Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disorder that can affect and damage a wide variety of the body’s systems. Rheumatoid arthritis definition is a chronic inflammatory disorder that primarily affects the joints but can also persist in the skin, eyes, lungs, blood vessels, and heart of the afflicted patient. 

What is rheumatoid arthritis?

Osteoarthritis, while very similar to rheumatoid arthritis, does not have the same damaging corrosive effects on the lining of your joints.  The deteriorative effects of rheumatoid arthritis can lead to painful swelling in the joints which can lead to joint deformity and bone erosion over time. Untreated rheumatoid arthritis can cause physical disabilities in severe cases. Types of rheumatoid arthritis can be divided into two main categories: seropositive and seronegative Rheumatoid arthritis. There is also juvenile rheumatoid arthritis which only affects children. 

Seropositive rheumatoid arthritis is more severe and accelerates faster rather than seronegative rheumatoid arthritis. Seropositive rheumatoid arthritis causes more joint damage, lung complications, deformities, rheumatoid nodules, rheumatoid nodules, and can manifest outside of the joint, which is known as extra-articular manifestations.

Symptoms of rheumatoid arthritis

 Symptoms of rheumatoid arthritis include:

  • Warm, tender joints
  • Swollen joints 
  • Knee pain, wrist pain, etc.  
  • Joint stiffness
  • Fatigue
  • Loss of appetite

40% of people who have been diagnosed with rheumatoid arthritis can experience symptoms in other areas that do not include the joints. These areas include:

  • Skin 
  • Lungs
  • Eyes
  • Kidneys
  • Heart
  • Salivary glands
  • Nerve tissue
  • Bone marrow
  • Blood vessels

What causes rheumatoid arthritis is often a result of the body’s immune system attacking its own healthy cells. The specific causes of rheumatoid arthritis are still unknown but there are factors that can increase the risk of developing the disease. 

Risk factors that may increase the likelihood of developing rheumatoid arthritis include. 

  • Sex Women are two to three times more likely to develop rheumatoid arthritis than men. 
  • Age Those over the age of sixty are more likely to develop rheumatoid arthritis, but it can develop at any age. 
  • Smoking Cigarette smoking has been showing in several studies to increase a person’s risk and make the disease worse.
  • Obesity Several studies have shown that being overweight can increase a person’s risk of developing rheumatoid arthritis. In these studies, it has been examined that the more overweight a person was, the higher the risk becomes. 
  • Genetic traits. Certain genes called HLA (human leukocyte antigen) can increase the risk of developing rheumatoid arthritis and may make arthritis worse. People born with this genetic trait are at the highest risk when they are also obese or are exposed to smoking. 

Diagnoses of rheumatoid arthritis

Rheumatoid arthritis diagnosis is determined by conducting a physical examination to review the symptoms and performing lab tests that may include an X-ray. Early diagnoses of rheumatoid arthritis are best – within the first 6 months of onset symptoms- so that treatment can begin, and the progression of the disease can be slowed down. Early diagnoses and treatment can help to reduce the corrosive effects of rheumatoid arthritis. 

Treatment 

Rheumatoid arthritis can be managed with medications as well as lifestyle changes. 

The medications for rheumatoid arthritis are called disease-modifying antirheumatic drugs (DMARDs), which help to slow the disease and prevent joint deformities. There are also biological response modifiers which are medications that are used in addition to DMARD’s. Rheumatoid arthritis treatments include physical activity programs, maintaining a healthy weight, and stopping smoking. Experts recommend moderate physical activities such as walking, swimming, or biking for 30 minutes a day to help reduce the risk of rheumatoid arthritis progressing or developing. 

There are also several foods that can help with the inflammatory symptoms of rheumatoid arthritis. A rheumatoid arthritis diet includes the Paleo diet, Mediterranean diet, and gluten-free diet. Fruits, veggies, and cold-water fish that are high in omega-3 fatty acids are considered some of the best food for rheumatoid arthritis because they are anti-inflammatory and can potentially result in fewer flare-ups. 

Psoriatic Arthritis

Psoriatic arthritis is a condition that affects some people who have psoriasis. Psoriasis is a condition that shows up on the skin as red patches topped with silvery scales and the nails as thick pitted fingernails. Most people will develop psoriasis first before symptoms od psoriatic arthritis become apparent. 

