Maybe then I can understand why the damage is permanent. Wow. So far, very informative answers. I didnt realize it could go in "remission". Keep em comin! =) When rheumatoid arthritis flares up, it makes joints feel stiff and achy. That discomfort may go away at times, but there may still be permanent damage. Eventually rheumatoid arthritis can harm joints so they don't work as well even when the disease itself is not active. How does joint damage occur, and how can it be prevented?
Doctors call the active periods of rheumatoid arthritis disease activity. During disease activity, infection-fighting cells (white blood cells) are mistakenly allowed into the joint. No one understands why this happens, but it's clear the infection fighters don't belong there.
Inside the joint, these cells produce chemicals that they usually use to kill invading microorganisms - only none are there. Instead, the chemicals damage the healthy joint tissue. During high levels of disease activity, you experience a flare - joints become swollen, stiff, and painful. You can also have low levels of disease activity that come and go without your feeling any symptoms.
There are two main ways this process can cause joint damage:
The infection-fighting chemicals cause cartilage to slowly weaken. Cartilage is the cushion between bones in a joint. Over time, putting stress on the joint or bearing weight on it can wear down the weak cartilage more. This is called degenerative disease, and it is similar to what happens in "regular" arthritis (osteoarthritis) - only it happens faster in people with rheumatoid arthritis.
The inflammation inside the joint stimulates the joint lining (synovium) to grow and spread where it doesn't belong. If it continues long enough, it can harm healthy cartilage or bone.
The simple rule of thumb is, the "longer" and "stronger" the disease activity, the more joint damage is probably occurring.
A person with joint swelling and stiffness every day is more likely to have joint damage than a person with these symptoms once a month. (Longer disease activity)
Someone with a lot of joint swelling is more likely to have damage than a person with just a little bit. (Stronger disease activity)
How can you tell if you are having disease activity? It can sometimes be difficult.
You can be feeling a lot of pain, yet suffer no damage to your joints.
Joint damage can also occur without feeling any pain.
Joint swelling is a reliable sign, though. For the most part, having joint swelling is proof of having ongoing disease activity.
The length of morning stiffness each day is also useful. Ask yourself, after getting up, "How long does it take until I'm feeling as loose as I'll feel for the day?" The longer you feel stiff, the more likely it is that your rheumatoid arthritis is active.
Another sign you can look for is a "boggy" joint. When the joint lining begins to grow abnormally, it may give a joint a mushy texture. This boggy condition will remain even when you are not having a flare. If you notice this happening, you should see your rheumatologist
http://www.webmd.com/rheumatoid-arthriti... In Rheumatoid Arthritis, white blood cells attack the lining of joints which causes inflammation. During inflammation the lining becomes thickened. When the inflammation goes on for long periods of time, the inflammation extends from the lining into the cartilage and bone around the joint, which damages these structures. Eventually, the muscles, ligaments, and tendons around the joint become weakened and so there is a loss of function in that joint.
My daughter had Juvenile Rheumatoid Arthritis. She has been in remission for over 10 years now, but you can still see the damage to her affected joints on x-rays; there are jagged, calcified spots on the lining and some of the cartilage in those joints, basically it looks like scar tissue or damaged tissue that has hardened.
How Rheumatoid Arthritis Develops and Progresses
National Institute of Arthritis and Musculoskeletal and Skin Diseases
http://www.niams.nih.gov/Health_Info/Rhe... Go to WebMd.com for a complete and full report on rheumatoid arthritis.
About one per cent of the population is affected by this disease while women, for unknown reasons get it three times more then a man. It's considered a genetic, evolutionary and general disease that affects people different ways. Some get it for a time then it goes into remission for unknown reasions. Others get it and are cripled for life in pain.
It can and does attack the young as well as the old. It's known for the redness, the swelling and water retention in the joints but, can attack the skin, the eyes and the heart as well. Through inflammation, your immune system is trying to kill infected body cells. Over time, bone extremities become deformed with added calcium creating permanent bumps.
Rheumatic diseases are the result of a defective gene and collagen inflammation, often from a chronic infection. Collagen is present throughout the body, from the eyes, skin and joints to the heart. Hence, the multiplicity of symptoms, depending on the location of the most affected internal organs or body parts.
I have had seronegative rheumatoid arthritis for more than 27 years. The telling signs of seronegative rheumatoid arthritis are the following:
- Joint pain in the feet (or cracking ankles) in the early 20's or late teens;
- Fatigue, especially after a moderate exercise like a 30 minute walk;
- Blood test showing a negative or low level of Rheumatoid Factor (RF);
- Joint deformities of the fingers, after a few years, a specific sign of rheumatoid arthritis;
- Consecutive X-Rays, over several years, showing bone erosion, a consequence of rheumatoid arthritis;
- Generalized arthritis, involving the whole body;
- Blood tests showing elevated levels of C-Reactive Protein (CRP) and Sedimentation rate (ESR).
NSAIDs like Voltaren, COX-2 inhibitors like Celebrex, acetaminophen like Tylenol, and codeine are all used to control inflammation and relieve the pain of arthritis.
Regular exercise like walking, biking and swimming is also helpful for most patients. Make sure that you are not overweight as carrying too much weight can only increase the pain of arthritis in the supporting joints of the hips, knees, ankles and feet.
For any form of arthritis, you should consult an orthopaedist who will order blood tests, joint scans and X-Rays to better diagnose the type of arthritis from which you suffer.
The American Academy of Orthopaedic Surgeons at http://www.aaos.org maintains a public online directory where you can find the address and phone number of orthopaedists who belong to the American Academy of Orthopaedic Surgeons. Orthopaedists are listed by geographic location and family name, inside the USA and in most countries.
The membership directory of the AAOS is located at:
http://www6.aaos.org/about/public/member...
Lyme disease could be a possibility. Ask your doctor to test you for the bacteria causing Lyme disease.
Are there any other cases of arthritis or rheumatic diseases among your relatives? Chronic forms of arthritis are usually prevalent in families where a defective gene is passed on by parents to their children.
There are a few hundred types of arthritis and rheumatic diseases. The good news is that science is progressing rapidly in its understanding of rheumatic diseases.
Antibiotics are now used to achieve full remissions for at least 40%, if not 65% of patients with rheumatoid arthritis. For more info, please join the antibio group at:
http://health.groups.yahoo.com/group/ant... |
