Rheumatoid Arthritis

Rheumatoid Arthritis, or RA, is an autoimmune immune disease caused when a person's immune system is overactive and malfunctions, attacking the body's tissues and causing chronic inflammation. The inflammation can then cause joint and organ damage. RA is related to various similar autoimmune diseases, including ankylosing spondylitis, psoriatic arthritis, and ulcerative colitis. Although these diseases all belong to the same family, and an individual can have more than one of them, their primary difference is which areas of the body they attack. RA tends to attack the linings of joints, called the synovial tissues. Over time, the constant inflammation of these tissues can cause joints to deform. Unfortunately, hands are often the worst affected.

The first symptoms noticed by RA patients are painful, swollen, hot, or stiff joints. Although RA can attack any joint in the body, it often affects the spine and hands. Often stiffness is worst after periods of inactivity, such as first thing in the morning or after sitting for long periods. One of the most common areas for this is the back. Patients also often report feelings of fatigue and low-level fevers (101° F or below). Long-term symptoms often include chronic pain due to joint deterioration or deformity.

Rheumatoid Arthritis is diagnosed by a specialist called a rheumatologist. Generally, a primary care physician referral is required to see a rheumatologist. Screening for RA often involves blood testing and imaging, such as X-rays and a physical examination. Unfortunately, diagnosis is often delayed for many patients, with doctors making an incorrect diagnosis, especially frequently in patients with no family history of RA.

This disease is hereditary, meaning it tends to run in families, and some genetic discoveries have been associated with it. However, environmental factors can also trigger this kind of disease. Frequent illnesses or infections and prolonged trauma, such as growing up in an abusive home, are risk factors for autoimmune diseases in people with no family history of this kind of illness.

RA can develop at any point in a person's life, although it is often misdiagnosed for years. Most cases of this illness create after a person has reached adulthood. When children have this disease, it is called juvenile rheumatoid arthritis. Having RA as an adult can be a challenging, frustrating, debilitating predicament but imagine developing a condition that causes joint damage before one is even finished growing. That is the unfortunate situation faced by children with juvenile RA.

While rheumatoid arthritis is not curable, it is treatable. Treatment is focused on reducing inflammation and slowing joint deterioration. The most common initial medication prescribed for RA are NSAIDs or non-steroidal anti-inflammatories. These are related to drugs such as ibuprofen and naproxen sodium (Advil, Motrin, and Aleve). Often if the patient is in the middle of a flare-up, steroids, such as prednisone, may be required to bring things under control. Hydroxychloroquine is increasingly being used to manage the inflammation of autoimmune diseases. Next in line is the drug methotrexate, a low-dose chemotherapy treatment that is very effective in managing RA. It is a DMARD or Disease Modifying Anti-Rheumatic Drug that changes the body's inflammatory response over time. Last in line are biologics, such as Enbrel, Humira, and Remicade. These advanced medications are expensive but also cutting-edge treatments for preventing the immune system from damaging joints. They work by suppressing a specific part of the immune system in attacking the body's tissues.

The most severe side effects of these medications are a suppressed immune system. This can make patients more susceptible to opportunistic infections, including viral, fungal, and bacterial infections. Regular blood work will be necessary to ensure that the patient's liver functions do not change. Regular use of prednisone puts a person at risk of developing osteoporosis, and Biologics can carry an increased risk of some rare cancers (although rare). While many medications used to treat this disease can have serious side effects, they are generally less severe than the long-term consequences caused by untreated RA.

Because RA patients are prone to excessive inflammation, even the most minor fender benders can significantly impact their functionality and recovery post-collision. Inflammation drives swelling, so any body part injured in a car accident will be susceptible to more swelling than a person without RA would experience. The swelling can be so severe that joints cannot function for an extended time and may require longer rest periods. If the patient is already on prescription NSAIDs, doctors will not be able to prescribe more, as a higher dose or combination of these drugs can cause gastric bleeding. Unfortunately, the best treatment for extended swelling in these cases is prolonged rest periods, meaning the patient may miss additional work or have a reduced workload. Unfortunately, swelling doesn't only affect the joints but also muscle tissue, making a recovery more painful as well.

The YouTube video from John Hopkins Rheumatology below explains the triggers that can cause Rheumatoid Arthritis flare-ups and what patients can do to prevent them.

If you or a loved one has been seriously injured in a motor vehicle accident and have developed Rheumatoid Arthritis as a result, please call our Sacramento personal injury law firm at (916) 921-6400 or (800) 404-5400 for free, friendly case advice.