Symptoms

The main symptoms of psoriatic arthritis are joint pain, stiffness, and swelling. This can affect any part of your body including the spine and can range in severity. If you experience any psoriatic arthritis symptoms it is important to contact your doctor right away as it is a disease that worsens over time. While the symptoms of psoriatic arthritis are very similar to those of rheumatoid arthritis psoriatic arthritis is more likely to cause swollen fingers and toes, foot pain, and lower back pain. 

While doctors are not entirely certain as to what causes psoriatic arthritis there are several genetic and environmental factors that can increase the likelihood of developing the disease. Risk factors can include a viral or bacterial infection in those with a family history of psoriasis. Those between the ages of 30 and 50 are more likely to develop psoriatic arthritis although it can develop in anyone. The largest risk factor for developing psoriatic arthritis is psoriasis. 

Diagnoses

If you have been diagnosed with psoriasis it is important to keep your doctor informed of any joint pains, knee pains or other symptoms you may develop. Psoriatic arthritis diagnosis is determined through several different methods including a physical examination, skin examination, nail examination, blood tests, and x-rays. 

Treatments

Psoriatic arthritis treatment is dependent on your age, symptoms, severity, and overall health.  Early treatment and diagnosis can help to prevent joint damage. 

Medications that are used to treat psoriatic arthritis include.

  • Nonsteroidal anti-inflammatory (NSAIDs)
  • Immunosuppressive medicines to reduce inflammation if NSAIDs are not effective. 
  • Biological medicines and Corticosteroids to ease inflammation.
  • Vitamins and minerals heavy in calcium and vitamin D to slow bone deformities.  

Other treatments may include exercise, physical therapy, ultraviolet light treatments, splints, management of psoriasis skin rash, and surgery to repair or replace damaged joints in sever prolonged cases. 

Including anti-inflammatory foods into your diet can also help to ease the symptoms. Conditions such as diabetes, high blood pressure, high cholesterol, and obesity can increase the risks of developing and worsening psoriatic arthritis, so it is important for patients to monitor their diets. A psoriatic arthritis diet can include the Pagano diet, paleo diet, Mediterranean diet, gluten-free diet, and the leaky gut diet. 

Systemic Lupus Erythematous 

Systemic Lupus Erythematosus is an autoimmune disease in which the immune system attacks its own tissues which causes widespread inflammation and tissue damage to the organs that are affected. This can affect your joints, skin, kidneys, blood cells, brain, heart, and lungs. Systemic lupus erythematosus is the most common form of lupus. While there is still no cure for lupus it can be treated with medications and lifestyle changes. 

Symptoms

The symptoms of lupus can vary in severity and progression depending on what area of the body is affected. Early symptoms of lupus include unexplained rash, ongoing fever, fatigue, or persistent aching. Most people will experience minor flares where symptoms will worsen for a while and then improve or completely disappear. Other commons signs include:

  • Joint pain
  • Stiffness and swelling
  • Skin lesions that appear or worsen with sun exposure. 
  • Fingers and toes that turn blue or white when exposed to cold or during stressful events.
  • Difficulty breathing and shortness of breath.
  • Chest pains
  • Headaches, memory loss, and confusion
  • Dry eyes
  • Butterfly-shaped rash that covers the cheeks and bridge of the nose on the face. (Also known as a malar rash)  

If you experience any of these symptoms it is important to see your doctor right away to slow down the progression of the disease. 

While SLE can affect people of ages and sex women between the ages 15-44 are at the highest risk for developing SLE. Lupus in women can cause pregnancy complications and are considered a “high-risk pregnancy.” However women with lupus are still able to safely become pregnant and have normal pregnancies. 

Diagnoses

An SLE diagnosis is determined by physical examinations, symptom assessments, x-rays and lab tests. It may be difficult to diagnose the early signs and symptoms because they can look like the symptoms of other diseases. SLE may also be misdiagnosed if only a blood test is performed for diagnosis. It is important to see a doctor who specializes in rheumatology for final diagnosis because of these challenges. A rheumatologist can better asses using specific criteria to classify SLE.

Treatment 

The treatment for SLE is often taken on by a team of doctors and specialists because of the number and range of organs that can be affected. Immunosuppressive drugs that inhibit activity of the immune system are one of the main forms of treatment. Other treatments that are often used include Hydroxychloroquine and corticosteroids. Prednisone is one of the more common forms of this type of treatment. 

