What Is Rheumatoid Arthritis? What Are The Symptoms And Treatment ...
rheumatoid arthritis
rheumatoid arthritis
What is rheumatoid arthritis? What are the symptoms and treatment of rheumatoid arthritis? 1

Rheumatoid arthritis is the most common form of rheumatoid arthritis and causes inflammation of the lining (synovium) inside the joints and/or other internal organs. The joint line thickens and can lead to increased warmth, swelling, and pain in the joint. Rheumatoid arthritis is a chronic disease that lasts for years. It affects many different joints in the body. It damages cartilage, bone, and joint structures.

The cause of rheumatoid arthritis is not yet known and the disease differs from person to person. It can affect anyone, including children and the elderly. However, the disease usually begins in the young and middle-age periods. Among patients with rheumatoid arthritis, the female to male ratio is 3/1. 2/3 of the patients are women. The disease can be seen in all races and in all parts of the world.

What causes rheumatoid arthritis?
Can infections cause rheumatoid arthritis?
How does rheumatoid arthritis differ from other types of rheumatism?
Diagnosis and tests for rheumatoid arthritis
What are the symptoms of rheumatoid arthritis?
Treatment of rheumatoid arthritis
rheumatoid arthritis medications
rheumatoid arthritis exercises
physical or occupational therapy
When is rheumatoid arthritis joint surgery the best option?

What causes rheumatoid arthritis?

When the immune system, that is, the defense system, works properly, the body’s defense fights against bacteria, viruses, and other foreign cells. In rheumatoid arthritis, the immune system does not work properly and the body attacks its own joints and other organs. In rheumatoid arthritis, inflammatory cells (white blood cells, or white blood cells) move from the blood to the joint tissues and attack the joints. Joint fluid increases and swelling occurs in the joint. Inflammatory cells in the joint tissue affect the joint and cause damage.

Can infections cause rheumatoid arthritis?

Many scientists and doctors believe that rheumatoid arthritis is triggered by infection. But for now there is no proof of this. Rheumatoid arthritis is not contagious. A previous infection can lead to the onset of RA.

Role of Genes:

Rheumatoid arthritis is not passed from mother or father to children. Instead, genes that predispose to developing rheumatoid arthritis can be passed on to children. A predisposition to RA disease develops in children.

How does rheumatoid arthritis differ from other types of rheumatism?

An important way to distinguish rheumatoid arthritis from other forms of arthritis is the feature of joint involvement. For example, Rheumatoid arthritis affects the wrist and many small joints of the hands. It usually does not affect the joints close to the nails. On the contrary, osteoarthritis, in other words, calcification, mostly involves the joints of the hand close to the nail. Other joints most commonly involved in rheumatoid arthritis are elbows, shoulders, neck, jaw, hips, knees, ankles, and toes. Spinal joints are not usually involved in rheumatoid arthritis. Sometimes neck vertebrae are involved, causing neck and neck pain.

In a person with rheumatoid arthritis, the joints are usually symmetrical, meaning that both sides tend to be involved (such as with both knees or both wrists). So if the knuckles of the right hand are swollen, often the knuckles of the left hand will also swell. The location of swollen joints and some blood tests play a key role in differentiating RA from other rheumatic diseases.

Diagnosis and tests for rheumatoid arthritis

To diagnose rheumatoid arthritis, your doctor will listen to your history and perform an examination. The doctor will look for swelling in your joints, increased warmth, limited range of motion, and other signs of rheumatoid arthritis (such as a rheumatoid nodule). In addition, your doctor will ask if you have RA-related symptoms such as weakness, fatigue, morning stiffness (limited movement, feeling of stiffness when you wake up in the morning). The characteristics of the involved joints are fundamental in differentiating RA from other rheumatic diseases.

Your doctor will also order certain blood tests and X-rays. A positive (+) (positive) test called rheumatoid factor (RF) supports RA. RF is a rheumatism test. However, a positive (+) RF test in a patient who does not have joint complaints does not mean that that person also has RA, so RF test alone does not diagnose rheumatism. The frequently used ASO test is never a rheumatism test, and the ASO test is definitely not checked and used in rheumatic diseases, especially in RA. ASO is only an indicator of a previous microbial throat infection and is only a helpful test in diagnosing acute rheumatoid arthritis. In rheumatology outpatient clinics, the ASO test is only used for suspected acute joint rheumatism.

Sedimentation (ESR) and CRP tests are also examined in order to observe the severity of your disease, exacerbation and follow-up of the disease. These tests are elevated in the presence of inflammation in the body. They are very useful tests in the follow-up of the disease-related inflammation and very useful in the regulation of treatment.

