Rheumatoid Arthritis (RA) is a progressive inflammatory disease and can be debilitating. Not only does it affect you physically, but also emotionally. It is different than traditional arthritis. It is not associated with certain defining factors like injury, age, or obesity and it can cause damage to the organs. When pain keeps you from doing what you love, your overall quality of life changes. Approximately 1.3 million Americans suffer from RA. Out of every 100,000 people, 41 are diagnosed with RA yearly. Almost 70% of those diagnosed are women.
What is Rheumatoid Arthritis?
RA is a chronic, autoimmune disease. In advanced cases, it can cause permanent joint destruction. Naturally, the immune system works to protect the body from germs or viruses. For someone diagnosed with RA, the immune system is unable to distinguish between healthy cells and bad ones so white blood cells set out to destroy all “bad” cells. In the process, cytokines, molecules that regulate immunity and inflammation, invade the synovial space in joints and cause destruction to healthy joint tissues, bones, cartilage, and, in advanced cases, organs. This damage causes inflammation and leads to pain and stiffness. If the inflammation is not dealt with, it will get worse. Joints progressively lose their mobility and eventually lose their function. Researchers believe that joint damage occurs within 12 months of the onset. X-Rays of more than 50% of patients diagnosed with RA reveal significant joint damage within a two year time period of symptoms developing.
What Causes Rheumatoid Arthritis?
Experts have not yet discovered exactly what causes Rheumatoid Arthritis, but they believe it is the result of a combination of the following risk factors:
- Genetics- Certain genes one inherits from their family can make them more likely to develop RA.
- Environment- RA may be triggered by certain viruses or bacteria.
- Hormones- Since it is more common for a woman to be diagnosed, some doctors think that female hormones and how their body copes with stress may be influential in the development of RA.
What are the symptoms of Rheumatoid Arthritis?
RA can occur at any age, but is most likely to occur in the 30-50 age range. A periodical bout of remission may occur but is usually followed by another flare up. If a woman who has been diagnosed with RA becomes pregnant, often times the symptoms of Rheumatoid Arthritis may subside during the pregnancy but reappear sometime after the child is born. Symptoms can vary from one individual to another, but the most common symptoms of rheumatoid arthritis include:
- Weakness, fatigue, and muscle pain
- Pain is symmetrical. This means that if you have joint pain and swelling on one side of your body, you will also feel it in the same joint on the other side of the body. This is not the case with other types of arthritis.
- Flu-like symptoms
- Loss of Appetite and/or weight loss
- Joint stiffness that becomes worse after rest that lasts for more than one hour, especially in the morning after sleeping.
- Limited range of motion in the joints.
Other symptoms that have little to do with the joints but may also be indicators of Rheumatoid Arthritis include:
- Dry eyes and dry mouth, which are symptoms of Sjogren’s Syndrome, another autoimmune disease that frequently accompanies RA.
- Pleurisy- pain when taking a breath
- Burning and Itching eyes
- Burning, tingling, or numbness in the hands and feet
- Difficulty sleeping due to pain or discomfort
In advanced, untreated cases of RA:
- Lumps, referred to as “Rheumatoid Nodules”may develop. These nodules grow under the skin near the arthritic joints. Sizes vary between a pea or walnut. Sometimes they move around when pushed on, but in other cases, they are firmly connected to tendons or fascia. In extreme cases, the nodules may also grow on internal organs including the vocal cords, lungs, or heart.
- RA can include joint damage that causes deformities in the thumb, finger joints, especially the upper portion of the fingers (referred to as the swan-neck deformity). If terrible joint damage occurs, surgery may be necessary to repair damage and fix any deformities.
How Do You Know if You Have Rheumatoid Arthritis?
Like all other autoimmune diseases, there is no surefire way to know that you have the disease. It is important to visit a doctor as soon as you suspect something. The quicker you get an accurate diagnosis, the quicker you can manage your symptoms and decrease chances for joint damage. Do not risk losing your active lifestyle. If your doctor suspects you have RA, several types of diagnostic tests will be administered. Since, many results come back as negative even though they should not, these tests cannot be completely relied upon. Your doctor should conduct a thorough exam and ask extensive questions concerning your family history and symptoms. Tests include: blood tests to check for anemia (deficiency of red blood cells), rheumatoid factor (an antibody often found in the blood of RA sufferers), Elevated erythrocyte sedimentation rate (indicates the level of the body’s inflammatory activity), C-Reactive Protein (another test that checks the body’s inflammation levels). They are more than likely to order an X-Ray to assess damage in the joints and see if the disease is progressing.
