Rheumatoid arthritis: an expert’s guide

Rheumatoid arthritis (RA) is a chronic autoimmune disorder affecting millions worldwide. Beyond joint pain and inflammation, RA can impact daily life and lead to disability. Renowned consultant rheumatologist Dr Elisa Astorri, explores the early signs and symptoms, treatment options and potential complications of the disease.

What are the early signs and symptoms of rheumatoid arthritis?

One of the most clear, early indications that someone is suffering from rheumatoid arthritis is when they experience painful and swollen small joints in the morning. 
 

Other early signs of the condition in the joints include the following:

• Fatigue
• Redness in the joints
• Joint deformities
• Stiffness, particularly in the morning
• Reduced range of motion
• Flu-like symptoms

What are the risk factors for developing rheumatoid arthritis?

Rheumatoid arthritis is a multifactorial disease. A person is more likely to suffer from rheumatoid arthritis if they have a family history of the condition. Environmental factors such as a viral infection may provoke the condition, as well a variety of other factors such as pregnancy, stress, and being a smoker.

Furthermore, women are more likely to develop rheumatoid arthritis than men, and a person’s age can affect the likelihood of developing the condition; it often develops between the ages of 30 and 60.

How is rheumatoid arthritis diagnosed?

There are a range of options to clinically diagnose rheumatoid arthritis. Blood tests, such as rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies and C-reactive protein (CRP), as well as erythrocyte sedimentation rate (ESR) aim to uncover antibodies and inflammation.

Other options include imaging tests, including x-rays or MRI scans, alongside an examination of the patient’s medical history.

What are the different treatment options for rheumatoid arthritis?

We are constantly seeing new developments in the treatment and options for rheumatoid arthritis. A popular treatment option is monoclonal antibodies, which are a targeted drug therapy that can identify and locate particular proteins present in cancer cells.

Physical therapy works to maintain joint function, improve muscle strength, and reduce pain, while occupational therapy focuses on adapting daily activities to the individual's abilities and needs.

In addition, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help to reduce pain and inflammation.

What are the potential complications of rheumatoid arthritis?

There are a several potential complications linked to rheumatoid arthritis. These may include:

• Joint damage: persistent inflammation in the joints can result in the erosion of cartilage and bone, leading to deformities and loss of function.
• Joint deformities: RA can cause joints to become misshapen and lead to deformities, affecting mobility and daily activities.
• Organ involvement: In some cases, RA may affect organs such as the heart, lungs, or eyes, leading to complications in these vital systems.
• Cardiovascular issues: RA is associated with an increased risk of cardiovascular diseases, including heart attacks and strokes.
• Respiratory complications: Inflammation can affect the lungs, leading to conditions like interstitial lung disease.
• Rheumatoid nodules: Firm lumps, known as rheumatoid nodules, can develop under the skin, typically around pressure points or joints.
• Osteoporosis: chronic inflammation and the use of certain medications for RA can contribute to bone loss, increasing the risk of osteoporosis.
• Infections: RA and its treatments can suppress the immune system, making individuals more susceptible to infections.
• Fatigue and depression: chronic pain, inflammation, and the challenges of managing RA can contribute to fatigue and emotional health issues, including depression.
• Increased risk of lymphoma: people with RA may have a slightly higher risk of developing lymphoma, a type of blood cancer.

What can people with rheumatoid arthritis do to improve their quality of life?

To improve their quality of life, individuals with rheumatoid arthritis can adopt several strategies. Regular, low-impact exercises are recommended to enhance joint flexibility and reduce pain, while adherence to prescribed medications, including disease-modifying antirheumatic drugs (DMARDs), helps manage symptoms.

A balanced diet rich in anti-inflammatory foods contributes to overall health, and stress management techniques, such as meditation or yoga, can alleviate emotional and physical strain. Furthermore, adequate rest and sleep are crucial for managing fatigue.

If you are suffering from rheumatoid arthritis and would like to book a consultation with Dr Astorri, do not hesitate to do so by visiting her Top Doctors profile today.