arthritis treatment The early treatment of rheumatoid arthritis is fundamental

Do you have joint pain?
The early treatment of rheumatoid arthritis is fundamental

Illustration of an older adult rubbing the aching joints of his hands while cooking. Swelling, stiffness and joint pain can be a sign of arthritis. Rheumatoid arthritis is one of the most common forms. Pain and stiffness can interfere with your daily life, at home and at work. For some people, the disease is mild, but for others it can cause them disability. Scientists continue to look for the causes of this disease and ways to improve treatment.

Arthritis is an inflammation of the joints. There are more than 100 types of arthritis. While the symptoms may be similar, the underlying causes vary. Osteoarthritis is the most common type of arthritis. It is much more common than rheumatoid arthritis. Osteoarthritis is caused by the use and wear and tear of the joints. In rheumatoid arthritis, the immune system, which normally helps protect the body from infections and diseases, begins to attack the joint tissue.

Anyone can have rheumatoid arthritis. The disease usually begins in middle age or later. But it can appear at any age. Even children sometimes have a similar type of arthritis. Some types of arthritis affect one joint at a time, but rheumatoid arthritis can affect the entire body.

It is important to receive the correct diagnosis because each form of arthritis needs to be treated differently. To diagnose rheumatoid arthritis, doctors use your medical history, physical exams, x-rays, and laboratory tests. There is not a single test to detect the disease, and it is not easy to diagnose.

"Joint inflammation in rheumatoid arthritis is soft and very different from the hard bony protrusions in the finger joints that sometimes occur in osteoarthritis," explains Dr. Michael M. Ward, who oversees research on rheumatoid arthritis of the NIH.

Your joints may be red and hot. Pain and stiffness can be worse when you just wake up or have been resting for a prolonged period. With the passage of time, the immune system damages the resistant and flexible tissue (cartilage) that lines the joints. This damage can be serious and deform your joints.

Scientists do not know exactly what causes rheumatoid arthritis. It is probably a combination of genetic factors and environmental triggers, such as cigarette smoke or viruses. Hormones may also play a role in their appearance. Rheumatoid arthritis is diagnosed more in women than in men. The disease sometimes improves during pregnancy, or has a push after it.

What scientists do know is that the damage is caused by a malfunctioning immune system. The body's defense system mistakenly attacks the membrane that lines the joints, such as the wrists, fingers and toes. The joints of the neck, knees, hips, ankles and others may also be affected.

"The immune system is supposed to protect us," says Dr. M. Kirsten Demourelle, an arthritis expert funded by the NIH at the Anschutz Medical Campus at the University of Colorado. "It's supposed to help fight infections, but in rheumatoid arthritis, for reasons we still do not know, the immune system gets confused and begins to attack the joints."

Rheumatoid arthritis has no cure. But there are effective treatments. The treatment can relieve pain, reduce stiffness and inflammation of the joints and prevent further damage.

Advances in research have improved patient outcomes over the past 10 to 20 years. Doctors no longer wait to treat a person with rheumatoid arthritis. Now they know that they should start treatment immediately, before the damage to the joints gets worse. Early detection is very important to improve the likelihood that the treatment will be successful.


"If we achieve that his illness has a low activity at 6 months and that he enters remission (without signs of illness) in a 1 year, we have an incredibly high probability that the disease has a minimal impact on his life", says the Dr. Vivian P. Bykerk, arthritis researcher funded by the NIH of the Hospital for Special Surgery of New York.

There are many types of medications available. Many medications, such as NSAIDs (non-steroidal anti-inflammatory drugs) and steroids, reduce inflammation. These medications can be used in combination with others that have been shown to slow down the destruction of the joints.

NIH scientists helped develop a new class of rheumatoid arthritis medication called Janus kinase inhibitors (JAK). These medications suppress the body's immune response. Several years ago, the first drug of this type was approved by the FDA to treat moderate to severe rheumatoid arthritis. Researchers continue to investigate new types of medications and drug combinations.

"We really have to rely on our experience, we take into account the combination of the signs, the symptoms and the results of the blood tests to choose the right treatment," explains Bykerk. Once the treatment for rheumatoid arthritis has begun, patients should have frequent check-ups. Doctors may have to try and adjust several medications or combinations of medications to determine which is best for each person. In general, treatments must be continued long-term to keep the disease under control. Some people have symptoms for years or even throughout their lives. Sometimes, after months of having mild symptoms, they get worse again.

Bykerk also works with a team of scientists supported by the NIH who seek more effective treatment approaches. The team analyzes joint tissue and blood samples from people with rheumatoid arthritis to better understand the genes and proteins that trigger and drive the disease. Researchers seek to understand why some people respond differently to different treatments. They also hope some day to adapt the treatments to each person. Other studies explore how long people should continue treatment once the disease is under control to prevent it from coming back.

Rheumatoid arthritis can affect virtually every area of ​​your life, from your work to your personal relationships. If you have rheumatoid arthritis, you can do many things to help maintain your lifestyle and an optimistic outlook. Exercise helps maintain healthy and strong muscles, preserve joint mobility and maintain flexibility. Rest helps reduce joint inflammation, pain and fatigue. Ask your doctor how to achieve the best balance between exercise and rest for your particular case.

New research advances continue to help improve the quality of life for people with rheumatoid arthritis. Talk to your doctor about how to treat pain and joint stiffness in order to lead a full, active and independent life.
Definitions

Inflammation

Swelling and irritation caused by the body's protective response to an injury.
Smart elections

Signs of a learning disability

Consider consulting a doctor if you observe these signs:

    Do not smoke. Smoking increases the risk of developing rheumatoid arthritis.
    Stay active Walking, swimming and other types of physical activity help reduce pain and stiffness.
    Rest. Taking breaks from activity helps to reduce active joint inflammation and pain, and to fight fatigue.
    Take your medications. Follow your doctor's instructions about the use of painkillers and other medications.
    Use heat or cold. You can use hot or cold packs to reduce pain.
    Find a support group. It may be helpful to talk with others about their coping strategies.