What Can You Do About Rheumatoid Arthritis?
If the diagnosis is positive for Rheumatoid Arthritis, the ultimate goal is to make the disease go into remission, but this rarely happens. Beginning treatment right away is the most effective way of reducing the progression of the disease. Doctors are known to recommend aggressive medications since it seems to be the most effective way to ease symptoms. By treating the disease quickly, less joint damage can occur which can prevent the disease from becoming disabling.
In the past, doctors started slow and conservatively. They would start with ibuprofen then advance as necessary. Today, strong medications exist and are most often used, but all come with their potential side effects. Your doctor may prescribe one type of medication, but they often find that a combination of medications is the best approach to handle RA. The most common RA medications are as follows:
- Disease-modifying Anti-rheumatic Drugs (DMARDs): So far, these drugs are considered to be the most successful treatment to slow the progression of RA. Doctors have seen success in the numbers of cases achieving remission, as well as, fewer patients having long-term joint damage occur. DMARDs interrupt the immune system functions that promote inflammation. Since these drugs target the immune system’s defense against infections, it makes the person taking them more at risk of developing infections. It is also important to receive regular blood tests in order to monitor the effects of the drug on the blood cells, liver, lungs, and kidneys. It can take up to 6 months for the drug to be fully effective. Some common DMARDs prescribed are as follows: methotrexate, sulfasalazine, sodium aurothiomalate, azathioprine, etc. The U.S Food and Drug Administration (FDA) now requires warning labels on all boxes of biological DMARDs due to new evidence linking it to increased risk of malignancy and cases of lymphoma. Often times, doctors use this drug in combination with NSAIDs or Glucocorticoids. In advanced cases, doctors are known to pair DMARDs with biologic response modifiers or painkillers. Common side effects are upset stomach, rash, damage to the liver or bone marrow, and possible birth defects.
- Biologic Response Modifiers (Enbrel, Orencia, Humira, Rituxan, etc.): Doctors have found a way to produce bio-pharmaceutical drugs that mimic a substance naturally produced in the body to either enhance or suppress the immune system’s response and natural defense mechanisms. Some keep the body responding to infections while others regulate this response to keep it from becoming excessive. They are known as BRMs and their main reason for being prescribed to an RA patient is to target parts of the immune system that trigger inflammation. However, they can increase the risk of infections. Other possible side effects include: fever and chills, nausea and vomiting, diarrhea, muscle aches, weakness, skin rash, loss of appetite, increased occurrences of bleeding and swelling.
- Glucocorticoids: They are naturally released from the adrenal gland and are essential elements for the body’s natural response to stress and utilization of carbohydrates, fats, and proteins within the body. They have very powerful anti-inflammatory properties. The medical industry has found a way to produce synthetic glucocorticoids, like prednisone, which help treat inflammatory conditions like arthritis and referred to by many as Corticosteroid. This medicine is injected into joints and may temporarily reduce inflammation and pain. The shots must be given by a doctor. The doctor will more than likely use a local anesthesia to provide comfort during the injections. Cortisone may provide relief for months, maybe even a year. Three injections a year are the maximum amount of injections a person should receive, due to serious, potential complications associated with cortisone injections. Below is a list of those risks:
- Death of nearby bone (osteonecrosis)
- Joint infection
- Nerve damage
- Weight gain
- Thinning of skin and soft tissue around the injection site
- Temporary flare of pain and inflammation in the joint
- Tendon weakening or rupture
- Thinning of nearby bone (osteoporosis)
- Whitening or lightening of the skin around the injection site
- NSAIDs are a viable source for relieving pain and are commonly used in conjunction with other medications to provide relief. They work by blocking Cyclooxygenase (COX) enzymes. There are two types COX-1 and COX-2 and they both produce prostaglandins in the body which lead to inflammation, pain, and fever. By blocking these enzymes, NSAIDs reduce swelling and pain. Many people are able to use them without dealing with any side effects. However, some researchers claim that prolonged use and high dosages are very bad for individuals. The documented possible side effects are rashes, upset stomach, stomach bleeding, stomach ulcers, high blood pressure, heart problems, kidney problems, and fluid retention which leads to swelling around the lower legs, feet, ankles, and hands.
