Treatment of rheumatoid arthritis

Prolonged joint pain, morning stiffness, swelling, or a feeling that habitual movements have become more difficult may be not simply a consequence of overfatigue or physical exertion. If such symptoms recur or gradually intensify, it is important to undergo an examination in a timely manner.

At the «Oxford Medical» medical center, patients can receive a consultation with a rheumatologist, take tests and undergo ultrasound and other instrumental examinations to assess the condition of the joints and confirm the diagnosis. Schedule a consultation at a time convenient for you by phone or through the online appointment form on the website.

Rheumatoid arthritis — is a chronic autoimmune disease in which the immune system mistakenly attacks the body’s own tissues, primarily the inner lining of the joints. Because of this, inflammation, pain, swelling and gradual limitation of mobility occur.

Most often, the small joints of the hands and feet are affected, and the changes usually occur symmetrically — on both sides of the body. Over time, the inflammatory process can affect not only the musculoskeletal system, but also other organs and systems.

In some patients, rheumatoid arthritis develops gradually — first morning stiffness, discomfort in the fingers or slight swelling appear. In other cases, the symptoms increase faster and more noticeably affect everyday activity. That is why it is important not to ignore the first manifestations of the disease and to consult a doctor in a timely manner.

Rheumatoid arthritis may differ by the features of its course, the activity of inflammation and immunological indicators. This is important for assessing the risk of disease progression and choosing treatment tactics.

Immunological classification (by rheumatoid factor):

• seropositive rheumatoid arthritis — rheumatoid factor or anti-CCP antibodies are detected in the blood;
• seronegative rheumatoid arthritis — characteristic antibodies are not determined, but symptoms and joint changes correspond to the disease.

According to the course of the disease, the following are distinguished:

• slowly progressive course — symptoms increase gradually over a long period of time;
• rapidly progressive — pain, swelling and impaired mobility intensify faster;
• course with periods of remission and exacerbations — after improvement of the condition, symptoms may intensify again.

Also during the examination, the doctor assesses the number of affected joints, the degree of mobility limitation and the presence of extra-articular manifestations. If inflammation involves one joint, the term monoarthritis may be used, and if many joints are affected simultaneously — polyarthritis.

The exact cause of the development of rheumatoid arthritis has not been definitively established. It is believed that the disease occurs due to a combination of several factors: impaired functioning of the immune system, hereditary predisposition and the influence of external factors. As a result, the immune system mistakenly attacks the tissues of its own joints, because of which chronic inflammation occurs.

Factors that may increase the risk of developing the disease include:

• hereditary predisposition to autoimmune diseases;
• smoking;
• hormonal changes;
• previous viral or bacterial infections;
• prolonged stress;
• excess body weight and some metabolic disorders.

In some patients, the first manifestations may occur gradually: first morning stiffness, pain or swelling in the small joints of the hands or feet appear. Sometimes the inflammatory process is accompanied by general weakness, increased fatigue or enlargement of the lymph nodes — lymphadenopathy.

According to American College of Rheumatology, the risk of developing rheumatoid arthritis may be higher in people with hereditary predisposition, as well as under the influence of external factors, in particular smoking. That is why during the consultation the doctor clarifies the patient’s family history, lifestyle and concomitant diseases.

Diagnosis of rheumatoid arthritis helps confirm the presence of inflammation, assess the activity of the disease and determine how much the joints are affected. During the consultation, the doctor clarifies the complaints, the duration of symptoms, the presence of morning stiffness, pain, swelling and limitation of mobility.

To clarify the diagnosis, the following may be prescribed:

• laboratory blood tests to assess inflammation and autoimmune activity;
• tests for rheumatoid factor and anti-CCP antibodies;
• X-ray of the joints to assess changes;
• joint ultrasound to detect inflammation, swelling and changes in soft tissues;
• MRI according to indications, if it is necessary to assess the condition of the joint structures in more detail.

Comprehensive diagnosis helps select further treatment and observation tactics.

