Rheumatoid arthritis: symptoms and treatment

Hyperhidrosis – or excessive sweating – can range from mild to severe. It can be a slight nuisance, or a condition that interferes with work and is socially embarrassing. Studies show more than seven million people in the U.S. suffer from Hyperhidrosis.

Rheumatoid arthritis is caused when your immune system is not working properly. Often abbreviated "RA," rheumatoid arthritis causes a variety of symptoms, most notably pain and swelling in the wrist and small joints of the hands and feet. It is also sometimes called rheumatoid disease because it can cause systemic illnesses that impact several organs of the body.

Anyone can get RA, though it occurs more often in women. The onset of rheumatoid arthritis often begins in middle age and is common in older people, but children and young adults can also get it.

While symptoms of rheumatoid arthritis are similar to other illnesses, diagnosing RA early on can be helpful in limiting the long-term effects of the disease. The illness is said to fluctuate in levels of “activity” and the treatment goal is to achieve remission where possible. Symptoms and signs include:

• Anemia: The chronic inflammation of rheumatoid arthritis often causes the bone marrow to decrease the release of red blood cells into the circulation. This lowers the red blood count to cause anemia when rheumatoid arthritis is active.
• Fatigue: This can be caused by the body's reaction to inflammation, poor sleep, anemia, and medications.
• Fever: Fever, while not common in rheumatoid arthritis, does occur in some patients when the disease is actively causing inflammation. Because patients with rheumatoid arthritis frequently require medications that can decrease the normal immune response, it is important that when they develop fever, infection is considered as a possible cause. Infections can require aggressive treatment and interruption of some underlying rheumatoid treatments.
• Joint deformity: Deformity occurs when unchecked inflammation leads to erosion of cartilage and bone as well as ligament loosening. Early detection and treatment is critical to prevent permanent joint destruction and deformity.
• Joint pain: When the disease is active, pain is caused by inflammation in a joint. However, if the joint has been damaged by RA in the past, pain can also occur when the disease is inactive or controlled.
• Joint redness: This occurs because the capillaries of the skin are widened by the nearby inflammation.
• Joint stiffness: Joints affected by active rheumatoid arthritis are inflamed and typically stiffer in the morning than later in the day. The duration of the morning stiffness is a measure of the severity of the inflammation.
• Joint swelling: Swollen joints are very common and can lead to loss of range of motion of the joint.
• Joint tenderness: Inflamed joint lining tissue may irritate the nerves in the joint capsules. The pain from compression is immediate, which is why RA can often lead to insomnia.
• Joint warmth: Warmth of the joints is a sign of active inflammation.
• Limping: Limping frequently occurs when rheumatoid arthritis affects the hips, knees, ankles, or feet. A child with rheumatoid arthritis may have a painless limp as the first sign of the disease.
• Loss of range of motion: Range of motion is limited by the swelling within a joint. Joints affected by longstanding RA commonly lose range of motion permanently.

The first strategy is to quickly reduce or stop inflammation and if possible, put the disease in remission with early, aggressive treatment. A treatment plan will also be developed to:

• Relieve symptoms
• Prevent joint and organ damage
•  Improve physical function and overall well-being
• Reduce long-term complications

There are many different drugs used for different purposes in the treatment of rheumatoid arthritis.

• Nonsteroidal anti-inflammatory drugs (NSAIDs), available over-the-counter and by prescription, are used to help ease arthritis pain and inflammation. They include ibuprofen and naproxen sodium, among others.
• Corticosteroid medications are potent and quick-acting anti-inflammatory medications. Because of the risk of side effects, doctors prefer to use these drugs for as short a time as possible and in lowest sufficient doses.
• DMARDs, short for “disease-modifying antirheumatic drugs,” are drugs that work to modify the course of the disease. These medicines can be taken by mouth, injected or given as an infusion in a doctor’s office.
• Biologics are a subset of DMARDs. They may work more quickly than traditional DMARDs, and are injected or given by infusion in a doctor’s office. Because they target specific steps in the inflammatory process, they don’t threaten the entire immune response as some other RA treatments do. In many people, a biologic can slow, modify or stop the disease, even when other treatments haven’t helped much.
• JAK inhibitors, a new subcategory of DMARDs, block what is known as the Janus Kinase or JAK pathways, which are involved in the body’s immune response. Unlike biologics, they can be taken by mouth.

For people seeking relief from permanent damage that limits daily function, mobility and independence, joint replacement surgery is an option. The procedure involves replacing damaged parts of a joint with metal and plastic parts. Hip and knee replacements are most common. However, ankles, shoulders, wrists, elbows, and other joints may be considered for replacement.