Anemia (anemia) and deterioration in kidney and liver functions may develop in patients with rheumatoid arthritis due to long-term chronic disease and continuous use of painkillers. Your doctor will follow these blood tests at regular intervals and take necessary actions when necessary. In this regard, you; Go to your regular check-ups on the dates recommended by your doctor, use the medications your doctor gives you without interruption, consult your doctor without delay when you have a complaint.

There is no test that diagnoses RA or makes a definitive diagnosis. X-rays are completely normal in the early stages of rheumatoid arthritis. As the disease progresses, joint damage begins to be seen on X-rays. These damages seen on joint x-ray films are very helpful in making the definitive diagnosis and confirming the diagnosis.

Rheumatoid arthritis symptoms , what are the symptoms ?

Symptoms of rheumatoid arthritis vary from person to person. Joint inflammation is usually permanent in every person with RA. In some people, the disease may progress with bouts of exacerbation, with a moderate and slower course. But usually the disease is constantly active if left untreated. If not treated successfully, the disease progresses day by day and may cause permanent disability.

If you have rheumatoid arthritis, you will experience warmth, swelling, tenderness, pain and limitation of movement in your joints, that is, joint inflammation. These joint inflammation (arthritis) symptoms are caused by inflammation of the joint membranes (synovium). Inflammatory cells that enter the joint membrane of the immune system maintain inflammation and cause tissue damage. If this inflammation persists or is not treated, it causes permanent damage to cartilage, bone, tendon and joint ligaments. This often causes injury to the joint.

Rheumatoid arthritis flare-ups can make you feel sick and unwell. It can cause loss of appetite, weakness, fatigue, weight loss and fever. Anemia (anemia) may develop. In about 1/5 of patients with rheumatoid arthritis, small, painless bumps called rheumatoid nodules may form under the skin. These often occur in the elbows, knees, areas of flat bone that are more exposed to pressure. They mostly occur around the elbow, but can be found anywhere else in the body and even in internal organs.

Sometimes patients with rheumatoid arthritis may develop inflammation in the lungs and heart. Dry eyes and dry mouth may also occur due to inflammation of the tear and salivary glands.

Rarely, inflammation of the vessel wall (rheumatoid vasculitis), which causes inflammation in the skin, nerves and other organs, may develop.

Treatment of rheumatoid arthritis

There is no complete cure for rheumatoid arthritis as of now. With current treatments, it is possible to stop the progression of the disease. Current treatment methods are aimed at relieving pain, reducing inflammation, preventing or slowing joint damage, and maintaining patient well-being. Modern treatments have improved the quality of life of patients with rheumatoid arthritis. Your treatment program; It is organized taking into account your needs, your individual lifestyle, other medical problems, and the severity and severity of your illness.

In the treatment of rheumatoid arthritis, ROMATOLOG is the leader of the healthcare team. Rheumatologists are specialist physicians specially trained in muscle, bone and joint diseases. The rheumatologist acts as the person responsible for the medical treatment of RA. Other healthcare professionals, such as the PTR physician, physical therapist, nurse, psychiatrist, orthopedic physician, and social worker, play important roles in helping to beat the disease.

The drugs used in the treatment of rheumatoid arthritis are divided into two: drugs that help relieve your symptoms (symptoms) and drugs that stop the damage done by the disease and help maintain (modify) this condition. Your doctor may suggest that you use two or more medications at the same time. Each of these are drugs that serve specific purposes in the treatment of rheumatoid arthritis. Some of these drugs require careful monitoring during treatment. All drugs have side effects, but RA is a disease that must be treated.

Therefore, the patient should be informed as much as possible about the treatment options and the risks of the treatment against the wounds. Ask your doctor, nurse or pharmacist any questions you might have about treatment. Tell your doctor if you suspect a treatment-related side effect or if you think the treatment is not working well. Despite all the treatment, you should not forget that you may have minor complaints from time to time, even if everything is going well.

Rheumatoid arthritis medications

The following medicines relieve symptoms (complaints) of rheumatoid arthritis.

NSAIDs (non-cortisone pain relievers and anti-inflammatory agents) and aspirin:

NSAIDs (such as voltaren, cataflam, apranax, naprosyn, majezik, endol…) and aspirin are used to treat inflammation. Pain also NSAIDs alone are never enough to treat RA. Patients with RA must also take drugs that suppress disease activity. NSAIDs and aspirin can cause side effects such as stomach bleeding. These drugs should be used with or after meals. In addition, your doctor will prescribe additional drugs (such as stomach protectors – Lansor, Omeprol, Protonex, Nexium) to prevent these side effects.

Aspirin is used by some doctors to treat RA. To be effective, it must be used in much higher doses than the normal dose. Aspirin causes stomach problems and stomach bleeding more than other drugs, and it needs to be used in high doses, so aspirin is not preferred in the treatment of RA. Many rheumatologists today do not use aspirin as a pain reliever or anti-inflammatory.

