Rheumatoid arthritis (RA) is a recurring, systemic, inflammatory joint disease which occurs in about 1% of the population, causing a symmetrical polyarthritis and generalized involvement of many tissues such as the skin, eyes, lungs and heart. Due to the logic-wide effects patients often feel fatigue, have depression and marked stiffness in the mornings. As RA causes peripheral joint hurt it is the cause of a large amount of disability in sufferers, but recent scientific advances in drug therapy hold out the hope of reducing or preventing joint hurt. Infections are often linked with RA but an agreed cause has not been found.
As rheumatoid arthritis is responsible for high levels of disability, disease complications and increased mortality, it is not a benign process. As activities of daily living (ADL) can be terribly affected about a third of patients are powerless to work with 5 years since their diagnosis and with ten years 50% typically have an vital loss of ability to function. The rheumatoid complications and therapy side effects may result in a shorter life span by five to ten years, RA occurs across ethnic groups and is more common in women in a ratio of three to one. The peak time for diagnosis is between thirty-five and fifty years but RA can be diagnosed in children and in elderly persons.
Rheumatoid arthritis diagnosis is made by the doctors clinical examination and by the self report of the patient rather than laboratory tests. A typical complaint is severe stiffness in the morning, left over for an hour or longer until it improves as much as it is going to. Three joint areas must be affected by the swelling and pain of arthritis, with a symmetrical joint presentation and involvement of the hand tiny joints. Usually the disease comes on slowly but sometimes here is an acute, sudden onset of severe joint swelling and pain. Typical symptoms also include losing weight, feeling below par, a fever and muscle pain.
The management and treatment of RA involves a wide multi-disciplinary team try due to the complex scenery of the disease. RA is a honest disease with severe effects upon an individual so educating the patient about the condition and how to cope with the problems and the treatment is vital. Physio treatment concentrates initially on joint pain and inflammation, moving on to range of movement and the maintaining of muscle strength. Occupational therapists give joint protection advice, provide joint splinting, activities of daily living and home adaptations. Orthopaedic intervention is common as joint hurt progresses, with joint substitution a common treatment.
Anti-inflammatory drugs and painkillers are the initially drugs of scale to treat the inflammation and pain, with disease modifying anti-rheumatoid drugs (DMARDS) added to attack the rheumatoid process itself. DMARDS are the product of intensive scientific research into the underlying rheumatoid process, basing the drugs actions on the real pathological process occurring in patients. These drugs are able to interrupt the disease process itself, slowing or stopping the joint hurt which has such negative effects on functional abilities, allowing a much brighter outlook for the future for patients with rheumatoid and other arthritic diseases.
Physiotherapists in rheumatology routinely assess are treat patients with rheumatoid arthritis, initially watching their gait as they walk in and observing any joint abnormalities. Common areas of joint distortion are the hands, primarily the knuckle joints, the knees and the wrists. Hand function can be terribly impaired by the joint deformities which develop, leading to honest difficulty in doing normal manual tasks we take for granted. Walking ability is assessed by physios due to the affects of RA on the hips, knees and feet which limit weight bearing function, along with the complications of the hands being powerless to use walking aids easily.
Initially, as the joints are inflamed and painful, physio treatment aims to rest the joints, reduce inflammation and pain, protect the joints with splints and to maintain function by gently joint exercise. When the condition becomes sub-acute the physiotherapist will include range of motion exercises and strengthening along with functional work. Successful management of RA requires a thwart-disciplinary co-surgical procedure due to its complex scenery.
Jonathan Blood Smyth is Superintendent of a large team of Physiotherapists at an NHS hospital in Devon. He specialises in orthopaedic conditions and looking with joint replacements as well as managing recurring pain. Visit the website he edits if you are looking for physiotherapists in Leeds or elsewhere in the UK.
