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Severe rheumatoid arthritis affects the synovium and can cause pain, damage, and disability. It can occur in children and is more common in women aged 40-60. Treatment includes medication, surgery, and physical therapy. Genetic factors and viral infections may trigger the disease. Early treatment is important to reduce disability and prevent damage to other organs.
Severe rheumatoid arthritis (RA) is an autoimmune disease that affects the synovium, or joint lining, which causes pain and extensive damage. RA typically affects people between the ages of 20 and 60, but can affect younger victims. The cause is not known. Treatments for this disease include medications, surgery, and physical therapy. Long-term severe RA can increase the risk of other serious health problems, including disability and vision complications.
Unlike osteoarthritis, which is found in older individuals and involves wear and tear on the joints, severe rheumatoid arthritis, known as juvenile RA, can occur in children. Inflammatory cells release cytokines, causing changes in the synovium of the affected area. The lining becomes thicker and eventually the cartilage is destroyed, making the joints unstable. Usually the hands, wrists, feet and ankles are affected first. Eventually, your knees, hips, elbows, and shoulders will begin to show signs of the disease.
The first symptoms that people who have severe rheumatoid arthritis may notice at the outset are stiffness and pain in the joints, usually on both sides of the body. Swelling, redness and tiredness are common. As the disease progresses, severe damage will occur, causing decreased motion, bone destruction, and deformation that can render the patient nearly immobile. A patient who has long-standing severe rheumatoid arthritis may have a characteristic claw-like hand resulting from contraction of the ulnar towards the little finger.
Although the causes of chronic inflammatory diseases such as severe rheumatoid arthritis are unknown, genetic factors are suspected to increase susceptibility. Environmental triggers such as viral infection appear to activate the disease. It is more common in women aged 40-60. Identifying RA can be difficult and usually comes with time and observation. Blood tests for an elevated erythrocyte sedimentation rate (ESR), rheumatoid factor, and some antibodies can help diagnose the disease.
Treatment must begin quickly to reduce disability. Severe rheumatoid arthritis can affect other organs in the body, especially the eyes and lungs. Drugs called disease-modifying antirheumatic drugs (DMARDs) slow the disease but are not a cure. Immunosuppressants and anti-inflammatory drugs attack the immune response that is causing the symptoms. Aspirin, ibuprofen, and other over-the-counter medications can help relieve the pain of RA.
Physical therapy along with regular exercise will help keep stiffness at bay. Occupational therapy teaches patients to perform tasks in alternative ways to reduce painful joint stress. There are a number of assistive devices on the market to help patients walk or cook and allow them to maintain independence. When joints have been decimated, replacement surgery can allow patients with severe rheumatoid arthritis to function again.
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