If the pain is very severe, the muscles surrounding
the affected joints contract and stiffen up.
This is called muscle spasm. People with rheumatoid
arthritis may lose their appetite and their
weight. General tiredness and fatigue are
related to the amount of inflammation present.
Sometimes, depression sets in and excessive
worry about having arthritis impedes improvement.
Other possible body changes include anaemia
(low red blood cell counts), lumps or nodules
under the skin, inflammation of the eyes and
pleurisy (pain in the chest on deep breathing).
Diagnosis
The diagnosis of rheumatoid arthritis may
require several visits to the doctor over
a period of time. You will be asked questions
about your symptoms. The doctor will perform
a physical examination, looking at and inspecting
each joint for signs of inflammation or other
problems. The diagnosis will be based on the
overall pattern of the symptoms, physical
examination, laboratory tests and x-rays.
The doctor may drain fluid from your joints
and examine it to make sure the arthritis
is not due to an infection or some other cause.
The fluid is removed by putting a needle into
the joint. Rarely, your doctor may remove
small bits of inflamed joint tissue or nodules
for examination with a microscope. This procedure
is called a biopsy.
Is There Any
Effective Treatment for Rheumatoid Arthritis?
YES. Treatment involves a combination of
medication, rest, exercise and methods of
protecting the joints.
Medication
This consists of anti-inflammatory
drugs which reduce the swelling, pain and
stiffness which result from the inflammatory
response. They are called non-steroidal
anti-inflammatory drugs (NSAIDs) and
include aspirin, ibuprofen diclofenic acid
and piroxicam. A patient's response to a particular
drug and the degree of disease activity dictate
the potency of the drugs prescribed. Some
patients require drugs called "disease-modifying"
agents such as gold salts, penicillamine,
sulphasalazine or methotrexate. The main aim
of treatment is the control of the inflammatory
process early so as to lessen the disability
that can result from long-term effects of
joint destruction.
Corticosteroids are drugs related to the
natural hormone cortisone. They are not often
used to treat rheumatoid arthritis unless
the disease is severe and has not responded
to other drugs. The decision to start or stop
corticosteroids must be made by your physician.
Exercise
Once inflammation is satisfactorily controlled,
appropriate and regular exercises is essential
to strengthen muscles weakened by disease.
Rheumatoid arthritis often makes joints stiff
and restrict their motion if they aren't used
regularly. Exercises are designed to meet
the needs of each patient and should be monitored
by professionals specialising in physical
medicine.
Heat and Cold Treatment
Heat and cold treatment are effective means
of relaxing muscles and relieving pain in
arthritic joints. A hot bath, hot pads, paraffin
wax and cold compresses are some methods frequently
used.
Adequate Rest
Rest decreases the swelling and pain around
inflamed joints and reduces fatigue. The number
of hours that a patient should rest every
day and the way they should rest should be
reviewed with your doctor. In some cases,
splints may be prescribed to rest joints,
hold them in correct positions and prevent
muscles around joints from becoming too tight.
No special diet causes or cures rheumatoid
arthritis. Nevertheless, a well-balanced and
nutritious diet is beneficial. If you are
overweight, a diet to reduce weight will reduce
stress on affected joints.
Is There a
Cure for Rheumatoid Arthritis?
NO. But with appropriate treatment the disease
can be kept under control. There is still
no drug or remedy which will wipe out the
disease in all cases.
What is the
Outlook for Patients?
Rheumatoid arthritis can be mild, moderate
or severe. For most people who begin to follow
a proper treatment program early in their
illness, the amount of permanent joint damage
is small. In fact, most of the disabilities
due to rheumatoid arthritis are preventable.
A small minority of patients develop severely
deformed joints. This is because of unusually
severe disease or neglect. In the early stages
of the disease with appropriate treatment,
the majority of patients improve. Most patients
with rheumatoid arthritis can look to the
future with confidence.