Ankylosing Spondylitis

Ankylosing Spondylitis is a rare form of arthritis defined as an inflammatory disease that can cause bones in the vertebrate to fuse together. Spondylitis means inflammation in your vertebrae and ankylosis means fused bones.  This can result in the spine becoming less flexible resulting in a hunched-forward posture. The ribs can also be affected which causes difficulties with breathing deeply. Ankylosing spondylitis is a lifelong disease that often starts in the lower back and spreads its way up the spine. In some cases, it can spread up to your neck and cause damage to other joints in your body 

While there is no ankylosing spondylitis cure there are medications and exercises that can ease inflammation and pain.  

What are the Symptoms of Ankylosing Spondylitis?

Ankylosing spondylitis often starts in your lower back where your spine connects to your pelvis. The most common AS symptoms are stiffness or pain in your

  • Lower back
  • Shoulders
  • Hands
  • Buttocks
  • Rib cage
  • Hips
  • Thighs
  • Feet
  • Heels

Other symptoms of ankylosing spondylitis include:

  • Fatigue or tiredness
  • Swelling of the joints
  • Difficulty breathing or taking deep breathes.
  • Severe pain in the morning or after prolonged inactivity
  • A rigid spine that curves forward

You may also experience pain and inflammation in other parts of your body including your eyes, heart, and spine. 40% of patients who have AS have also been diagnosed with uveitis. Uveitis is a type of eye inflammation that can make you sensitive to bright light and blur your vision. If you have been diagnosed with uveitis be sure to check for symptoms of AS with your doctor. 

Diagnosis

While ankylosing spondylitis cause has not been determined by doctors, there are certain genetics that play a key role. People with the gene that produces a protein HLA-B27, a genetic marker, are 30% likely to develop AS. Other genes that increase the risk are ERAP 1, IL-17, IL-23, and IL-12. Most people will develop symptoms before the age of 45 and those who have Crohn’s disease, psoriasis, or ulcerative colitis are at higher risk for developing AS. If you test positive for HLA-B27 your doctor can work with you to begin treatment and help you manage the disease. 

Diagnosing ankylosing spondylitis can be done by examining genetic traits, family history, physical exam, x-rays, and MRIs. Imaging tests may not always show joint damage so it is important to keep track of any other symptoms you may have and be aware of your family’s medical history. Being diagnosed early on can greatly help to ease progression and improve your quality of life. 

Treatment 

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common prescription for people who have AS but they can lead to stomach bleeding, heart complications, and other side effects. In severe cases, biologics may be prescribed but they can also cause serious side effects. 

Ankylosing Spondylitis natural treatments are considered the best to help manage symptoms. Natural remedies include exercise and physical therapy. Stretching and remaining active helps to keep the spine strong and can help to rid you of pain. Working with a physical therapist is the most beneficial but there are several exercises that you can perform at home daily. Working out in water has been reported as the most effective for people who have AS. 

Switching to an ankylosing spondylitis diet can help reduce inflammation and ease joint pain. Foods high in Omega-3s, fruits, veggies, whole foods, and grains are all part of a healthy diet. Maintaining a healthy weight is also crucial to help keep stress off of joints and improve mobility. 

Smoking has been shown to increase symptoms and their severity for people as they age.

Only in very severe cases is ankylosing spondylitis surgery needed. The most common procedure is known as laminectomy. A laminectomy involves removing part of the vertebra bone to relieve pressure from the spine. While it is a minimally invasive procedure surgery can be prevented by maintaining a healthy lifestyle. 

Osteoporosis

Osteoporosis is a bone disease that weakens bones and can increase your risk of broken bones or fractures. It is often referred to as a “silent” disease as you may not have any symptoms and will now know until you break a bone. It is thought of as a women’s disease but osteoporosis in men over 50 has the same effects and dangers. 

Symptoms

The early stages of osteoporosis typically show no symptoms but once it has progressed you may experience

  • Back pain
  • Loss of height
  • a slouched or stooped posture
  • bones breaking more easily than expected

Because Osteoporosis symptoms are so difficult to detect it is important to see your doctor right away if you went through early menopause, you have a family history of hip fractures, or you took corticosteroids for several months in a row. 

Osteoporosis is very serious and can be very costly if it is not treated properly. Bone breaks are more likely to occur in the hip, spine, or wrist but other bones can be affected as well. Hip fractures are the most detrimental as it has been reported that 20% of senior citizens who break a hip die within one year due to either complications during surgery or the broken bone itself. 

