What is Rheumatoid Arthritis?
Rheumatoid arthritis is an inflammatory disease of connective tissue, which occurs in the eddies and is characterized by pain, islet, stiffness, and loss of joint function.
It is a chronic, inflammatory disease characterized by symmetrical inflammation of the joints. It can often involve the internal organs, the skin, and the nervous system. The course of the disease is progressive. It leads to damage and deformation of the joints, reduces the working ability, increases the disability, and shortens the patient’s life.
Reuma is really a serious disease, which does not occur only in the late years.
In most patients, RA is a severe disease, during which the joint damage progresses, weakness or loss of ability to work, and self-discharge.
The peculiarity is reflected in the symmetry of disease occurrence. This means that if one knee or arm is affected then another knee or hand is also affected.
Out-of-heart rheumatism is also known as soft tissue rheumatism, and by definition about thirty years ago, and as inflammatory and degenerative changes in the connective tissue of the movement system, which are characterized by pain and functional disturbances of the affected tissue. It can occur as part of systemic diseases (RA and others) or in response to overuse and trauma. These are the most common rheumatic diseases, and it is considered that any person over 40 years old at least once in life has problems due to extra-rheumatic rheumatism.
The body’s defense system (the immune system) plays a decisive role in the development of rheumatoid arthritis. In doing so, the immune system is too strong – not too weak – and therefore attacks its own body (autoimmune disease), in this case, the tissue of the joint. The synovial membrane is also attacked and destroyed. If the permanent inflammation of the synovial membrane can not be calmed, then it begins to atrophy and thereby destroys the bone and cartilage of the joint. Factors such as mental stress (e.g., stress), environmental conditions (e.g., nicotine), or hormone components can further weaken the immune system.
Rheumatoid arthritis affects women more often than men in a 3: 1 ratio, and a total of about 1% -2.5% of the population is thought to be affected by this disease. This figure rises to 6% of the affected male population at age and above 75 years, and 16% of female populations are over 65 years old (Barnes, 1980). The illness usually begins between the ages of 20 and 45. Year, although it can occur in childhood or age.
How do I recognize that I have rheumatoid arthritis?
The above symptoms can manifest manifested differently in each person; they can appear in different parts of the body and last for years. Rheumatoid arthritis manifests itself differently from man to man.
Increased joint destruction can lead to stiffness, deformation of the joints, up to work incapacity.
Reuma is a connective tissue disease and occurs virtually everywhere in the body, inflammation over time may involve internal organs, such as the heart, liver, kidneys, and lungs.
How to detect early rheumatoid arthritis?
- Early RA diagnosis is based on anemia and clinical examination.
- Suspicions on RA await the following clinical findings:
– long-lasting night and morning pain in the joints and morning joints of the joints lasting longer than half an hour;
– the sensitivity of the joint to the joint, clinical signs of joint inflammation (anemia, elevated temperature, and limited mobility of the joint);
- Clinical diagnosis of joint inflammation (synovitis) is the most important individual diagnostic test.
- Laboratory tests (primarily rheumatoid factors – RF blood tests) and methods of imaging (primarily erosion findings) do not help significantly because their findings only confirm the diagnosis, and if they do not exclude the existence of the disease.
Unknown primary agents change some proteins in the body and do not recognize them as their own; the body creates antibodies against them. The immune process of auto-aggression develops, immunocomplexes emerge everywhere, and especially on the walls of the blood vessels causing diffuse vasculitis, and then synovitis, i.e., the inner bumps of the articular capsule, which starts the inflammation of the joints. The increase in the number of the cover surfaces of the sonic layer and the accumulation of the cells’ characteristics of inflammation are increasing. From the synovial layer, the inflammatory fluid is released into the articular cavity, the synovial layer is hypertrophied, and its scales are enlarged and penetrated into the joint.
Cell proliferation develops granular tissue rich in aggressive cells and breakdown enzymes that destroy joint cartilage and bone. The disintegration begins at the hinges of the sinewave joint and then spreads to all the articular surfaces. When the granulation tissue is subsequently sprinkled with a binder, a so-called panic is formed, which can further bind the bones of the bones that formed the joint. Thus an analysis can arise in the final phase, which is at first fibrotic, and later the eye. If the destruction of the joint surfaces is extremely high, severe joint deformations occur, up to the subluxation and luxation. Such joints are functionally unusable.
