Rheumatoid arthritis

Rheumatoid arthritis

Rheumatoid arthritis is a chronic disease. There is inflammation in the joints. Bursa, tendon sheaths, and muscles can also be affected. Sometimes other organs are also involved. Over time, the joints damage. The disease occurs in 1% of the Dutch population. It’s an autoimmune disease. The immune system then produces antibodies against the body.

Rheumatoid arthritis symptoms

Pain complaints of the affected joints are in the foreground. It mainly concerns the joints of the hands and feet. But all other joints can also become infected. The joints are otherwise stiff and may be swollen. General complaints also occur, such as feeling flu and tired. The complaints can vary greatly over time. The inflammation can damage the joints.

Rheumatoid arthritis increases the risk of gum problems

People with rheumatoid arthritis are more likely to experience gum disease than people without it. Gum disease is significantly more severe in people with rheumatoid arthritis. People with rheumatoid arthritis were also more likely to test positive for the presence of certain antibodies (APCA) during testing. Antibodies are foreign substances in the blood. According to the researchers, these antibodies cause and maintain inflammation in the mouth and other parts of the body. The amount of APCA in the body was higher in people with rheumatoid arthritis with gum disease than without it.

How does rheumatoid arthritis develop?

The exact cause of rheumatoid arthritis is not known. Hereditary disposition plays an important role. Smoking is also an unfavorable factor in the development of rheumatoid arthritis. The immune system aims to eliminate intruders within the body. It does this, among other things, by making antibodies. These attach themselves to invaders and allow them to be cleared up by the immune cells. This is accompanied by inflammatory symptoms (redness, swelling and pain). In rheumatoid arthritis, the immune system makes antibodies against the body’s own cells in the joints. The resulting inflammations cause the complaints.

Is it serious what can you expect?

Diagnosis can be difficult. Especially in the beginning of the disease. The diagnosis is made on the basis of a number of criteria. The criteria concern the number of joints affected, the location of the joints, the presence of morning stiffness, subcutaneous bumps, abnormalities in the photos and blood abnormalities.

Rheumatoid arthritis presents problems with the use of the affected joints. This is primarily due to the inflammation in the joints. Later this is mainly due to damage to the joint. The course can be very variable. In most people the complaints increase over the years. That is not always the case. The damage to the joints can sometimes lead to serious disability. Factors that can play a role in deterioration are stress and changes in the hormone balance.

Rheumatoid arthritis is a chronic disease, the disease cannot be cured yet. Living measures aimed at staying in motion and relieving the joints are important. Quitting smoking also has a positive effect. Various paramedical treatments can provide support. Starting treatment quickly helps to prevent joint damage.

When to go to the doctor?

In case of complaints that could indicate rheumatoid arthritis, it is advisable to contact your doctor. It concerns complaints of pain, stiffness and swelling of the joints. If symptoms last longer than 4 weeks and are symmetrical, rheumatoid arthritis is likely. The doctor will refer you to the rheumatologist for further treatment. If during the treatment the complaints become more severe or new complaints arise, it is also advisable to contact your doctor.

Medicines for rheumatoid arthritis

The main role in treatment is for the drugs. This concerns painkillers and medicines that interfere with inflammation and defense. A simple pain reliever is paracetamol. Stronger painkillers are the opiates. These agents have no effect on the inflammation.

Anti-inflammatory painkillers, such as NSAIDs or COX-2 inhibitors, are prescribed to counteract inflammation and limit damage. More powerful anti-inflammatory drugs that act on the immune system are the classic anti-inflammatory drugs (DMARDs). These can affect various places in the immune system. The effect usually only comes after weeks to months. They affect about half of the people. Prednisone is one of the most powerful anti-inflammatory drugs available. Do classic DMARDs not work enough or are they not well tolerated? Then a targeted synthetic DMARD, such as a JAK inhibitor, is also an option. This new class inhibits a signaling pathway within the cell that is responsible for inflammation.

Another group of drugs that inhibit the immune response are the biologicals. They act quite quickly and are given by injection.

Would you like to read more about medication for this condition? Then also read the dossier ‘ Arthritis in intestinal diseases: which medicines are there? ‘on edexme.com.

What can you do about it yourself?

There is nothing you can do to prevent rheumatoid arthritis from developing. There are, however, factors that have a favorable effect on the course and severity of the complaints. You can influence a number of these factors yourself (see: General advice and precautions’).

General advice and precautions

An inflamed weight must rest. If the joint is warm, cooling with an ice pack can be useful. Make sure that the skin cannot freeze by wrapping the ice pack in a tea towel.

Movement is important for keeping the joints flexible, it prevents osteoporosis and has a beneficial effect on the heart and lungs. Sports, in which the joints are evenly loaded, are preferred (walking, cycling, swimming). The tax must be tailored to the complaints. Talk to your doctor or physical therapist about what is best for you. When the complaints increase after or during sports, the intensity must be reduced. Overload must be avoided.

A healthy, varied diet and a healthy body weight have a beneficial effect. Excessive alcohol consumption is detrimental. In general, heat has a beneficial effect on the complaints, for example with a warm bath or shower.

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