Rheumatoid arthritis (RA) is a chronic autoimmune disorder that causes inflammation of the joints. It commonly affects the hands, wrists, and feet, but can involve other organs as well. The body’s immune system mistakenly attacks the lining of the joints, leading to pain, stiffness, swelling, and long-term joint damage. Early diagnosis and appropriate therapy are essential to slow disease progression.
Causes and Risk Factors
Although the exact cause is unknown, several factors contribute to the development of RA:
- Genetic predisposition
- Female gender (more common in women)
- Smoking
- Family history of autoimmune diseases
- Obesity
- Hormonal factors
Symptoms of Rheumatoid Arthritis
- Joint pain and tenderness
- Morning stiffness lasting more than 30 minutes
- Warm, swollen joints
- Fatigue
- Loss of appetite
- Symmetrical joint involvement
Extra-articular Manifestations
- Rheumatoid nodules
- Lung involvement
- Anemia
- Eye inflammation
- Vasculitis
Diagnosis
- Rheumatoid factor (RF) – positive in many cases
- Anti-CCP antibodies – highly specific for RA
- Elevated ESR and CRP – indicate inflammation
- X-rays or MRI – detect joint erosion
- Clinical evaluation of joint swelling and stiffness
Treatment Goals
- Relieve pain
- Reduce inflammation
- Prevent joint damage
- Improve mobility and quality of life
Treatment Options
1. NSAIDs (Symptomatic Relief)
- Ibuprofen
- Diclofenac
- Naproxen
These help reduce pain and swelling but do not prevent joint damage.
2. Corticosteroids
- Prednisolone
Used for flare-ups or short-term control of inflammation.
3. DMARDs (Disease-Modifying Antirheumatic Drugs)
These slow the progression of the disease and prevent joint damage.
- Methotrexate – first-line DMARD
- Leflunomide
- Sulfasalazine
- Hydroxychloroquine
4. Biological Agents (For Moderate to Severe RA)
- TNF inhibitors – etanercept, infliximab, adalimumab
- IL-6 inhibitors – tocilizumab
- CD20 inhibitors – rituximab
- JAK inhibitors – tofacitinib
5. Physical Therapy and Lifestyle Changes
- Regular exercise
- Joint protection techniques
- Balanced diet
- Weight management
Complications of RA
- Joint deformity
- Osteoporosis
- Heart disease
- Nerve compression (carpal tunnel syndrome)
- Infections (due to immunosuppressive therapy)
Patient Counseling
- Take medications exactly as prescribed
- Do not skip DMARD doses
- Monitor for side effects (especially with methotrexate)
- Regular blood tests are essential
- Stop smoking to reduce disease severity
- Maintain physical activity and joint mobility
Detailed Notes:
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