There are several misconceptions when it comes to arthritis with the most common being that it is something only older people suffer with. The truth is, that arthritis, especially rheumatoid arthritis, impacts patients of all ages (even me).
What is rheumatoid arthritis?
Rheumatoid arthritis is a systemic autoimmune disease that can affect multiple organs in the body but often manifests in joint pain and swelling. If you aren’t familiar with autoimmune disease, it is a condition where your immune system attacks your body causing chronic inflammation.
It is different from osteoarthritis which is a non-inflammatory form of the disease commonly caused by wear and tear to joints. If you suspect that you might have a form of arthritis, talk to your doctor right away. Rheumatoid arthritis is a serious condition and the impact is irreversible so it should be treated right away.
How do we diagnose rheumatoid arthritis?
Since the root cause of rheumatoid and osteoarthritis are different but the symptoms can manifest in similar ways, getting a proper diagnosis can be tricky but is key when determining a treatment plan. To differentiate the two, I often ask my patients questions like:
- When did your pain start?
- Is it worse in the morning or at night?
- Does stiffness last more than 30 minutes in the morning? If the answer is yes, rheumatoid arthritis might be the culprit.
- Do you experience a pattern of joint pain?
- Do you experience pain in your hands? Specifically your knuckles and finger joints?
- Do you have trouble taking off your rings?
Keep a close eye on when your symptoms are occurring, how long they last, etc. The more information you provide to your doctor, the easier it will be to reach a diagnosis. I focus heavily on patient history and listening to my patients but a lot of doctors want to see the symptoms for themselves before making a final diagnosis. This can be frustrating for patients because you might feel awful at home but then symptoms subside by the time you make it to the doctor’s office. Pay close attention to your body and keep a log of your symptoms.
What tests will be used to diagnose rheumatoid arthritis?
Labs are a key part of diagnosing rheumatoid arthritis. Inflammatory markers can come back negative even if you have active disease. Antibodies can also come back negative and you can still be diagnosed with rheumatoid arthritis. When diagnosing rheumatoid arthritis, doctors will likely order the following standard labs that might be indicators of RA:
- CBC or a complete blood count – This checks white blood cell count, hemoglobin, and platelets.
- Comprehensive metabolic panel – This checks kidneys, electrolytes, and liver.
- ESR – Erythrocyte sedimentation rate
- CRP – Measures C-reactive protein in the blood
- Rheumatoid Factor and cyclic citrullinated peptide (CCP) antibody
- CarP – Checks anti-carbamylated protein antibodies
While it can be an easy diagnosis if any of these labs come back positive, sometimes they do not which makes the diagnosis more challenging. Negative results do not mean that you do not have RA.
X-rays are also used in the diagnosis process to identify common indicators like bone thinning or erosion of the jaw (TMJ), hands, wrists, shoulders, elbows, neck, feet, or ankles. Since lungs, skin, and eyes can also be impacted, issues in those areas can also be indicators.
How do we treat and prevent RA?
There are several common medication types for treating RA. While all of them suppress the immune system in some way to block inflammation and preserve joints and other good tissues, there are some variations. Because all RA medications suppress the immune system to a certain extent, most of them can lead to an increased risk of infection. While there are various methods and they’re sometimes combined or mixed and matched, the two main medication options for RA are:
- Conventional Disease Modifying Medications (DMARDs) suppress the immune system broadly and tend to be a little weaker but have less side effects. Conventional DMARDs include Methotrexate, Leflunomide, Plaquenil, and Sulfasalazine.
- Biologic DMARDs (Biologics) are genetically engineered drugs produced by living cells and work in a more targeted way to attack immune proteins called cytokines. They are stronger medications with more significant side effects like allergic relations and in some rare cases forms of cancer such as lymphoma and melanoma. Some examples of biologics are Humira, Enbrel, Simponi, Remicade, and Cimzia.
When it comes to treating and preventing RA naturally, there are several factors to keep in mind including:
- Exercise is key – Strengthens muscles creates more support for joints so exercise is key whether you are trying to prevent RA and other health issues or if you have been diagnosed with RA and want to use exercise to manage your symptoms.
- Quit smoking – The Centers for Disease Control and Prevention (CDC) states that smoking significantly increases the risk of RA and can also cause symptoms of RA to advance more quickly.
- Lose excess weight – Carrying excess weight put individuals at a much higher risk of developing RA.
- Avoid exposure to environmental pollutants – Toxins can lead to inflammation.
- Avoid inflammatory foods – Limit intake of raw meat, alcohol, excess sodium, sugar, ultra processed foods, and saturated fats. These foods are all linked to increased inflammation.
- Try an anti-inflammatory diet – Food is fuel and there are a ton of foods out there that can help to nourish and heal your body like the omega 3 fatty acids in some fish and in herbs like turmeric.
If you have RA, there is hope!
As someone who has suffered with a chronic autoimmune disease and treats patients every day facing these challenges, I know how difficult it can be to keep a positive mindset when faced with a chronic illness.
Managing your RA might feel like a puzzle you can’t solve, but know that there is hope. With the right lifestyle and treatment, RA patients can live happy and fulfilling lives. I encourage you or your loved one suffering with RA or other autoimmune diseases to educate yourself on the condition and work collaboratively with your doctor.
Research on managing and preventing RA is ongoing and doctors have identified certain genetic and blood markers that could indicate if a person is at greater risk for RA so they can potentially catch and treat the condition early.
This article is for informational purposes only. Everyone is different so talk to your doctor about the right care for you. If you need help and do not not know where to turn, I encourage you to reach out and book an appointment with me at my clinic, Dr. Lifestyle. Check out my Youtube video on it here and be sure to subscribe for more videos like these!