Rheumatoid arthritis, what is it?
Rheumatoid arthritis is a chronic inflammatory disease of your joints. It is an autoimmune disease: it means your body makes antibodies against your own joints.
Any joint can become inflamed, but it is usually the joints of the hands and feet that are affected.
What is the difference between rheumatoid arthritis and ‘rheumatism’?
In popular parlance, we often speak of “rheumatism” to refer to rheumatoid arthritis. But this is not quite correct. “Rheumatism” is a word used for a number of joint disorders. Rheumatoid arthritis is one such disorder.
How does rheumatoid arthritis develop?
Rheumatoid arthritis is a chronic disease. Early diagnosis and treatment is important to keep your symptoms and disease under control. So your joints don’t get damaged and you can continue to function.
The course of the disease is different from person to person. You can have :
few symptoms;
flare-ups that can affect your joints and lead to deformities later
an alternation of periods with few complaints and periods with severe complaints.
Rheumatoid arthritis and other conditions
Rheumatoid arthritis increases the risk of cardiovascular disease.
It can be associated with:
other conditions such as dry eyes and dry mouth (Sjögren syndrome), or osteoporosis;
a higher risk of infection if the inflammation of the joint persists.
Where and how often?
Rheumatoid arthritis affects about 1 in 100 people. If one person in the family has the disease, it affects 3 to 5 in 100 people.
Rheumatoid arthritis can start at any age, sometimes even at a young age. It is more common in women.
Smoking doubles the risk of rheumatoid arthritis.
How to recognize rheumatoid arthritis?
Rheumatoid arthritis usually starts gradually. People mostly suffer from swollen, painful and stiff joints.
Inflammation of the joints in rheumatoid arthritis
The inflamed joint:
is swollen;
is tender or painful, even at rest and at night;
may be hot to the touch;
may be red;
is not easy to move;
usually causes more discomfort in the morning. The stiffness lasts more than half an hour after getting up, but it can also appear at night. Symptoms decrease with movement.
Often, it is the small joints that become inflamed, usually the ones:
hands (except the joints between the last phalanges) and wrists;
feet and ankles.
Sometimes the large joints become inflamed, those:
knee;
elbow;
of the shoulder.
Usually the inflammation affects both sides of the body.
Other complaints
In addition to joint complaints, you can also have:
inflammation of your tendons (tendonitis);
inflammation of the eyes;
bumps on the skin, for example at the elbows (elbow extension side);
fatigue;
a slight fever;
a feeling of general ill-being.
How is the diagnosis made?
Discussion and physical examination
Your doctor will ask you a few questions:
what are your complaints?
Are there people in your family who have the same symptoms, now or in the past?
Then it will examine you:
a general clinical examination;
an examination of your joints.
Other examinations
Your doctor may order your blood to be tested for antibodies:
rheumatoid factor (RF);
antinuclear antibodies (anti-CCP).
If these antibodies are found in your blood (positive results), they may indicate rheumatoid arthritis. But the result can be positive even if you do not have rheumatoid arthritis (this is called a false positive).
Conversely, if these antibodies are not found (negative results), it does not necessarily mean that you do not have rheumatoid arthritis. Indeed, out of 3 people with rheumatoid arthritis, one person does not have these antibodies (false negative).
Orientation
A blood test is not helpful when your doctor is pretty sure you have rheumatoid arthritis. He will then generally refer you straight away to a specialist (rheumatologist).
What can you do ?
Do you have symptoms that sound like rheumatoid arthritis? So see your GP.
If you have rheumatoid arthritis, it is helpful to take the following tips:
Try to quit smoking:
it can improve treatment results;
your risk of cardiovascular disease will no longer increase.
Keep moving, despite your joint pain ulars.
To move.
Exercising is safe, even if your joint is swollen and stiff in the morning. Are you hesitating? Ask your doctor or physiotherapist for advice;
You can learn exercises under the supervision of a physiotherapist.
Move, why?
Moving has a positive effect on:
pain,
stiffness,
your day-to-day functioning.
It is good for the heart and blood vessels.
Move, how?
Walking, cycling or swimming are good choices;
The intensity is good if after 10 minutes you start to sweat a little, breathe more deeply, if you can still speak, but sing more.
Strength training twice a week is very helpful. You do not know how to do it ? Your physiotherapist can help you.
Take your medication well.
Contact your doctor:
if you have difficulty following the exercise advice correctly after starting treatment;
if you have trouble taking your medicines correctly;
if you want to get pregnant because some anti-rheumatic drugs should not be taken during pregnancy;
if you are sick or have a fever for the following reasons:
certain anti-rheumatic drugs reduce your resistance,
if you have an infection with bacteria, you will need to start antibiotics soon,
you may need to stop your treatment for a while.
if you are due to have an operation because you may need to stop your treatment for a while.
What can you do with your physiotherapist?