Treatment of rheumatoid arthritis is aimed not only at reducing pain, but also at controlling chronic inflammation, preserving joint mobility and slowing the progression of the disease. The basis of therapy is usually disease-modifying antirheumatic drugs. They affect the activity of the autoimmune process and help reduce the risk of further joint damage. Some of these drugs begin to act gradually, so treatment requires regular control and observation by a doctor.

To control symptoms and the inflammatory process, the doctor may recommend:

• anti-inflammatory drugs to reduce pain and stiffness;
• glucocorticosteroids according to indications, if it is necessary to reduce the activity of inflammation faster.

Doctors of «Oxford Medical» explain: in rheumatoid arthritis, it is important to regularly maintain joint mobility, since prolonged inflammation and low mobility can increase stiffness and limitation of movements. For this, therapeutic physical exercises may be recommended — specially selected exercises that help maintain joint flexibility, muscle strength and make it easier to perform everyday movements.

According to the recommendations of the Ministry of Health of Ukraine, early start of therapy and regular control of disease activity help slow the progression of joint damage and improve patients’ quality of life.

With rheumatoid arthritis, it is important to pay attention to nutrition and the individual reaction of the body to certain products. In some patients, certain food may increase discomfort, swelling or affect general well-being, so the diet should be balanced and complete. It is also important to maintain a normal body weight, since excess weight creates an additional load on the joints.

It is recommended to include in the diet:

• fish and products with omega-3 fatty acids (salmon, mackerel, sardines);
• vegetables, greens, berries and fruits;
• whole-grain products;
• lean meat, eggs, legumes;
• fermented dairy products with sufficient calcium content;
• a sufficient amount of water throughout the day.

It is desirable to limit:

• excess sugar and sweet drinks;
• ultra-processed products and fast food;
• fried and fatty food;
• alcohol;
• excess salt in case of a tendency to swelling or increased blood pressure.

With a prolonged inflammatory process and medication treatment, the body especially needs a sufficient amount of protein, calcium, vitamins and healthy fats. That is why strict restrictive diets without a doctor’s recommendation are undesirable.

Without control of the inflammatory process, rheumatoid arthritis can gradually progress and affect not only the joints, but also other organs and systems. The risk of complications is usually higher with prolonged active inflammation and absence of regular treatment.

Possible complications:

• deformation of the joints and persistent limitation of mobility;
• chronic pain and decreased physical activity;
• damage to tendons, ligaments and periarticular tissues;
• osteoporosis and increased risk of fractures;
• damage to the cardiovascular system, lungs or eyes;
• enlargement of lymph nodes — lymphadenopathy;
• decreased work capacity and deterioration of quality of life.

Doctors of «Oxford Medical» recommend not postponing treatment even with moderate symptoms. Early control of inflammation helps reduce the risk of joint damage and development of complications in the future.

It is impossible to completely prevent the development of rheumatoid arthritis, since the disease is associated with impaired functioning of the immune system and hereditary predisposition. At the same time, control of risk factors and attentive attitude to the first symptoms help reduce the risk of progression of the inflammatory process and joint damage.

For prevention, it is recommended to:

• give up smoking;
• maintain a normal body weight;
• adhere to regular moderate physical activity;
• treat infectious and chronic diseases in a timely manner;
• not ignore prolonged pain, swelling or morning stiffness in the joints;
• regularly undergo doctor consultations if there are autoimmune diseases in the family.

It is especially important to consult a specialist if discomfort in the joints recurs, intensifies or lasts longer than several weeks. Early detection of the disease and timely start of treatment help better control the course of rheumatoid arthritis.

You can familiarize yourself with the prices for medical services here. At the private clinic «Oxford Medical», patients can undergo a consultation with a rheumatologist, laboratory and instrumental diagnostics and receive recommendations regarding further treatment and observation. To schedule a consultation, contact the contact center or use the online appointment form on the website.

The information is for informational purposes and does not replace a doctor’s consultation.

Sources:

• American College of Rheumatology
• National Institute for Health and Care Excellence
• Ministry of Health of Ukraine