What is it?
Rheumatoid arthritis is a disease which affects the joints and may affect other systems of the body. In its mild form, it may cause no more than minor discomfort and does not lead to serious joint deformity. In its most serious form, it causes painful, badly damaged joints.
As with other forms of arthritis, no cure has been found. However, advances in scientific research have meant that people with rheumatoid arthritis can be assured of effective treatment resulting in much less pain and fewer physical disabilities.
Who gets it?
Most commonly, it first develops between the ages of 25 and 50, but it is not uncommon among the elderly. A similar form of arthritis affects children.
It is three times more common in women than men and often first occurs in women in their 30s, at a time in their lives when they can least afford to be ill because of physical demands of home, family and employment.
What causes it?
The causes are not known. For many years researchers sought to identify an infectious cause, a virus or bacterium, without success. It is now thought that it involves the body’s immune system and that a triggering agent causes the disease only in people with genetic or inherited susceptibility.
How does Rheumatoid Arthritis affect the body?
It results from over activity of the body’s immune system. For reasons not fully understood, the body’s immune system attacks its own organs, in this case the tissues surrounding the joint.
The auto-immune reaction causes inflammation of the joints, particularly of the synovial membrane which lines them. There is an over-production of synovial (joint) fluid and this, combined with the inflammation, causes joints to become swollen and painful. If the process continues, damage to the cartilage can cause joint deformities.
Symptoms
- Pain and aching in and around joints, particularly the hands, feet and knees. Joints on both sides of the body are usually affected equally
- Joint stiffness, most noticeably in the morning
- Swelling of joints, particularly hands, feet, and knees
- Persistent fatigue and feeling “run down”
- Muscle weakness associated with stiff joints and decreased physical activity
- Inability to sleep well at night due to painful joints
Rheumatoid Arthritis can develop gradually or can start with a sudden, severe attack.
It is a chronic disease and may last a lifetime. Often, however, people experience periods of remission, when the disease subsides. Remissions can vary from short periods of time to many years and, in some cases, the disease does not reappear.
Diagnosis
The first requirement is a thorough physical examination and assessment by a general practitioner or rheumatologist (specialist in arthritis).
Sometimes a diagnosis cannot be made straight away. Laboratory tests may be needed to assist diagnosis and blood tests used to identify an antigen called rheumatoid factor, present in about 80% of people with the disease. A test called the erythrocyte sedimentation rate (ESR) is sometimes used to assess the degree of disease activity. A high ESR indicates more active disease.
X-rays are not necessary to make a diagnosis, but they help to determine whether damage to bones or cartilage has occurred. However, it is rare for damage to occur in the early months of the disease.
Management
The management of rheumatoid arthritis usually involves a combination of education, medication, exercise, rest and understanding of how to protect the joints.
An individual management program can be planned by the doctor and person involved, in consultation with other members of the health team. These may include a physiotherapist, occupational therapist, nurse, podiatrist and dietitian.
If management is started early and the person affected carries out his or her program conscientiously the chances of long-term damage to joints are minimised.
How Physiotherapy can help Rheumatoid Arthritis
A Physiotherapist can help you to manage your pain by getting you moving safely, rebuilding and restoring affected joints, and increasing your strength whilst maintaining your fitness, so that you’re able to take part in your daily activities.
Your Physio can tailor an exercise program for you, that will help to increase your strength, flexibility, balance and coordination, this may include a Physio Group Exercise routine. They’re able to give you tips to improve your posture, so that you can take part in daily activities with less pain and improved movement. Your Physio can analyse your daily environment and recommend items such as ergonomic furniture or a cushioned mat in your kitchen that will help to relieve your pain.
Your Physio is also able to suggest and show you how best to use assistive items such as walkers and canes. They can also recommend other treatment techniques such as braces and splints for your joints, as well as hot and cold therapy to relieve stiffness and joint pain.
Self Help and Education
Management is a daily activity. It involves constant readjustment to the demands of life and of the disease. Research has shown that a person’s attitude and communication is of utmost importance.
People with rheumatoid arthritis should have adequate knowledge of the condition and its management. This will enable them to be actively involved in making decisions regarding management and helping themselves. Self-help means being willing to learn about and assume responsibility for the daily care of the condition.
Important aspects of an education program include:
- Pain management, including the use of hot and cold packs
- Stress management, including meditation and assertiveness training
- Relaxation, including deep breathing and visual imagery exercises
The arthritis foundation in every state runs education programs to provide people with rheumatoid arthritis with information about management and a chance to meet other people with similar problems. To make a booking with one of our Physios at a location across metro Adelaide press here. You can find out more about how the services that we provide can help you, by visiting this link.