Diagnoses

Measuring your bone density with an x-ray machine to determine the proportion of minerals in your bones is the most common form of diagnosis. A bone mineral density test will give you what is known as your T-score by comparing the amount of calcium in your bones to that of a younger adult. This test is painless and simple and is very important in helping to slow down the progression of osteoporosis. 

If you have a family history, joint pain, have broken a bone before the age of 50, or experienced early menopause it is important to speak with your doctor about getting an examination to help prevent any bone breakage or damage in the future. 

The risk of osteoporosis increase with age as the body begins to lose bone mass. Men tend to lose bone mass slower than women but by age 65 both men and women are losing bone mass at the same rate. 

Treatment

Osteoporosis medications are known as bisphosphonates. While they can help slow down progression, they can also upset the stomach and must be taken consistently.

There are several natural and lifestyle remedies that can decrease the risk of bone fractures. The most important form of treatment is preventative methods.

These methods include eating a healthy diet, not smoking, maintaining a healthy weight, and regular exercise to build strong muscles. Diets rich in vitamin D and Calcium help to strengthen bones and improve bone health in other ways. Exercises for osteoporosis include strength training, stretching, and other low-impact workouts. Strength training exercises help to improve the spine and are considered some of the best exercises. Cardiovascular exercises such as running, cycling, and rowing do not improve bone health and should be avoided if you have developed osteoporosis. 

Osteoarthritis 

Osteoarthritis is a degenerative joint disease that is sometimes known as the “wear and tear” disease. It is the most common form of arthritis and affects millions of people worldwide. OA works by breaking down the cartilage in your joints over time making them painful and swollen. OA most commonly occurs in the hands, knees, hips, lower back, and neck. While old age is the primary osteoarthritis because it can begin at any age. There have also been some cases occurring in multiple family members, that would suggest a gene linked to osteoarthritis. Overuse, injury, weak muscles, obesity, gout, diabetes, and unusual joints at birth have also been linked to developing osteoarthritis with age.

Symptoms

Symptoms are often not apparent right away but worsen in severity over time. Osteoarthritis symptoms include.

  • Swelling around a joint
  • Joint instability or buckling
  • Muscle weakness around the joints
  • Clicking or cracking when a joint bends
  • Limited range of mobility of a joint that may come and go
  • Stiffness right away in the morning or after long periods of inactivity
  • Pain or aching joints after excessive physical activity or at the end of the day

Osteoarthritis symptoms will vary depending on what joint it is affecting. In the hips, there may be a pain in the buttocks or the inside of the knee and thigh. Signs and symptoms of osteoarthritis in the knee include a grating or scarping feeling when moving the knee. In the hand, fingers can become swollen, red, and tender. There will often be pain experienced at the base of the thumb. In feet, the big toe can become tender, and the ankle may swell. 

Diagnosis

If you experience any joint pain, it is important to tell your primary care physician so that other tests may occur and treatment can begin. Osteoarthritis diagnosis methods include a physical examination, x-ray, MRI, and joint aspiration. Joint aspiration is a simple test that involves numbing an area and inserting a needle into the joint to pull out the fluid. This test checks for crystals in the fluid and can help rule out other forms of arthritis or medical conditions. 

Treatment

While there is no cure for osteoarthritis there are several treatments and preventative measures that can be taken throughout life. Osteoarthritis medications include nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, corticosteroids, hyaluronic acid, and counterirritants.

These medications in combination with a healthy lifestyle can greatly reduce pain and slow down progression. Doctors advise 2 and a half hours of moderate exercise per week. A combination of strength exercises, stretching, balance exercise, and cardio are advised to maintain a healthy weight and improve joint health. An osteoarthritis diet often includes whole foods and is low in sugar as high glucose levels can make cartilage stiffen and increases the risk of diabetes. Diabetes causes inflammation which weakens cartilage over time. 

In severe cases, surgery may be needed to relieve pain and restore mobility. Osteoarthritis hip and knee surgery are the most common procedures performed for osteoarthritis. By living a healthy lifestyle and practicing good habits surgery can avoid or put off for several years. 

Sjogren’s Syndrome 

Sjogren’s Syndrome is a chronic autoimmune disorder typically affecting the salivary and tear glands. This condition often arises alongside rheumatoid arthritis, lupus, and other immune system disorders. In Sjogren’s syndrome, the mucous membranes and moisture-secreting glands of your eyes and mouth are usually affected first. This typically results in a lack of tears or saliva.  

