Best Practices to Cope Up with 4 Stages of Rheumatoid Arthritis

Overview

Rheumatoid arthritis, a progressive disease

Rheumatoid arthritis is a complex and multifactorial disease that involves the immune system, genetics, environment, and lifestyle factors. The disease usually affects multiple joints, such as the hands, wrists, feet, and ankles, in a symmetrical pattern. However, other joints, such as the neck, shoulders, hips, and knees, may also be affected.

The disease process in RA involves the activation of immune cells, such as T cells, B cells, and macrophages, which release pro-inflammatory cytokines, such as TNF-alpha, IL-6, and IL-1. These cytokines cause the synovial membrane, a thin layer of tissue that lines the joint space, to become inflamed and thickened, leading to cartilage and bone erosion, joint deformity, and reduced function.

The diagnosis of RA is based on a combination of clinical, laboratory, and imaging findings, such as joint pain, swelling, stiffness, elevated levels of rheumatoid factor and anti-citrullinated protein antibodies, and radiographic evidence of joint damage. The American College of Rheumatology and the European League Against Rheumatism have developed classification criteria for RA that take into account these factors and help distinguish RA from other types of arthritis. Collectively, they have classified rheumatoid arthritis into 4 stages.

Stages

The 4 stages of rheumatoid arthritis, are meticulously divided with an intent of unique and different treatment goals.

Stage 1 is early-stage RA, which is characterized by joint pain, stiffness, or swelling. During this stage, there is inflammation inside the joint, causing the tissue to swell up. However, there is no damage to the bones yet, and the joint lining (the synovium) is inflamed. Symptoms are not always obvious during this stage, and people may not be aware of having the disease. However, early diagnosis and appropriate treatment within 12 weeks of onset can help manage symptoms and prevent further joint damage.
Stage 2 is moderate-stage RA, which is marked by damage to the joint cartilage and bone due to inflammation in the synovium. Cartilage is the tissue that covers the end of bones at the joint site. Inflammation can cause the cartilage to break down, leading to pain and loss of mobility. This can cause limitations in the range of motion in the joints. Blood tests may still not show any sign of RA antibodies at this stage, which may make it difficult to diagnose. However, most people with RA have positive antibodies years before symptoms appear.
Stage 3 is severe RA, where the damage extends to the cartilage and bone destruction progresses. When the cushion between bones wears away, the bones rub together, leading to more pain and swelling. Symptoms can include muscle weakness, more mobility loss, twisted fingers, and thickened knuckles. Changes in bone formation may also occur, and some symptoms may be permanent, such as compressed tendons at the wrist, carpal tunnel syndrome, or tendon rupture.
Stage 4 is end-stage RA, where there is no longer inflammation in the joint, but the joints no longer work as they should. Symptoms may include pain, swelling, stiffness, mobility loss, and fused bones. Depending on the location and progression of the end-stage RA, individuals may have difficulty using their hands or bending their knees and hips.

How to cope with RA

Below are some self-management strategies to alleviate the pain and reduce stress associated with any of the 4 stages of rheumatoid arthritis:

Get a good night’s sleep: Sleep is essential for people with RA because it helps to reduce inflammation, boost the immune system, and improve mood. Therefore, it’s important to aim for at least 7-9 hours of sleep per night. To make sleep easier, create a comfortable sleep environment, such as using comfortable pillows and mattresses, and try relaxation techniques before bed.
Exercise regularly: Regular exercise is vital for people with RA as it helps to maintain flexibility, strength, and range of motion in the joints. However, it’s important to work with a physical therapist or doctor to develop an exercise program that’s safe and appropriate for individual needs.
Eat a healthy diet: A healthy diet can help manage inflammation and reduce the risk of other health conditions. Foods rich in omega-3 fatty acids, such as fish and nuts, are particularly beneficial for people with RA. Additionally, eating a variety of fruits, vegetables, and whole grains can provide essential nutrients and support overall health.
Manage stress: Stress can trigger RA flare-ups, so it’s important to manage stress levels. This can be achieved through relaxation techniques such as meditation, yoga, or deep breathing exercises.
Use assistive devices: Assistive devices can make daily activities easier for people with RA. For example, using jar openers, reachers, or grip aids can make it easier to open jars, reach high shelves, or grip objects.
Adapt your environment: Adapting your home and workplace environment can make it easier to live with RA. For example, using ergonomic chairs, desks, or keyboards can reduce joint strain and improve posture.
Take breaks: It’s important to take breaks during the day to rest and avoid overusing joints. Breaks can include stretching, taking a walk, or simply relaxing.
Work with a healthcare team: Working with a healthcare team, including a rheumatologist, physical therapist, and occupational therapist, can help to manage RA symptoms effectively and prevent complications.

Positive outlook

Maintaining a positive outlook while living with Rheumatoid Arthritis (RA) can be challenging, but here are a few tips to help:

Stay active: Regular exercise can help manage RA symptoms and improve your mood.
Build a support network: Surround yourself with positive, supportive people who can encourage you on difficult days.
Practice self-care: Take time for yourself every day to do something you enjoy.
Stay informed: Educate yourself about RA and stay up-to-date on new treatments and therapies.
Focus on what you can control: Instead of dwelling on things you can’t control, focus on the things you can control, like your attitude, diet, and exercise routine.
Keep a positive attitude: Try to stay optimistic and focus on the good things in your life. A positive attitude can go a long way in managing RA.

Citation

https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648
https://www.everydayhealth.com/rheumatoid-arthritis/living-with/coping-with-rheumatoid-arthritis/

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