About arthritic rheumatoid disease

What is arthritic rheumatoid disease?

Polymyalgia rheumatica is a rare inflammatory disease characterized by muscle pain (myalgia), stiffness, and additional generalized systemic symptoms such as fatigue, low-grade fever, and/or a general feeling of ill health (malaise). Polymyalgia rheumatica can be a relatively benign condition that is extremely responsive to treatment. In some rare cases, permanent muscle weakness, degeneration and loss (atrophy) of muscle mass, and disability may occur. The exact cause of polymyalgia rheumatica is unknown, although immunological factors and familial tendencies (genetic predisposition) have been mentioned in the medical literature.

Polymyalgia rheumatica is closely related to giant cell arteritis, another inflammatory disorder. Giant cell arteritis is characterized by progressive inflammation of many arteries of the body. These two disorders have been described in the medical literature as possible variants of the same disease process. Some researchers believe they represent different ends of a disease continuum. The exact nature of the association is not fully understood.

What are the symptoms for arthritic rheumatoid disease?

Early rheumatoid Arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet.

As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.

About 40% of people who have rheumatoid Arthritis also experience signs and symptoms that don't involve the joints. Areas that may be affected include:

  • Skin
  • Eyes
  • Lungs
  • Heart
  • Kidneys
  • Salivary glands
  • Nerve tissue
  • Bone marrow
  • Blood vessels

Rheumatoid Arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission — when the Swelling and Pain fade or disappear. Over time, rheumatoid Arthritis can cause joints to deform and shift out of place.

What are the causes for arthritic rheumatoid disease?

Rheumatoid arthritis is an autoimmune disease. Normally, your immune system helps protect your body from infection and disease. In rheumatoid arthritis, your immune system attacks healthy tissue in your joints. It can also cause medical problems with your heart, lungs, nerves, eyes and skin.

Doctors don't know what starts this process, although a genetic component appears likely. While your genes don't actually cause rheumatoid arthritis, they can make you more likely to react to environmental factors — such as infection with certain viruses and bacteria — that may trigger the disease.

What are the treatments for arthritic rheumatoid disease?

There is no cure for rheumatoid arthritis. But clinical studies indicate that remission of symptoms is more likely when treatment begins early with medications known as disease-modifying antirheumatic drugs (DMARDs).

Medications

The types of medications recommended by your doctor will depend on the severity of your symptoms and how long you've had rheumatoid arthritis.

  • NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription. Side effects may include stomach irritation, heart problems and kidney damage.
  • Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, weight gain and diabetes. Doctors often prescribe a corticosteroid to relieve symptoms quickly, with the goal of gradually tapering off the medication.
  • Conventional DMARDs. These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Common DMARDs include methotrexate (Trexall, Otrexup, others), leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine). Side effects vary but may include liver damage and severe lung infections.
  • Biologic agents. Also known as biologic response modifiers, this newer class of DMARDs includes abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), certolizumab (Cimzia), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), rituximab (Rituxan), sarilumab (Kevzara) and tocilizumab (Actemra).

    Biologic DMARDs are usually most effective when paired with a conventional DMARD, such as methotrexate. This type of drug also increases the risk of infections.

  • Targeted synthetic DMARDs. Baricitinib (Olumiant), tofacitinib (Xeljanz) and upadacitinib (Rinvoq) may be used if conventional DMARDs and biologics haven't been effective. Higher doses of tofacitinib can increase the risk of blood clots in the lungs, serious heart-related events and cancer.

Therapy

Your doctor may refer you to a physical or occupational therapist who can teach you exercises to help keep your joints flexible. The therapist may also suggest new ways to do daily tasks that will be easier on your joints. For example, you may want to pick up an object using your forearms.

Assistive devices can make it easier to avoid stressing your painful joints. For instance, a kitchen knife equipped with a hand grip helps protect your finger and wrist joints. Certain tools, such as buttonhooks, can make it easier to get dressed. Catalogs and medical supply stores are good places to look for ideas.

Surgery

If medications fail to prevent or slow joint damage, you and your doctor may consider surgery to repair damaged joints. Surgery may help restore your ability to use your joint. It can also reduce pain and improve function.

Rheumatoid arthritis surgery may involve one or more of the following procedures:

  • Synovectomy. Surgery to remove the inflamed lining of the joint (synovium) can help reduce pain and improve the joint's flexibility.
  • Tendon repair. Inflammation and joint damage may cause tendons around your joint to loosen or rupture. Your surgeon may be able to repair the tendons around your joint.
  • Joint fusion. Surgically fusing a joint may be recommended to stabilize or realign a joint and for pain relief when a joint replacement isn't an option.
  • Total joint replacement. During joint replacement surgery, your surgeon removes the damaged parts of your joint and inserts a prosthesis made of metal and plastic.

Surgery carries a risk of bleeding, infection and pain. Discuss the benefits and risks with your doctor.

What are the risk factors for arthritic rheumatoid disease?

Factors that may increase your risk of rheumatoid arthritis include:

  • Your sex. Women are more likely than men to develop rheumatoid arthritis.
  • Age. Rheumatoid arthritis can occur at any age, but it most commonly begins in middle age.
  • Family history. If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease.
  • Smoking. Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity.
  • Excess weight. People who are overweight appear to be at a somewhat higher risk of developing rheumatoid arthritis.

Is there a cure/medications for arthritic rheumatoid disease?

Arthritis is a disease that affects your joints and causes pain, swelling, and stiffness. There are many different types of arthritis, but the most common type is osteoarthritis.

Osteoarthritis is caused by wear and tear on the joints over time. It's more common in older people, but it can happen at any age. Osteoarthritis can also be caused by injury or repetitive stress on the joints.

1. The most common medication is called prednisone. It is an anti-inflammatory corticosteroid drug that is usually used to treat inflammation and swelling in the joints of patients with arthritis. The main side effect of prednisone is fluid retention, which can increase your blood pressure and cause bloating or swelling in your face and fingers.

2. Another common medication is methotrexate, which suppresses the immune system's inflammatory response by using a different mechanism than prednisone. This drug can cause liver damage if taken in large doses over time, so it should be taken only under a doctor's supervision. Other side effects include bone marrow suppression (which can lead to infections), low white blood cell counts (which increases susceptibility to infection), diarrhea and nausea, hair loss, fatigue and muscle pain.

There are many medications for arthritic rheumatoid disease. These include:

1. Non-steroidal anti-inflammatory drugs (NSAIDs) - These drugs can be taken to relieve pain, and reduce inflammation and swelling. They include ibuprofen, aspirin, and naproxen. These are available over the counter but some require a prescription.

2. Corticosteroids - These reduce inflammation in the body and can be injected directly into joints or taken as tablets or injections. They have side effects such as thinning of the bones and increased risk of infection.

3. Immunosuppressants - These drugs help your immune system to work less effectively so it cannot attack healthy tissue such as joints. They may be used if other treatments do not work well enough or if there is a risk of complications from them such as infections. They include methotrexate, cyclosporin A and azathioprine.

Symptoms
Pain or stiffness in your joints,Swelling of your fingers, wrists, elbows, knees or ankles,Warmth over the affected area,Tenderness when pressing on the joint,A feeling of weakness in your legs if you have arthritis involving your hips or knees
Conditions
Lupus (Systemic lupus erythematosus),Psoriatic arthritis,Ankylosing spondylitis,Reactive arthritis (Reiter's syndrome),Juvenile idiopathic arthritis
Drugs
Methotrexate,Corticosteroids,NSAIDs (Non-steroidal anti-inflammatory drugs),Antibiotics,Disease-modifying antirheumatic drugs (DMARDs)

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