What is Rheumatoid Arthritis
You can easily see what a joint looks like next time you carve a chicken. At the end of each bone there is a shiny substance called cartilage and the two bones are joined together by a sleeve of tissue, called connective tissue and inside this sleeve of connective tissue the shiny cartilage surfaces of the two bones are lubricated by a fluid called synovial fluid. The joint is supported by strong fibrous bands going from one bone to another, called ligaments but joints are also greatly strengthened and supported by the muscles that move them and the tendons, the shiny bits of tissue you can see in a leg of lamb or a chicken leg, which attach the muscles to the bone. When a word ends with itis, as in tonsillitis or appendicitis, it implies to many people infection but the real meaning of the word it is in the medical world is inflammation and inflammation can occur without infection. The commonest type of arthritis is osteoarthritis which is due to a combination of decades of using a joint combined with putting additional strain on a joint through being overweight. This type of arthritis is called osteoarthritis.
Rheumatoid arthritis is a completely different condition. It is an inflammatory condition of the joints that affects some people.
You might see the term autoimmune when searching on the web about rheumatoid arthritis and this means that the body is attacking its own tissues, again for no known reason, but the result is inflammation and the result of inflammation is damage to the joint and the surrounding tissues which in turn causes stiffness, pain and fatigue.
Why is rheumatoid arthritis important?Rheumatoid arthritis is important because left untreated, or is poorly treated, it can result not only in pain but also in limitations of movement of the joint and damage to the joint which may need joint replacement. Fortunately, rheumatoid arthritis is one of the diseases in which research and development of new drugs has led to a transformation of the condition with significant reductions in the need for joint replacement and significant improvements in quality of life.
Who is there to help?The general practitioner is the first port of call for arthritis but for rheumatoid arthritis it is best to be assessed by a team led by a consultant rheumatologist in the hospital specialist service.¬† Rheumatologists are usually based in orthopaedic departments but the training is completely different from that of an orthopaedic surgeon.
The primary aim is accurate diagnosis and treatment of arthritis by appropriate use of drugs and other services.Modern drugs have had an amazing impact on rheumatoid arthritis but of course all drugs have side effects in a proportion of patients so it can take time to find the right combination of drugs for the individual person. Sometimes the drugs interact with the drugs being taken for other conditions and for this reason there are specialist pharmacists working with the rheumatologist who know about drug interactions and the steps that can be taken to get the best balance of benefit with the least side effects. Also in the team are physiotherapists and occupational therapists.¬† The job of the physiotherapist is to help cope with the secondary effects of rheumatoid arthritis, namely the effects of the inactivity which is a consequence of the pain and stiffness because inactivity leads to muscle weakness and joint stiffness, just as it does in people without rheumatoid arthritis. However the problem is that if you have rheumatoid arthritis and lose fitness as a consequence of the painful condition then this results in joints which are even more stiffer and more difficult to move.
It is now known that activity has a very important therapeutic part to play in the treatment of rheumatoid arthritis in combination with the powerful new drugs.Sometimes certain activities of daily living become impossible as a result of the joint problems, for example the availability to dress or to take the top off a jar of jam. The occupational therapist has been trained to help people minimise the impact of disability and maximise their independence. These developments have taken place as a result of research in the last twenty years and the charity Arthritis Research UK has been a major driving force in helping people with rheumatoid arthritis. Its website also contains very useful information and they have an online advice service too which can be contacted by telephone if personal advice is needed. You can also find good information about rheumatoid arthritis on NHS Choices.
What can you do - top tips for people with rheumatoid arthritisThe first step is to make sure that the condition is accurately diagnosed and well treated and for this it is usually appropriate for referral to a specialist rheumatology team in the early stage of the condition so that you can get a drug treatment plan worked out and get the advice of expert physiotherapists and occupational therapists. However, healthcare is what you do for yourself so you are the person that is the most important person in the management of rheumatoid arthritis and here are some simple things you can do:
- Keep active; rest is sometimes necessary in the acute flair ups that occur from time to time but in general the diagnosis of rheumatoid arthritis, like the diagnosis of any long-term condition means you need to increase activity particularly if your life is one in which a lot of time is spent sitting at a desk. Of particular importance are exercises that maintain and increase the suppleness and strength. Pilates, yoga and the alexander technique or tai chi are all very helpful but it is important to keep muscle strong too with simple exercises and the Arthritis Research UK website has particular exercises you can do as does the book Sod Sitting Get Moving. You need to think about a ten-minute suppleness and strength programme every day except when there are acute flair ups.
- Tiredness is now recognised as one of the main problems that people experience with rheumatoid arthritis and this means that you need to give more attention to sleep.
- There are no specific dietary steps you can take, except to make sure that you don't put on weight, and of course try to lose weight if you have let your weight creep up over the years because extra weight protects the strain on the joints.
- Finally, even with the best treatment rheumatoid arthritis like all other conditions increases stress and stress certainly affects sleep and has other adverse effects on the body and mind. The best response to stress is not the development of a drug but techniques to control it, for example a mindfulness programme and NHS Choices has a good section on stress and how stress can be reduced.
Any information of a medical nature on this website is given to provide a general understanding of a medical condition or conditions. No patient/doctor relationship is to be inferred and you should seek medical advice from a qualified practitioner. Nothing on this site should be used as a substitute for competent advice from a qualified medical practitioner.