Rheumatoid arthritis is a major health issue which is common in woman. It is an inflammatory autoimmune disorder. It affects approximately 1-2% of the population. Usually women are more prone to this chronic disease. RA is a systemic disease, autoimmune disarray in which the defense system of the body attacks the joints through the thin layer of cells called the synovium that line and lubricates the joints. The runaway resistant response blocks the synovium with infection-fighting cells that release proteins called cytokines. These are compounds that cause swelling. The synovium becomes inflamed with new blood vessels and begins to grow, kudzu-like, penetrating and further destructing cartilage and bone. Rheumatoid arthritis can occur at any stage of life.
The most noticeable symptoms of Rheumatoid arthritis are swollen joints and crippling stiffness, particularly of the hands and feet. Patient feels fatigue, fever and there is loss of appetite. This disease also affects heart and lungs and their surrounding membranes. The main symptoms are pain, stiffness, fatigue, and progressive joint destruction. Damaging effects of disease are on both physical activity and role functioning. It hits mental as well as physical health. Depression is most general mental disorder of RA affected patients. Dr. Anand Malaviya, India's foremost expert on the disease, cautions that this is a complicated order in Asia. He further stated that in India alone, approximately10 million people are affected with RA. Large number of doctors would be required to treat them all. There is a need to generate awareness among people to control this disease. Rheumatoid arthritis unlike osteoarthritis is not the result of wear and tear of the cartilage or other tissues surrounding the bone (The Hindu). Gender-linked personality factors that have been linked with mental and physical health outcomes may get worse with Rheumatoid arthritis patients. Many research reports indicate that the effect of the disease on psychological distress decreased over the years. It has been found that women affected by this disease exhibit more psychological symptoms rather than physical symptoms.
The cause of this disease is still uncertain, despite wide studies of many variables such as endocrinic, metabolic, nutritional, geographic, occupational, and psychosocial factors influence disease manifestation but not incidence of the disease. Statistical data that suggest infectious etiologies include resemblance of RA to caprine arthritis-encephalitis caused by lente viruses, mycoplasmal arthritis in rodents, and Erysipelothrix infections in swine. Measles and parvovirus have been cultured from seronegative RA joints. Current studies are examining these implications. Doctors should carefully attend the patient because wrong diagnosis can lead to serious problems as the patients may get permanent disability and malformation. There is a particular blood test for diagnosing RA and distinguishing it from other types of arthritis. It is known as the anti-CCP antibody test.
The best treatment of Rheumatoid arthritis is combination therapies. Since last 30 years, Methotrexate, a cancer drug is used to treat RA. The main objective of rehabilitation for patients with RA is to relieve pain, increased range of motion, increased strength and endurance, prevention and correction of deformities, and provision of various counseling and educational services. Many nonpharmacologic methods are available which to the physiatrist use to help out patients in accomplishing these goals. These techniques are therapeutic modalities, splints and orthotics, assistive device equipment, joint protection and energy conservation techniques, and education and therapeutic exercise programs. Superficial or deep heat is an effectual modality to alleviate joint pain and inflexibility caused by RA. It is also used to treat joints in preparation for ROM, stretching, and muscle strengthening exercises. Heat may be administered through moist hot packs, electric mittens, a hot shower, spas, ultrasound, diathermy, or paraffin. Both superficial and deep heating methods have been shown to elevate the intra-articular temperature in patients. Cold is preferred for treatment of an extremely inflamed joint. When cold is applied, results in decreased pain and decreased muscle spasm. Ice packs, ice sticks, topical sprays, or ice water is used to deliver cold. When these patients are compared to age-matched subjects without RA, a decrease in aerobic capacity and muscular strength is observed. This lessening is due both to the disease itself and to the lack of physical activity in these patients.
For patient with RA, exercise is an important part of the rehabilitation management. Aerobic conditioning in patients with RA perks up maximum oxygen uptake and decreases perceived exertion at submaximal workloads. At the same time, no unpleasant effects were observed in the joints of patients. Patient must exercise for thirty minutes daily, several times each week. Isometric exercises re-establish and maintain strength in patients with RA without feeling pain. Resistance exercises may be started when the isometric program has been well established and when the patient does not feel pain. Occupational therapy is also very effective for such patients. An occupational therapist may work in combination with the physical therapist to make certain that the patient gets relief. An occupational therapist may also help in the recommendation and use of splints and orthotics, especially when the upper extremity is affected.
Proper diet can be supportive as medications when patient is fighting from joint disease. Some foods naturally reduce joint disease symptoms. Numerous studies have revealed that fish oils, oranges, and plant oils can actually decrease joint inflammation from joint pain. The oils decrease joint tenderness and fatigue as well. Some dietitians advise organically grown fruits and vegetables. Cold water fish like tuna and salmon could help relieve rheumatoid arthritis as well with their omega 3 fatty acids. Person must make a balanced food plan to fight against such disease. Alcohol should be avoided on the special food plan, because it could act together with an arthritic medication. Patient of RA must take plenty of starch and fiber for energy. In addition, avoid saturated fat, cholesterol and fat found in many attractive foods. Rheumatoid arthritis also affects men and children. Therefore all of us should be careful and have balanced to avoid these diseases.