Muscles for this, but also because of inactivity, are atrophied. All these changes disturb the biomechanics of the joints and contribute to the development of deformities. On the bones, osteoporosis develops due to inflammation and inactivity, initially at the ends of the bones, and later on the entire skeleton.
Each diagnostic starts from the anamnesis, that is, a conversation with a patient. In the history, we are looking for information on painful joints, morning overdose, febrile abnormalities, urinary or intestinal infections, photophobia, ulcerations in the mucous membranes, then data such as fatigue, insomnia, weakness.
The standard for diagnosis of diseases has been set up by the American Society for Rheumatism. The diagnosis of rheumatoid arthritis is based on clinical examinations, history, X-ray examinations, and blood tests.
To list some of the basic;
- Morning braking (takes at least 1 hour),
- Arthritis of 3 or more joints (at least three articular areas of simultaneous thickening of soft tissues or outflow in the joint),
- Arthritis of the joints on the hand (swelling of at least one joint region in hand, MCP or PIP joints),
- Symmetrical arthritis (concomitant swelling of the artificial joints)
- Rheumatoid Nodes,
- Rheumatoid factor in serum,
- Radiological changes (osteoporosis and erosion visible on dorsal wave surgery);
For the diagnosis of RA, 4 of these seven criteria must be present, and the criteria 1-4 must be present for at least six weeks.
In the blood, we can find an increased sedimentation characteristic of inflammation and a reduced amount of hemoglobin. More specific for RA is the discovery of C-reactive protein (CRP), plasma viscosity, and immunoglobulin estimate including rheumatoid factor (RF).
X-ray images show bone damage and deformation and can show how advanced the disease progresses. An X-ray examination is required in patients with the affected cervical part of the spine, with which we can notice any progression, such as the progression of subluxation. In the X-ray, we can also see the degree of osteoporosis of the bones.
Physical examination is a basic prerequisite for a better approach to the patient, his needs, and problems, with the aim of healing and proper care of this individual approach to a particular type of problem. The therapy procedures are an integral part of the treatment of patients with RA both in the active and in the phase of the calm disease – remission.
Physical examination of the patient should be oriented to the examination of the joints (pain, swelling, outflow), the existence of deformities, and the functionality of the patient (reduced range of movement).
Many physiological agents are used to treat patients with RA: climatic factors, heliotherapy, peloid, Thermo mineral waters, various types of heat, sound, electricity, magnetism, and mechanical energy, which is applied in the form of kinesitherapy and massage and work therapy.
The basic methods of physical examination are:
- Inspection of anatomical features and irregularities
- palpation of thickening, asymmetry
- the percutaneous formation, edema
- goniometric measurements, band tests, power, volume
- In the history and physical examination, data on muscle weakness, muscle mass, sensory outbreaks, and autonomic functions
Physical evaluation of rheumatological etiology:
- pain, stiffness, swelling of the joint,s and loss of mobility and function (arthralgia)
- Muscle weakness
- abnormalities of the spine: kyphosis, scoliosis, lordosis
- Asymmetry of the shoulders, hips, and gluteal regions
- I see paravertebral spinal muscles and limited mobility in degenerative or inflammatory changes.
THE MEANING OF EXERCISE
The idea that exercise exacerbates joint damage is not true. Regular exercise reduces pain and increases the mobility of the joints, prevents and slows the deformation of the joints, increases muscle strength and stretches muscle shorten, maintains the correct position of the body, and improves the overall condition of the patient.
Each exercise is based on pedagogical principles: type, goal, and a number of repetitions. The exercise includes understanding the movement, taking the starting position, performing the movement, holding the performed position for six seconds, returning to the starting position, repeating 5-10 times. During exercise, it is important to take the proper starting position because it keeps the spinal column, and each movement should be performed in full volume.
Rheumatoid arthritis is still incurable. But much can be done with the drugs that are available. The basis of a successful outcome of treatment of early diagnosis of the disease, as soon as clinically remission or low activity of the disease is achieved. RA is marked by the phases of calming and activating the disease with an unpredictable course. The main goal is to control the immune-inflammatory process.
The treatment goes from simple conservative measures (rest and proper diet) to medication and surgical procedures.
The therapy is coordinated individually, according to the patient, with the goals of the treatment always the same:
- Pain relief
- stopping inflammation
- slowing or stopping joint damage
- Retain mobility
In addition to treating drugs, other therapeutic options are also used. For the effective treatment of rheumatoid arthritis, the cooperation between the patient and the doctor is crucial.