Published On : Mon, Feb 25th, 2019

Rheumatologist Dr Palak Arora shares how to cope up with arthritis

Dr Palak Arora a MBBS, DNB, MRCP (UK), Fellowship and a specialist in Rheumatology working with Orange City Hospital and research Institute explained different aspects involved in Rheumatoid arthritis.

1. What is Rheumatoid Arthritis (RA) ?
Rheumatoid Arthritis is a chronic disease which effects your joint and other systems. It starts when your immune system begins to attack your own tissues.
Leading to damage to the lining of your joints. As a result one’s joints may become red, warm, swollen and painful. It affects joints on both sides of the
body, such as both hands, both wrists, and both knees. This symmetry helps to set it apart from other types of arthritis. Over time, RA can affect other body parts
and systems like eyes, heart, lungs and skin.

2. How is Rheumatoid arthritis different then Osteo Aarthritis (OA) ?
There are many similarities between OA and RA, including joint pain and inflammation. However, OA is defined as joint stiffness caused by loss of cartilage (the cushion between the bones) between joints due to wear and tear, while RA is a result of an autoimmune attack on joints leading to damage of the lining of the joint (synovium).
OA usually presents asymmetrically, meaning only 1 side of the body may be affected at time while RA is mostly symmetrical joint involvement. It is important to differentiate one disease for available treatment options for OA are different from those for RA.

3. What are the symptoms of Rheumatoid Arthritis ?
There are certain joint symptoms which may give clues to RA like

1.Joint pain and swelling,
2. Redness , warmth or stiffness of joint for six weeks or longer,
3. Morning stiffness for 30 minutes or longer in the joints,
4. small joints (wrists, certain joints of the hands and feet) are affected,
5 same joints on both sides of the body are affected.
Along with pain, many people experience fatigue, loss of appetite and a low- grade fever. Other smptoms could be skin rash, blurry vision , dry mouth, cough etc

4. How is Rheumatoid arthritis diagnosed?
No single test can confirm RA. To make a proper diagnosis, your doctor will ask questions about personal and family medical history and perform physical
exam looking at each joint. Also some blood tests like ESR (Erythrocyte sedimentation rate and C-reactive protein (CRP) level are measured as these are markers of inflammation. Also testing for Rheumatoid factor (RF) and Anti- Cyclic Citrullinated peptide (Anti CCP)are measured, RF is an antibody found in about 80 percent of people with
RA during the course of their disease. Anti-CCP occurs primarily in patients with RA. An X-ray of the joint is usually done to look for joint damage .

5. What are the possible treatment options ?
With newer drugs being available, treatment options are varied. Treatment goals are to first, control the pain and swelling and second to stop the joint
damage. Certain drugs like NSAIDS would ease the symptoms, other drugs called DMARDs (Disease modifying agents ) help in controlling the disease. Treatment
options are assessed at various stages of the disease.

6. What are the risk factors for developing RA?
There are specific causes to pin point for development of Rheumatoid arthritis. But certain factors can pose a risk.

Age: While rheumatoid arthritis can strike at any age, the onset of symptoms
usually begins between the ages of 40 and 60. Moreover, the risk will increase
the older you get older. Overall, the odds of developing.

Gender: Women are three times likely to get rheumatoid arthritis than men.
This could possibly due to Female hormones like estrogen .

Genetics: If you have a parent or sibling with rheumatoid arthritis, your risk of
developing the disease is three times greater than the general population.

Other include: Lifestyle risk factors are those that are modifiable. For instance
Smoking, Obesity, physical and emotional stress.

7. Diet in Rheumatoid Arthritis ?
Foods high in omega-3 fatty acids like fatty fishes, including salmon, chia seeds, flax seeds, walnuts. Antioxidants, such as vitamins A, C, and E, and selenium, may also help reduce inflammation like berries, dark chocolate, spinach, kidney beans. Diet rich in high fiber like choosing whole grain foods, fresh vegetables, and
fresh fruit. Strawberries may be particularly beneficial.

8. What are the complications of Rheumatoid Arthritis?
Complications include joint damage in the form of crippling of the finger and wrist joint leading to deformity. Others are weakening of the bone (osteoporosis), red eye, lumps and bumps on the skin, anaemia, shortness of breath, leg cramps , fatigue, low moods etc

9. Can RA effect children ?
Yes, it can . Juvenile rheumatoid arthritis is a known entity. Know called as Juvenile idiopathic arthritis. it causes joint pain and swelling. It typically starts before the age of 16 . Symptoms are different among children. Typically, joints become swollen, stiff, painful and warm to the touch. They may start as early as 6 months of age. Your child may limp, especially in the morning when stiffness is the worse. He or she may have lower back pain and avoid normal activities. Symptoms may come and go.

10. Any tips for coping up with RA?
Rheumatoid arthritis is more than just a disease of the joints. It's a life- changing event . there are few things to keep in mind o help you feel better.
Taking your medications on same time each day .

Address pain, if your joint pains after any activity please rest
Attending regular visits to your doctor
Regular physical exercise and stretching
Taking rest between activities
Getting emotional support around your friends and relatives.
Change positions often. When writing, release your grip every 10 minutes or so to keep your hand from stiffening up. When watching television or working at your laptop, get up at regular intervals to stretch your legs.
Find tools you can use. There are plenty of utensils and tools that are made for people with arthritis.