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Living with… rheumatoid arthritis

12:00am | & Health

There are many different types of arthritis, the most common being osteoarthritis, also known as ‘wear and tear’ arthritis. As that name suggests, it’s concerned with joints which become stiff, painful, worn and inflamed through prolonged or excessive use, and so is usually age-related.

However, the second most common type, ‘rheumatoid arthritis’, is very different in its origin and in the way it affects people living with the condition. Rheumatoid arthritis exhibits many of the same symptoms as osteoarthritis – notably pain, stiffness and swelling in the joints – but is an ‘autoimmune disease’.

In other words, it’s caused by your own immune systems malfunctioning and mistakenly attacking the cells which line your joints, making them swollen, stiff and painful. Over time this can damage the joint itself, both the cartilage and the nearby bone. While osteoarthritis tends to mostly affect weight-bearing joints such as the hips, knees and ankles, rheumatoid arthritis is mostly found in the small joints of the hands, feet and wrists, at least initially.

It’s not clear what triggers rheumatoid arthritis, but it affects more women than men, it tends to run in families (suggesting a genetic element), and you’re more at risk if you smoke. Symptoms include pain, stiffness and swelling in the joints, which can become red and feel warm to the touch. More general symptoms are tiredness and a lack of energy, a high temperature, sweating, a poor appetite and weight loss. If you experience any of these, you should tell your doctor (especially if you have a family history of rheumatoid arthritis), as early diagnosis is key to effective treatment.

The other big difference to osteoarthritis, which is there all the time and gets progressively worse, is that rheumatoid arthritis seems to come and go for many sufferers, who experience ‘flare-ups’ in the condition. Although there is no cure, early diagnosis and appropriate treatment enable most people to manage their rheumatoid arthritis effectively, sometimes going for months or even years between flare-ups.

Treatment options include long-term medication to ease symptoms and delay progress of the condition, supportive treatments such as physiotherapy, and, in some cases, surgery to counteract damage to joints. With proper treatment, good lifestyle choices and some helpful adaptations, people with rheumatoid arthritis can lead full lives, including continuing in regular employment.

Remember, it’s a long-term (chronic) condition and can be life-changing, but most people can learn to manage and adapt to those changes. As with most chronic conditions, self-care is very important and can significantly enhance your quality of life and future prospects. It falls into several areas:

Manage your medication: It’s crucial to take your medication as prescribed and continue to do so even if you feel better, as it can help prevent flare-ups and reduce the risk of joint damage. If you sometimes forget to take daily medication or can’t remember if you’ve taken it, invest a little money in a pill organiser box.

Attend regular reviews: Your healthcare team should keep in contact with you and schedule regular reviews to monitor your condition and treatment. It’s important that you always attend, even if you’re feeling better. You may be in respite, but the underlying condition hasn’t gone away. You may be able to gradually reduce your medication if your doctor advises it.

Keep well: Because rheumatoid arthritis is connected to your immune system, flare-ups can be linked to other illnesses. For this reason, it’s important to look after your general health by doing things like having an annual flu vaccination or a one-off pneumococcal vaccination, to protect against a serious chest infection called ‘pneumococcal pneumonia’. If you do have a flare-up, you’ll need plenty of rest to avoid further strain on affected joints.

Healthy diet and regular exercise: A fundamental part of maintaining good health is to stick to a healthy diet and have regular moderate exercise suitable for you. Seek your doctor’s advice on what exercise would benefit you most, but there are many forms which are ‘low impact’ on joints.

Self-management: Many arthritis care groups and charities offer courses or online advice to help you self-manage your condition. Techniques can include goal-setting exercises, relaxation and breathing exercises for pain control, and ways to promote positive thinking. Research online or speak to your medical team about organisations offering such support.

Talk to others: Joining a community of people who share your condition – either in the real world or online ­– can be very beneficial. It will provide a mine of information, including first-hand tips and advice, and a ready-made support network.

Emotional support: Like many long-term conditions, rheumatoid arthritis can impact negatively on your mental health as well as your physical state, especially during a flare-up. It can lead to depression, stress and anxiety, and it’s crucial you don’t face these alone. Be open about your feelings, let your medical team know if you’re struggling and need some extra help and support. Remember, you’re not alone and you needn’t deal with this alone.

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