Part of the "What is...?" series
In a previous blog post, we talked about the two different types of arthritis - osteoarthritis and inflammatory arthropathies (a.k.a. rheumatic diseases). This post will concentrate on inflammatory arthropathies, the most common of which is rheumatoid arthritis (RA).
RA is a type of autoimmune disease - the immune system mistakenly attacks the lining of the joints, thinking it is a foreign substance. This causes the joint to become red, hot, swollen and stiff. The symptoms are particularly worse if you've been sleeping or had a period of inactivity. You can also get "flare-ups" where the symptoms become particularly severe. It often runs in families, and is more common in women and in the over 50s. It can sometimes have effects in other areas of the body, such as the eyes, heart and lungs. It's also common to get other symptoms like fatigue and poor appetite. No-one knows why the immune system starts to behave this way, and the only known risk factor is smoking.
In another blog post I talk about inflammation as the first stage of the healing process, and this is true. However, in the case of these autoimmune conditions, the inflammation is happening in the absence of injury, and so the immune system is breaking down perfectly healthy tissue. In these cases the inflammation is inappropriate and so, rather than letting it run its course (like in an injury), it is best to stop it in its tracks.
There is no cure for RA, or any of the other inflammatory arthropathies. However, the medication currently available is very effective and there are many other things you can do to help manage the symptoms.
- Appropriate Exercise - Movement in the joint will provide relief from stiffness and swelling, and strengthening the muscles, tendons, ligaments and bony structures around the joint will also help the joint to stay stable and healthy. However, overly strenuous activity can lead to a release of substances that promote inflammation, so it's best to avoid high impact exercise like running/aerobics or contact sports like rugby and football. For a tailored programme specific to you, talk to a chiropractor, physiotherapist or OT.
- Diet - The things we digest become the things that make up our bodies, so eating things that promote the formation of anti-inflammatory substances can be helpful in RA. These include fresh leafy vegetables, tomatoes, fish and spices like turmeric. Similarly, avoiding things that promote inflammation can be helpful, like nut butters, meats that have been battered and/or deep fried, and alcohol.
- Smoking - Smoking increases the risk of developing RA and it also exacerbates the symptoms.
- Supplements - The government recommends that everyone, regardless of age, should take a 10mg Vitamin D supplement every day. However, evidence has shown that Vitamin D at higher doses can help to properly regulate the immune system, and therefore help manage RA. There is also some (slightly weaker) evidence that a high dose Vitamin D supplement can reduce the risk of ever getting RA, but this is less clear.
- Treatment - Manual therapies such as chiropractic, and also medical acupuncture, can help with pain relief during a flare-up, and reduce the frequency and severity of a flare-up.
- Get Support - RA and the other inflammatory diseases are life-long conditions. Although good medication is available and good self-care can help enormously with symptom control, it is almost inevitable that flare-ups and relapses will occur. This is a condition you will have to learn to manage for the rest of your life. Sometimes it can help to talk to people who are going through the same thing. You can find your local branch of VersusArthritis (previously ArthritisCare) here.