Dr. Dollinger: Rheumatoid Arthritis

If you, or anyone you know, deals with rheumatoid arthritis (RA), you know it can be just plain miserable. The pain, the stiffness (especially in the morning), the swelling and heat, the way it can deform the hands; all of this can be absolutely awful to deal with. Fortunately, advances in treatments are making huge differences in people’s lives, putting an end to much of that misery.

There are two main types of RA, juvenile and adult. For adults, it usually begins at middle age, sometimes staying on one side of the body or in one joint, but it can affect both sides of the body and can progress into multiple joints. RA is not inherited, however, certain genes are thought to possibly be triggered by infection or environmental factors. RA is an autoimmune disease, which means the body starts recognizing a joint as a threat and attacks that joint, causing pain, inflammation, stiffness, and deformity.

Diagnosing RA is based on whether a person has 4 or more out of 7 common symptoms. These symptoms, when occurring for more than 6 weeks, include:

  • Stiffness of the joints, especially in the morning,
  • 3 or more joints affected,
  • Hands and feet affected,
  • Both sides of the body,
  • Nodules under the skin,
  • Blood test results showing elevated rheumatoid factors,
  • Positive x-ray results.

Treatments can include simply using an anti-inflammatory (like ibuprofen), using prednisone (which can be a powerful treatment with equally powerful side effects), or using medical gold preparations. Newer treatments include DMARDS (disease-modifying antirheumatic drugs) like methotrexate, Plaquenil, and Arava, and biologic agents, like Humira and Rituxan. These medications have been showing amazing results, helping many people return to relatively normal joint health; however, these new medications can also be a little expensive. Finally, surgery may be a last resort, with reconstructive surgery for hands and feet and joint replacements for hips and knees.

There are also natural remedies that can help ease symptoms. Of course, different people have different results, and the FDA has not approved any of these remedies for the treatment of RA. That said, some say that acupuncture can be helpful, as well as staying on an anti-inflammatory diet (like a gluten-free diet). This may be useful for those who prefer to stay off of medications for as long as safely possible.

In the long run, as much as rheumatoid arthritis can be a debilitating disease, there is new and continued hope for effective treatments, which help people return to many of the things they once loved. Arnot Health’s Orthopedic Care, as a part of the Human Motion Institute, is a perfect place to start, if you, or a loved one, are dealing with rheumatoid arthritis.

To schedule an appointment with Dr. Beth Dollinger, click here to find her contact information listed in our provider directory.

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