Ronald W. Smith, M.D.

Rheumatoid Arthritis

reumatoid2I.      Definition:  Rheumatoid arthritis (RA) is a disease that attacks multiple joints throughout the body.  It causes inflammation, pain, swelling, and stiffness in the joints, and can be quite debilitating.   The affected joints may feel warm when in use.  Additional symptoms include loss of appetite, fever, loss of energy, anemia, and rheumatoid nodules (lumps of tissue under the skin).  It can be chronic with stages of active flare-ups and remissions.  In 90% of all RA cases, symptoms are experienced in the foot or ankle and are often the first indications of RA.  The symptoms typically appear in the toes and forefeet first, then appear in the hind feet, heel, and finally in the ankles.  People who suffer from RA often develop severe foot problems such as hammertoe and bunions.

II.      Cause:   The specific cause of RA is unknown but there is an underlying abnormablity in the immune system that affects joints, tendons, small muscles, and other tissues.  Some research indicates that heredity plays a role.  Studies indicate that females are more likely to suffer from RA than males.  A blood test can usually determine if you have rheumatoid arthritis.
III.      Treatment and Prevention:  There are a number of techniques used to ease the pain and reduce inflammation of the joints.
•    Special footwear including shoes with an extra-wide toe box, arch supports, or orthotic devices can ease the pain by taking pressure off the affected joint.
•    Exercising is important to maintain strength and mobility of the joints.  Emphasize low-impact activities, such as biking or swimming.
•    Resting the affected joints can help with the recovery of inflamed joints and prevent further damage.
•    Maintaining a healthy weight avoids placing additional pressure on the affected joints.
•    Medications such as aspirin, other anti-inflammatory drugs, or a number of prescription drugs recommended by your personal physician can relieve pain.
If arthritic pain and swelling is not relieved by prescribed medications or if you are developing progressively worsening deformities, you should seek medical advice from an orthopaedic specialist.  If conservative treatments fail to provide adequate help, surgery may be a recommended form of treatment.  Surgery may involve making an inflamed joint solid (fusion), excising a joint, replacing a joint with man made implants, and repairing affected tendons.

RA is a progressive disease that currently does not have a cure.  However, medications, self-care treatments, and surgical procedures of today can help ease the symptoms of the disease and may slow its progress and development of severe deformities.

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