NSAIDs are also used as adjunctive therapy to cortisone therapy, as they help the pain reliever and anti-inflammatory effect of cortisone and help minimize or even cut the cortisone dose.

Analgesics (Simple pain relievers):

In addition to aspirin or NSAIDs, simple pain relievers (analgesics) may be helpful to relieve pain. These drugs include paracetamol (vermidone, parol, tamol, etc.), and metamizole (novalgin, adepirone). Paracetamol and metamizole can be used with or without food. It has no side effects on the stomach. Side effects on kidneys and liver are very rare. In this respect, they can be easily used as an auxiliary pain reliever for cortisone and NSAIDs.

Narcotic pain relievers are not recommended for the treatment of rheumatic diseases because of their side effects, addiction and non-inflammatory properties. In some special cases, they can be used under the supervision of a physician.

Glucocorticoids (Cortisone):

Glucocorticoids (cortisone, prednisone) (prednol, deltacortril, ultralan, flantadine) are very effective in reducing and relieving RA-related complaints. They have a fast and strong painkiller, anti-inflammatory effect. However, they have serious side effects in long-term and high-dose use. These drugs are related to the hormone cortisol.

Cortisol is a hormone found naturally in the body and has very important functions that control important bodily functions such as blood pressure and heart rate. Life without cortisol is not possible. If you take high doses of cortisone for a long time, side effects begin.

Easy to use high-dose cortisone for a long time, bruises, bruises, cracks, acne, accumulation of fat in the neck, shoulders, and abdomen, early atherosclerosis, early coronary artery disease development, a tendency to diabetes, osteoporosis, muscle wasting, bone necrosis, early cataract development It can lead to increased eye pressure (glaucoma), weight gain, lunar face (round face), susceptibility to infections and psychiatric problems.

Rarely, severe bone damage may develop after a short period of treatment with high-dose cortisone. In general, high-dose cortisone is not necessary in the treatment of RA. Sometimes, high-dose cortisone can be used in cases of severe organ involvement or inflammation of the vessel wall (rheumatoid vasculitis). Low-dose cortisone can be used with NSAIDs to control joint inflammation.

Especially in the initial stages of the disease, cortisone can be used in the 1-3 months period until the effects of the drugs that suppress the activity of the disease appear. In some patients, it may be necessary to use cortisone continuously to suppress the symptoms related to the disease. In these cases, it is necessary to keep the side effects of cortisone under constant control and, if necessary, to give preventive treatments.

Many of the benefits and side effects of cortisone are dose dependent. The aim is to find the lowest and most effective cortisone dose, avoiding side effects as much as possible. The use of low-dose cortisone minimizes the risk of cortisone-related side effects. At the same time, its use as a single dose per day is also very effective in reducing the side effects of cortisone. Since patients with RA receive long-term treatment, cortisone treatment should not be considered as the main drug of treatment.

If you use cortisone regularly,

you need to take calcium and vitamin D. In addition, you should increase the daily consumption of milk and dairy products (at least 1 glass of milk or 1 bowl of yogurt or 1 matchbox size cheese per day). If you regularly consume milk and dairy products, you may not use calcium and vitamin D supplements or If you have osteoporosis, you should use drugs (Bonviva, Fosomax, Actonel, etc.) for this.

If you use Prednol over 16 mg or Deltacortril over 20 mg per day,

you should reduce the salt you take with meals. In high doses, cortisone can cause water and salt retention in the body, causing your blood pressure to rise.

Contrary to popular belief, cortisone does not cause weight gain, but increases appetite. You may experience weight gain due to this. You should keep your appetite under control while you use cortisone.

Long-term use of cortisone has the effect of reducing or stopping the body’s cortisol production. It is extremely dangerous for a patient using cortisone to significantly reduce or cut cortisone without the knowledge of his doctor, because the body cannot immediately begin to produce the necessary and sufficient cortisol for itself.

Cortisone dose should be increased as the cortisone requirement of the body will increase during high stress periods such as surgical intervention or traffic accident. In addition, you should tell every doctor you consult for any reason that you are using cortisone.

Ampoule forms of cortisone drugs (prednol vial, kenakort, etc.) can be administered as an injection into one or more joints. Such treatments can provide rapid recovery. It can relieve joints that are constantly sore and swollen or that often flare-up. Since the effect is in a specific area (local), injection into the joint temporarily controls inflammation and prevents unwanted side effects caused by daily cortisone pills.

If injections are given more than a few times a year, it can cause harmful side effects in the joints. Joint injections should not be repeated in less than 3 months.

https://web.archive.org/web/20060925143122/http://www.arthritis.org/conditions/DiseaseCenter/RA/default.asp Rheumatoid Arthritis (RA) What is it ?

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