through a physical exam, medical history, blood tests and a x-ray. Once you realize that your symptoms of arthritis are serious and persistent, you should start a symptom diary that helps you track the symptoms as they occur with pertinent facts of the condition such as the beginning of symptoms. This gives you a good overall picture of your symptoms to share with your doctor and rheumatologist. During the physical exam the rheumatologist will look for specific symptoms of other diseases to rule them out such as asymmetrical or one sided joint deformity in the wrist or fingers that indicates lupus. Any bumps and nodules are assessed, and a sample for joint fluid analysis may be taken. X-rays reveal any abnormalities or deformities of the bones and joints. The MRI can detect small changes in the body of the joints, bones and soft tissues. Blood tests will diagnose for arthritis, monitor your treatment and track the progress of the disease. Blood tests that determine inflammation in the body include c-reactive protein, complete blood cell count, erythrocyte sedimentation rate, anti-CCP and ANA tests. Specific blood tests to check uric acid levels will determine if your symptoms are from gout. A rheumatoid factor test to verify if you have rheumatoid arthritis, one of the most common autoimmune diseases in the world.