Rheumatoid arthritis (RA) is an autoimmune disease affecting the smaller joints of hands, feet, wrists, elbows, and uncommonly knees and ankles by causing inflammation of joint structures. There is a presence of the HLA-DR 4 gene in the person suffering from Rheumatoid arthritis.
As Rheumatoid Arthritis affects a lot of organs and body systems, such as the cardiovascular or respiratory systems, it is called a systemic disease. As complex and multi-organ affecting is the diseases more are the misperceptions attached to it. Let us look at some such slip-ups and their clarities in detail.
- Rheumatoid arthritis and Rheumatic heart diseases are the same
They are both a part of rheumatic diseases but not the same. In Rheumatoid Arthritis when excessive joint inflammation occurs destroying the joint structures like a synovial membrane, capsule and joint cartilage certain metabolites of destruction invoke the production of body defense producing cytokines. The same cytokines along with a few other factors circulate in the body through blood vessels affecting all organs and the vessel themselves. These factors increase vascular permeability allowing for the flow of small molecules in and out. More risk factors may flow in and deposit in the vascular lumen narrowing it. Narrow vessels consequently increase blood pressure and may result in heart failure or attack. This meaning Rheumatoid arthritis and changes due to it can cause heart issues. On the other hand, Rheumatic heart disease is an ailment where rheumatic fever causes permanent damage to the heart valves. It starts with a fever and throat infection by streptococci followed by damage to the heart valves.
- Rheumatoid arthritis and osteoarthritis are the same
Both are forms of arthritis and cause joint pain and degeneration but their origin, pathology are all different. While osteoarthritis is a result of the normal ageing process rheumatoid arthritis is an autoimmune disorder associated with the presence of the HLA-DR 4 gene. While osteoarthritis restricts its effects on joints, rheumatoid arthritis has its effects on almost all systems of the body including cardiac and respiratory. While osteoarthritis affects weight-bearing large joints like knee and back, rheumatoid arthritis is mainly seen in smaller joints of hands.
- Rheumatoid arthritis only affects joints
Rheumatoid Arthritis affects a lot of organs and body systems, such as the cardiovascular or respiratory systems. It affects metabolism, arterial lumen, and lipid and cholesterol level in the body, leading to blood pressure, obesity, blood sugar, and ultimately heart diseases.
- Rheumatoid arthritis medication should not be taken for a longer period
On the contrary, leaving Rheumatoid arthritis medications is risky. The optimum dosage of Anti-rheumatic drugs keeps the cardiological and other systemic effects of rheumatic arthritis at bay. Clinicians are aware enough to prescribe you the safest possible medication to better your symptoms.
- Symptoms of Rheumatoid arthritis will subside on their own
Rheumatoid arthritis is a condition autoimmune, acknowledged by the presence of a rare gene. How on earth will the symptoms get better on their own? Rheumatoid arthritis once presented its symptom will remain till you will. The symptoms will only get better after proper medication and physical therapy.
- Rheumatoid arthritis is because of ageing
Absolutely not. Rheumatoid arthritis has no relation with ageing or wear and tear. The details have been explained in the above points.
- Exercises and Physiotherapy is bad for Rheumatoid arthritis
Numerous studies comparing Rheumatoid arthritis patients with and without physiotherapy showed a remarkable difference in their physical limitations and body function. Both of which improved arithmetically for patients with physiotherapy. Hydrotherapy has also been reported to better the symptoms of Rheumatoid arthritis.
- There is no management to Rheumatoid arthritis
While the disease is incurable, it is easily manageable. The optimum dosage of Anti-rheumatic drugs keeps the cardiological and other systemic effects of rheumatic arthritis controlled. Physiotherapeutic modalities and joint mobilization techniques make sure your daily living activities remain qualitatively unaffected. Lifestyle modifications always add to a healthy being with or without Rheumatoid Arthritis. Newer techniques involving targeted therapies with disease-modifying biologics have taken the treatment to newfangled echelons.
- Patients with rheumatic arthritis can’t eat anything of their choice
You may have to follow restrictions initially so that medications seize the intensity of disease like an anti-inflammatory diet, less sugar, less dairy, etc. Once the disease progression is controlled you can eat a lot of stuff only after your dietician formally permits you.
- If I have rheumatic arthritis so will my child
While it does put them at a higher risk, it is not always true. Contact your genetic counsellor for gene mapping to find more.
I am sure the above write up must have helped you develop a clearer picture of Rheumatic arthritis.
Dr. Rajesh Verma, Director & Senior Consultant Orthopaedics, Spine Surgery, Narayana Superspeciality Hospital, Gurugram