Rheumatoid Arthritis
Rheumatoid arthritis is an auto immune disorder where the body’s own immune system attacks body tissues. Most damage occurs to the joint lining and cartilage, resulting in eventual erosion of opposing bones. However the attack is not only directed at the joint but other parts of the body too.
It is one of the most debilitating forms of arthritis.
Stiffness, especially in the morning, which reduces during the day, is a classic symptom of RA. In osteoarthritis, the pain may worsen as the day progresses. It occurs mostly in people aged 20 years and above and commonly affects joints in fingers, wrists, knees and elbows. It is symmetrical i.e. appears on both sides of the body.
RA is difficult to diagnose, however x rays of joints and blood tests, such as testing for ‘Rheumatoid factor’ or an ‘Anti-CCP antibody’ can provide a more definitive diagnosis.
RA is associated with increased risk of heart disease and heart related problems. RA is an inflammatory disease, and because of this it can damage your blood vessels and cause them to narrow over time. This then increases the risk of heart disease. You are also more likely to be hospitalised die to myocardial infarction, angina or congestive heart failure.
Other symptoms include malaise (general feeling of being unwell), weight loss and muscle pain (myalgia). As many as 40% of people with RA experience symptoms of depression.
RA is 3 times more common in women than in men. Obesity and smoking can be factors in developing the disease with smokers being twice as likely to develop the disease compared to non smokers.
Arthritis
Arthritis is a general term to mean any disorder that affects the joints causing joint pain and stiffness. The term is Greek ‘Arthro’ meaning joint, and ‘itis’ meaning inflammation. There are over 100 types of arthritis but the two most common forms are osteoarthritis and rheumatoid arthritis. Other types include gout, lupus and fibromyalgia.
Osteoarthritis
Osteoarthritis is the most common form of arthritis. It usually results from wear and tear of the weight bearing joints such as back, hip and knee.
Essentially the cartilage wears away, and the two opposing bones rub together causing minor pain initially. During physical activity, soon the pain increases to a continuous state, even whilst resting.
Joint or limb deformities e.g. knock knee can help to contribute to knee or hip osteoarthritis. Risk factors include prior joint trauma, obesity and a sedentary lifestyle.
It is a disease usually associated with the elderly, with women being particularly affected.
More than 30 percent of women have some degree of osteoarthritis by the age of 65.
Treatment
There is no known cure for either rheumatoid arthritis or osteoarthritis. Treatment options vary depending on the type of arthritis and include physical therapy, lifestyle changes (including exercise and weight control) orthopaedic bracing and medications.
Drug therapy can be divided into two main groups;
- NSAIDS
- DMARD – Disease modifying anti rheumatic drugs, these suppress the immune system e.g. Methotrexate.
Methotrexate is usually taken in tablet form once a week. An injectable form is available is tablets are not tolerated. It may take 3-12 weeks for benefits to be noticed so an anti-inflammatory is needed as well.
Methotrexate can cause nausea, vomiting, diarrhoea, mouth ulcers, hair loss and skin rashes. I can cause fewer blood cells to be made and also affect the liver and lungs. Regular blood checks are therefore necessary.
You should consult your doctor or pharmacist if you develop any of the following:
- Sore Throat, fever or signs of infection
- Shortness of breath
- Unexplained bruising or bleeding
- Yellowing of the eyes
- Any new symptoms
For more advice or information call into your local McDaid Pharmacy