Exercises and tips
If you have rheumatoid arthritis, your physiotherapist will follow you closely. In consultation with you and taking your situation into account, he will give you:
information and advice;
instructions for exercising;
Informations about :
the impact of exercise on the development of your condition and on your functioning,
the possible positive effects of exercise on your health,
opportunities for exercise and sport.
A more active lifestyle can be learned
Is exercising too difficult for you? Your physiotherapist can help you start over or relearn how to move and exercise.
Your physiotherapist
gives you information and advice;
helps you realize that physical activity:
has a positive influence on your general health,
helps you maintain a healthy lifestyle.
temporarily supervise your physical activities.
It is important that you are able to move and exercise.
To exercise :
does not represent any danger;
improves your quality of life;
helps you feel better, physically and mentally;
decreases your cardiovascular risk;
often relieves pain, even if you feel discomfort at first;
improves the mobility of your joints;
improves muscle strength, allowing you to:
to function better;
to better control your joints.
Little by little, you will notice that:
you start to enjoy moving again;
you can move normally again, maybe as before or even better;
you function better every day.
A tailor-made program
With your physiotherapist, you can discuss:
your goals;
which seems feasible to you, despite your health problems.
It can give you information on:
the course of rheumatoid arthritis and the possible consequences for your functioning;
treatment options and your own role in treatment;
exercise therapy and what you can expect from it
a more active lifestyle with enough rest;
adapt the intensity of the effort based on how you feel so that physical activity and exercises become feasible for you;
how to perform the exercises independently and integrate them into your daily life;
how to participate in exercise and sports programs that can also be fun.
If you have difficulty walking, cycling or swimming, the physiotherapist can help you:
practice specific movements;
safely increase the quality and quantity of exercise;
practice daily movements in case of specific joint complaints or fatigue.
Your physiotherapist can offer you extended support when:
you have difficulty performing more complicated movements on a daily basis;
your condition is not well controlled and your joint (s) are not working well;
you feel discomfort every day and your joints are severely damaged;
you have a prolonged loss of function of the joints;
your joint problems are a problem at home or at work.
Follow-up in a rehabilitation center
How is it
does he pass a rehabilitation center (physical medicine)?
An assessment of your physical and functional capacities is carried out to offer you training that takes into account your complaints and your limits;
You perform physical exercise under the supervision of physiotherapists who adapt the intensity and amount of exercise with the aim of obtaining maximum benefit from performing physical activity;
The goal is to teach you and to (re) give you a taste for regular physical activity;
An occupational therapy follow-up can be useful for the implementation of technical aids and advice to facilitate your daily functioning;
This treatment is carried out in close collaboration with rheumatologists and physical physicians for optimal monitoring of your disease.
Continue
After the accompaniment of your physiotherapist, try to stay as active as possible. This is how you will benefit the most from all the support offered by your physiotherapist.
What can your doctor do?
If the rheumatologist confirms that you have rheumatoid arthritis, he will immediately suggest medication. This treatment improves the prognosis of the condition. In other words: it prevents joint damage and prevents loss of function.
Disease-modifying drugs
Disease modifying drugs (also called “Disease modifying drugs” or DMARDs) are drugs that stop the inflammatory process in your joints. They prevent joint damage from continuing to be damaged. They are not pain relievers.
Your doctor will regularly check the effect of treatment with:
a blood test;
examination of the joint;
a global clinical examination.
This will see if
rheumatoid arthritis is under control;
the drug does not cause side effects, such as:
gastrointestinal problems,
liver problems,
anemia,
decrease in the number of white blood cells (leukopenia) leading to a higher risk of infection.
More than one in two people no longer have symptoms 6 months after starting treatment. Often at the start of treatment you will be given cortisone for a short time. This is because DMARDs work slowly and it is important to control inflammation quickly. However, long-term use of cortisone should be avoided.
Biologics in synthetic DMARDs
If treatment with DMARDs has no effect, there are biologics and synthetic DMARDs. They are also DMARDs, and they are often more powerful.
You cannot receive biological therapy or synthetic DMARDs if you have an underlying infection (eg tuberculosis or viral hepatitis).
Other drugs
Your doctor may also prescribe other medicines:
| Medication | objective | Remark |
| Paracetamol or anti-inflammatory (eg, ibuprofen or naproxen) | Ease the painTalk to your doctor if you need it | |
| Cortisone injection | Decrease joint inflammation | Local injection into the joint |
| Calcium and vitamin D supplements | Counter the risk of osteoporosis linked to cortisone |
Surgery
- Rheumatoid arthritis medications are getting more and more effective. Operations are therefore less necessary nowadays.
- Are your joints damaged and you suffer a lot? The rheumatologist may seek the advice of a surgeon to see if surgery is possible and useful for you.
- After the operation, you will need to follow a rehabilitation program: you will need to move the joint sufficiently and adequately with the help of exercises. This is very important to get a good result.
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