Smokers are at higher risk for Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic disease which affects roughly 1% of the population. Women are three times more likely to get it than men. It occurs more commonly in smokers. It can occur at any age even in children or elderly but the peak incidence of RA occurs in patients aged 40-60 years. If there is a family history of arthritis in first or second degree female relatives like daughter, sister, etc the risk of developing RA or arthritis is increased. RA causes pain, swelling and early morning stiffness of multiple joints especially the joints in the hands and feet. The immune system which helps us to fight infections starts attacking our healthy joints in RA. Apart from joints, RA can affect other organs like lungs, heart, kidneys, eyes and nerves. The duration of joint pains before treatment is initiated determines the response of treatment. The earlier the treatment is started, the better the outcome and damage to joints is prevented. Hence early diagnosis is crucial. The diagnosis is made by clinical examination followed by investigations including blood tests like ESR, Rheumatoid factor and Anti-CCP and x-rays.
Various treatment options are now available in the form of tablets and injections. Your rheumatologist will explain the benefits and side effects of these drugs and the expected treatment outcomes. The anchor drug in the treatment of rheumatoid arthritis is Methotrexate. RA if diagnosed in the early phase can go into remission by the available drugs. Newer medications called “Biologics” have improved the arthritis control in difficult to treat patients with RA, however they are expensive and should be tried after the first line medications have failed to control symptoms adequately. In special circumstances Biologics can be initiated as first line therapy for RA on the discretion of your Rheumatologist. Most people with rheumatoid arthritis can lead an active life while on treatment. The window of opportunity lies in diagnosing the condition early and starting treatment before joint damage has been established.
A key to successful control of any disease is living an active lifestyle and eating balanced diet. Endeavor to exercise half an hour every day and eat a good balanced high fiber rich diet with plenty of fruits, vegetables and dairy products. Learn to protect your joints from injury and cope with your pain and limitations. Feel free to ask your Rheumatologists about ways in which you can improve your general and emotional health.
Take home message: If joint pains persist for more than 6 weeks and early morning stiffness lasting for more than 30 minutes is present, consultation with a rheumatologist should be sought to evaluate for underlying Rheumatoid arthritis.
Dr Manish Dugar,
MBBS; MD (Medicine, CMC Vellore), FRACP (Rheumatology, Australia),