What is Rheumatoid   Arthritis?

Read about  Rheumatoid Arthritis  Disease presented in simple easy to understand language

Management and Treatment
Since RA is not curable, the aim of the treatment should be directed to relieve pain, reduce inflammation, slow down or stop joint damage, improve a person’s sense of well-being and ability to function. Treatment for RA most often involves some combination of medication with education, exercise, rest, joint protection, physical and occupational therapy, and surgery when necessary. There is no single standard treatment that applies to all people with RA. The disease can be very different from person to person. Instead a treatment programme should be designed to best meet your individual needs, taking into account the severity of the Arthritis, other medical problems, and lifestyle and preferences. 

The Following Guidelines can be Adopted for proper Management of RA
• Rest, both mental and physical. Rest in bed necessary during acute febrile stage. 
• Improve person’s ability to function and independently and maintain a positive outlook.
• Diet: Nutritious diet containing adequate calories, vitamins and minerals. 
• Correction of anaemia and reduction of stress. 
• Avoidance of cold, dampness and draught ( i.e. breeze produced by wind or fan). 
• Removal of any infection. 
• Preservation of functional capacity of the joints. 
• Physiotherapy as and when necessary. 
• Inflamed joints should be splinted to prevent contractures and maintain range of motion. 
• Exercise is important for maintaining healthy and strong muscles, preserving joint mobility and maintaining flexibility but avoid any exercises that produce increased pain. 
• Repeated medical, functional and social assessments are required to monitor the course of the disease, determine the effectiveness and any negative effects of medications, and change therapies as needed. 

Surgery in Rheumatoid Arthritis
The use of surgical procedures such as arthroplasty, e.g., total joint replacements, has been effective in very severe forms of RA. Usually, the first surgical treatment is removal of the synovium. A later alternative is total joint replacement with a joint prosthesis or an arthroplasty. In extreme cases, total knee or hip replacement can mean the difference between being totally dependent on others and having an independent life at home. Commonly performed surgical procedures include joint replacement, tendon reconstruction, and synovectomy. The primary purpose of surgery is to reduce pain, improve the affected joint’s function, and improve the patient’s ability to perform daily activities. Surgery is not for everyone and the decision should be made only after careful consideration by patient and doctor. 

Difference Between RA and other Forms of Arthritis
RA differs from many other forms of Arthritis because it is widespread in nature, affecting the whole body, not just the joints. The marked joint swelling and the deformity that can develop from chronic disease, as well as the development of nodules are also unique to RA . The presence of rheumatoid factor is characteristic of RA. Involvement via antibody clumping of any organ of the body is also typical of RA. 

Prognosis of the Disease
The prognosis of a patient of RA is bright even when it becomes chronic and a long-tem disease. It is rarely fatal if adequately controlled by medicine and physiotherapy. Although rheumatoid Arthritis can have serious effects on a person’s life and well-being, current treatment strategies – including pain relief and other medications a balance between rest and exercise, and patient education and support programmes – allow most people with the disease to lead active and productive lives. Patients who fail to get effective treatment in about a year from the onset of the disease may end up with some serious disability in restricted movement or some deformity of the joints. Left untreated, RA can irreversibly damage joints leading to pain, stiffness, deformity, loss of function and long-term disability. It is, therefore, important to receive appropriate treatment as early as possible. 

Complications
As the majority of damage to the joints occurs in the first two years of developing rheumatoid 
Arthritis, early diagnosis and appropriate treatment are essential. RA becomes a major problem primarily when treatment is delayed. Left untreated, RA can cause serious permanent damage, such as joint destruction and bone deformities. Rheumatoid vasculitis ( inflammation of the blood vessels) is the most serious complication of RA and can be life-threatening. It can lead to skin ulcerations, bleeding, intestinal ulcers and neuropathies. Skin rashes, Raynaud’s phenomenon, and massive haemorrahage may also result from vasculitis. Other complications are : gastrointestinal bleeding, heart failure, pericarditis, pleuritis, joint destruction, eye disease, cervical spine stability and neuropathy.  Read Previous