Although it’s typical for people older than the age of 40 to be diagnosed with Sjogren’s syndrome, you can develop it at any age. 90% of patients diagnosed with Sjogren’s syndrome are women.  

The symptoms are mild for many people and may worsen over time. Symptoms can often vary from patient to patient and may include: 

  • Dry eyes  
  • Dry mouth 
  • Dry skin 
  • Muscle or joint pain 
  • Respiratory issues including shortness of breath and coughing 
  • Rashes 
  • Swelling between jaw and ears 

Diagnoses 

Because there is no official test that will confirm the diagnosis of Sjogren’s, physicians typically conduct a series of tests and ask for a clarification of all of the patient’s symptoms. These tests include some of the following:

  • Blood tests 
  • Eye tests 
  • Dental tests 

Questions included in the diagnosis may include questions about ocular symptoms regarding dry eyes and oral symptoms. Complete medical history is often taken as well as discussing the various symptoms the patient may be experiencing.  

Treatment  

Sjogren’s affects each person differently, and therefore treatment options are usually given on a patient-to-patient basis. In some cases, over-the-counter products and lifestyle changes can help alleviate symptoms such as dryness. However, most patients will need prescribed medications to help control their disease and prevent further complications in the future. No single medication has been proven to slow the progression or treat all aspects of Sjogren’s. 

Scleroderma 

Scleroderma is a chronic autoimmune disease that causes inflammation in the skin and other areas of the body. As a result, the immune system causes the body to produce an enhanced amount of protein collagen, causing the skin and specific areas of the organs to harden, similar to the scarring process.  

There are two types of scleroderma. Localized, which mainly affects the skin, and systemic, which affects multiple systems in the body. Systemic scleroderma, or generalized scleroderma, is the more serious type of scleroderma and can damage various internal organs in the body.  

Scleroderma is relatively rare and generally develops in people in people between the ages of 35 and 55, although it is possible for it to develop in the pediatric stage. Scleroderma is known to be 4 times more common in women than men. 

Diagnoses 

Since the symptoms of scleroderma are so similar to other diseases, it can be tricky to diagnose. There generally are not any blood tests that can point directly to scleroderma, although a number of antibodies have been associated with the condition. To make an accurate diagnosis, a doctor will gather the patient’s medical history, do a physical exam, and conduct X-rays to look for abnormalities. 

Treatment  

Since symptoms vary so often, it’s hard to pinpoint a specific treatment for scleroderma. This is because the most common symptom is skin thickening and hardening, leaving very few options for treatment. Medications that are typically used in treating other autoimmune diseases, such as rheumatoid arthritis and lupus, generally are not affected for people with scleroderma.  

For other symptoms of scleroderma, it’s common to treat each one individually with medications specific to the symptoms. For example, antacids for heartburn, anti-inflammatory drugs for muscle pain, and ACE inhibitors for things like scleroderma kidney disease. 

Myositis 

Myositis is a rare group of diseases typically characterized by inflammation of the muscles. There are other types of myositis that are associated with skin rashes. This group includes juvenile myositis, dermatomyositis, polymyositis, and inclusion body myositis. 

Myositis is rare and the cause is often unknown. Since myositis is a group of diseases rather than one single disease on its own, symptoms vary and can either appear rapidly or gradually over an amount of time. Myositis symptoms can include: 

  • A reddish-purple rash over the eyelids or joints 
  • Muscle weakness 
  • Difficulty swallowing 
  • Loss of balance 
  • Fatigue 
  • Trouble raising arms 
  • Chronic dry cough 
  • Falling 
  • Trouble rising from a seated position 

Diagnoses

Diagnosis of myositis will typically include a physical examination so that doctors are provided with a better understanding of the patient’s overall condition. Treatment plans are highly specialized, so it’s incredibly important that an accurate diagnosis takes place. 

Other diagnostic tools can be used, such as blood tests, MRIs, spinal taps, and electromyography.  

Treatment  

Symptoms vary greatly depending on what type of myositis is diagnosed, so individual treatment for each symptom is generally recommended. Medications such as immunosuppressants and corticosteroids can be used, which will slow the body’s immune system to reduce its attack on the body. Physical therapy is also a common method to help improve the physical condition of the patient.