Download Treatment of Rheumatoid Arthritis

MOOR GREEN LANE MEDICAL CENTRE
339, MOOR GREEN LANE, MOSELEY, BIRMINGHAM B13 8QS
R. RAMACHANDRAM
PATIENT INFORMATION LEAFLET
Disease focus: Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an autoimmune disease. This means that the
white cells and antibody proteins in your blood that usually fight infections
enter your joints and cause inflammation. This causes heat, swelling and
excess fluid to be produced. Eventually, this may lead to thinning of the
cartilage that covers the ends of your bones, and may cause the bone to be
worn away. RA may also cause inflammation of the sheaths around your
tendons. Rarely, the condition can affect other parts of your body, such as
your lungs. RA affects more than 350,000 people in the UK and can start at
any age. Women are 3 times more likely to develop RA compared to men and
the disease runs in some families. Lifestyle factors may also increase your
risk, for example, if you smoke or are obese.
Symptoms of Rheumatoid Arthritis
Initially discomfort may occur in joints such as your fingers, knuckles, wrists or
the balls of your feet. RA is a 'symmetrical' arthritis - this means it affects
either wrists or both hands in the same way. RA develops slowly in the
majority of sufferers but sometimes can progress rapidly. Your symptoms can
come and go with little pain, swelling or inflammation in between the flare-ups,
which can last a few days to several months. Symptoms include:
 pain and swelling around the joint, making it tender and warm
 stiffness in the morning, or if you sit for a long time
 poor grip strength
 tiredness, making you feel irritable and depressed
 flu-like symptoms such as fever
 weight loss
 rheumatoid nodules - fleshy lumps that usually appear on your hands,
feet and elbows
Diagnosis of Rheumatoid Arthritis
When you first develop joint pains, it may be difficult for a doctor to say that
you definitely have RA. This is because there are many other causes of joint
pains. There is no single test, which diagnoses early RA with 100% certainty.
However, RA can usually be confidently diagnosed based on the following
combination of factors:
 Typical symptoms - as described above.
 A blood test for a marker called rheumatoid factor, present in 2 in 3 people
with RA but 1 in 20 of normal population so may not be conclusive
 Anti-CCP antibody testing. This has been found to be more specific than
rheumatoid factor in the diagnosis of RA.
PATIENT INFORMATION LEAFLET SERIES NO: 92 RHEUMATOID ARTHRITIS
MOOR GREEN LANE MEDICAL CENTRE
339, MOOR GREEN LANE, MOSELEY, BIRMINGHAM B13 8QS
R. RAMACHANDRAM
PATIENT INFORMATION LEAFLET
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Blood tests for anaemia (a condition when you have too few red blood
cells or not enough haemoglobin in your blood) - eight in ten people with
RA have anaemia.
X-ray, ultrasound or magnetic resonance imaging (MRI) to look for
characteristic early damage in your joints.
Associated conditions
The risk of developing certain other conditions is higher than average in
people with RA. These include cardiovascular disease (such as angina, heart
attack and stroke), anaemia, infections (joint infections and non-joint
infections), and osteoporosis (thinning of the bones).
Treatment of Rheumatoid Arthritis
It is important to be referred to a specialist to start treatment as early as
possible, especially if you have had symptoms for more than three months.
Treatment focuses on reducing inflammation to limit the damage to your
joints. If left untreated, RA may lead to serious disability.
There is no RA, but treatments can reduce symptoms and improve outlook.
 Painkillers such as paracetamol may help to relieve pain and stiffness.
 Non-steroidal anti-inflammatory drugs e.g Brufen (NSAIDs) reduce
symptoms of inflammation, relieving pain and swelling.
 Disease-modifying anti-rheumatic drugs (DMARDs) slow down the
progression of RA and ease its symptoms. They can take several months
to work so it is important to continue taking them. DMARDs have no
immediate effect on pains or inflammation and you may need to try one or
more.
 Biological medicines made from animal or human proteins block the
progress of RA in your immune system. The chemical TNF-alpha plays an
important role in causing inflammation in joints in RA. Blocking the effect of
TNF-alpha has been shown to reduce damage to joints, and reduce
symptoms. Similarly, Rituximab is another type of monoclonal antibody that
suppresses a part of the immune system that is involved in RA given by infusion.
 Steroids tablets are good at reducing inflammation and a short course of steroids
may help to 'damp down' a flare-up of symptoms, which has not responded much
to NSAIs.If you have a bad flare-up, you may be offered a corticosteroid
injection into a specific joint to reduce inflammation.
 Other treatments such as physiotherapy, occupational therapy, and surgery may
also be advised, depending on the severity of the disease and other factors. E.g.
Hip or Knee replacement, synovectomy to remove the lining of an inflamed
joint, removal or repair of severely inflamed tendons & surgery to fuse a
joint to make it more stable.
 Complementary therapies such as acupuncture and aromatherapy may
relieve pain and make you feel more relaxed but do not affect the
progression of the disease
 Oral hygiene, regular exercise to increase mobility, weight reduction,
smoking cessation and healthy diet also helps.
More * more ** more** just go on to www.patient.co.uk or
www.rheumatoid.org.uk
PATIENT INFORMATION LEAFLET SERIES NO: 92 RHEUMATOID ARTHRITIS