- Analgesics (Painkillers): While painkillers are known to reduce pain, they carry their risks. They can be addictive, and pose risk of overdosing: “About 120,000 Americans a year go to the emergency room after overdosing on opioid painkillers” says Laxmaiah Manchikanti, chief executive officer and board chairman for the American Society of Interventional Pain Physicians. Analgesics do not rehabilitate the damage; their sole purpose is to mask the pain. They raise Substance P levels in the body, which progressively changes your body’s ability to tolerate pain, and requires a person to take stronger drugs, or take larger doses. Just like NSAIDs, they also pose risks to the liver and kidneys.
- Therapy: An occupational and/or physical therapist can teach you correct ways to use your joints in order to protect them and keep your body moving in order to stay active. Therapists are known to teach exercises that keep the joints flexible and functioning.
- Surgery: Doctors may decide that surgery is best for you. Options may include: total replacement surgery, synovectomy (removal of abnormal joint lining), or bone or joint fusion surgery (performed to relieve pain by eliminating the joint and fusing bones together.
Each and every Rheumatoid Arthritis sufferer has to make the decision about what is right for them. Some will try anything and everything to find some relief. Along with the high-powered medications that doctors prescribe, there are simple, natural tips that you can incorporate into your daily routine.
- After waking in the morning, try to begin your day with some heat therapy. Take a warm bath or shower and allow your joints to rest. Afterwards, take a little bit of time to stretch. Do not overdo it; you do not need to force your body to do anything that hurts you. The idea is to just loosen up and try to get some blood flowing to your aching joints before beginning your daily routine.
- Make sure you are getting enough sleep and rest, especially when a flare-up occurs. It is a fact that RA patients need at least 10 hours of sleep, even if it means sleeping for a solid 8 hours at night and allowing yourself a 2 hour nap in the day. By giving yourself the rest you need, you can make a big difference in your recovery and the wear and tear that is happening to your body.
- Try to add Omega 3 Fatty Acids into your diet. Research suggests that it can decrease inflammation, pain, and joint stiffness. You can add this to your daily regimen simply by the food sources you consume such as fish, flaxseeds, walnuts, etc. If you do not like these options, you can also find Omega 3 Fish OIls in pill form. However, Omega 3s can interfere with a few medications so you should consult your physician first.
- For extra relief, you should try a topical lotion or cream that temporarily relieves pain. Most Rheumatoid Patients find that lotions containing, Capsaicin, Menthol, or a some type of Salicylate offer optimum relief.
If you suffer from Rheumatoid Arthritis and are trying everything you can to relieve your RA symptoms but still have to deal with painful flare ups, you should try Real Time Pain Relief (RTPR). It is a topical lotion that provides Relief in Minutes! Unlike other pain relievers that contain only a few ingredients, Real Time Pain Relief contains 19 ingredients that have been tested and proven to relieve pain such as Menthol, Capsaicin, Aloe Vera, Arnica, and Glucosamine. Emu Oil is a key ingredient in this topical lotion due to its transdermal nature. This means that Emu Oil can match the skin’s cell structure so closely that the natural protection barriers of your skin allow Emu Oil to penetrate through all layers of the skin, down to the site of your pain, and carry all the beneficial ingredients along with it! Real Time Pain Relief poses fewer side-effect risks than all medications prescribed for RA and is even free of Parabens and Sodium Lauryl Sulfate! The FDA warns that topical pain relievers containing more than 3% menthol can cause skin burns. Real Time Pain Relief is the most effective topical pain reliever available that maintains low levels of Menthol. When you apply Real Time Pain Relief to your aches and pains, you will get relief from muscle aches, pains, strains, and cramps, without the discomfort and potential health hazards that accompany high concentrations of Menthol. RTPR is Safe, Effective, and Fast Acting!