63 woman this month | November 2011 | synovium as well as the joint. While RA is often associated with old age, the common age of occurrence is anywhere between 40 and 50 years and can have a much earlier onset. For reasons unknown, the occurrence of rheumatoid arthritis is three times more common in women than men. Causes Although there are no established causes for rheumatoid arthritis, its occurrence is commonly linked to virus infection, genetics and a variety of hormonal factors. People who have a family history of this disease are more likely to develop it themselves. Early Signs Joint pain is one of the earliest symptoms of RA, as is early morning stiffness that lasts beyond 30 minutes. Small joints, such as wrists and fingers closest to the hand are usually the first to be affected. Joint inflammation could be accompanied by fatigue and an occasional fever. The swelling can occur in multiple joints and is usually symmetrical, that is, it affects joints on both sides of the body. The symptoms can worsen in winter or in an air-conditioned environment. RA affects different people differently and symptoms can range from mild to severe. In most cases the disease is chronic, meaning it lasts a long time — often a lifetime. For many people, periods of relatively mild disease activity can be punctuated by flare ups, or times of heightened disease activity, while for others, symptoms are constant. Women should be especially careful since they’re three times more likely to develop this disease and the symptoms are usually suppressed during pregnancy. What Next? Early intervention is crucial in the treatment of this condition. Often, people ignore the early RA symptoms, believing their joint stiffness is the normal consequence of aging. However, if left to progress, the symptoms can worsen. The pain can become more intense as the synovium thickens. Inflamed cells produce a particular type of enzyme that eats into bone and cartilage. This can cause even more pain and can also cause the bone to deform. In advanced stages, the joints lose shape as tendons slip out of place. Fingers or toes can curl, the hip gets out of alignment or the shoulders slump. Additional complications may develop, affecting the heart, lungs, eyes and may include skin rashes and hair loss as well. Treatment Even though it’s not completely curable, RA is a treatable disease that can be kept under check with early intervention. Physicians primarily administer disease-modifying medicines, commonly known as DMARDs (disease-modifying anti-rheumatic drugs), for the three to six months, coupled with anti-inflammation drugs and steroids. However, DMARDs work best when administered at the earliest possible stage — within the first three months of diagnosis — so it is important to find a specialist as early as possible to manage your condition. “It’s important that a diagnosis is made at the earliest and a patient comes for investigation on experiencing any symptoms. If treatment is started early, many complications can be arrested,” notes Dr Sumod Sukumaran, Specialist Orthopaedic Surgeon attached to KIMS Bahrain Medical Centre. When complications have developed as a result of neglect or the condition is not responding to treatment, surgery can be performed to remove the damaged covering of the joint. In case there’s deformity in the joints, corrective surgery including complete joint replacement can also be carried out. Managing Rheumatoid Arthritis If you have been diagnosed with RA, take heart — it’s not the end of the road for you. “The treatment available for RA is excellent and the condition can be as good as cured with proper and early intervention,” observes Dr Sumod. Since RA is a lifelong disease, regular follow ups with the physician, life-long monitoring and treatment is crucial to keep the condition under check. It’s important to catch any changes early. Your visits to the specialist can involve frequent examination of your joints to look for swelling, changes in strength or changes in range of motion, while periodic X-rays and blood tests can follow active inflammation or joint changes. Certain lifestyle changes can also help alleviate suffering in this condition. “Try to keep the body warm as far as possible and take a warm shower before going to bed at night and in the morning. Women should take regular exercise to relieve stiffness in their joints. They will also benefit if they keep their body weight in check as overweight people put more strain on their weight bearing joints,” advises Dr Sumod. Regular, gentle exercise is very beneficial in reducing overall pain from RA, while also strengthening the muscles around a joint and improving its stability. It also improves your functional ability and lets you accomplish more for yourself. Low impact exercise such as walking, cycling and swimming, particularly in heated pools, is recommended. Women with RA often fall victim to depression. Finding other patients and building a support system or joining an online community can be really worthwhile, since no one understands RA as much as someone who’s already been there.
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