...Is painful. Here are options for gaining control over it.
Your joints are sometimes a bit stiff when you first wake in the morning, but lately they’ve been downright swollen and uncomfortable. You were diagnosed with rheumatoid arthritis a couple of years back, and thanks to the medications your doctor recommended, your signs and symptoms have largely been kept in check – until now.
Inside Your JoInts Rheumatoid arthritis occurs when you immune system attacks the joint linings (synovial membranes) that protect and lubricate your joints. When this happens, the membranes become inflamed, causing your joints to feel warm, painful and swollen. This is called synovitis. The joints may also become stiff, particularly in the morning. Persistent inflammation can cause the release of cells, chemicals and enzymes that begin to eat away at the cartilage and bone. Damage to tendons and ligaments also may occur. Over time, this process may cause the muscles around the joint to become weak. Eventually, this inflammation leads to destruction of the joint. This is what makes prompt treatment of rheumatoid arthritis so important.
Who’s At RIsk Although experts don’t fully understand the cause of rheumatoid arthritis, hormones and environmental factors are involved. People with a specific genetic marker are five times more likely to develop rheumatoid arthritis than are people without the marker. In recent years, researchers have identified over 100 other genes linked to increased risk
of developing more severe disease. Infectious agents, such as bacteria and viruses, are thought to possibly trigger the disease in people who are genetically susceptible. The disease is predominantly found in women. Hormones also are believed to play a role. Lifestyle factors uch as smoking and obesity also increase the risk.
Getting A DIAGnosIs The onset of rheumatoid arthritis can be sudden and severe, with swelling in many joints, or it can be subtle and progress slowly, with swelling in only one or two joints. This variability can make the disease challenging to diagnose in its early stages. If you notice joint swelling that lasts longer than a couple of weeks, see your doctor. While there’s no one specific test used to make a diagnosis, your doctor will use information gathered from a physical examination, evaluation of symptoms, blood tests and imaging studies to confirm a diagnosis of rheumatoid arthritis. The imaging tests often include X-rays of the hands, wrists and feet, which are used to look for signs of joint damage. These images are also used as a baseline for monitoring any progression of the disease over time.
Early And AGGREssIvE tREAtmEnt The first goal in treating rheumatoid arthritis is usually to put the disease in remission by stopping or reducing inflammation. Early, aggressive treatment with medications improves the odds of remission. By gaining tight control of the disease, the pace of joint damage can be slowed or even halted. A number of drugs may be used to slow disease activity: traditional diseasemodifying anti-rheumatic drugs (DmARDs) – These drugs are typically the first line of treatment. Commonly used DMARDs include methotrexate, hydroxychloroquine, leflunomide and sulfasalazine. They are typically taken by mouth, but methotrexate may also be given in injection.
If you notice joint swelling that lasts longer than a couple of weeks, see your doctor.