Arthritis For Dummies. Barry Fox

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СКАЧАТЬ a test tube, which can indicate inflammation.This is a nonspecific marker of inflammation, which may be due to several factors, including age, obesity, infection, cancer, and autoimmune conditions.

       C-reactive protein (CRP) is another nonspecific marker of inflammation. It checks for a protein that indicates inflammation is present somewhere in the body.

       Cyclic citrullinated peptide (CCP) antibody checks for a type of antibody commonly produced in rheumatoid arthritis as well as certain other autoimmune disorders.

       Complete blood count (CBC) checks for anemia (meaning there are not enough red blood cells) and thrombocytosis (the production of too many platelets), both of which can occur with chronic inflammation and are often seen in RA. These findings are not specific to RA, just a sign of chronic inflammation.

       Antinuclear antibody (ANA) checks for antibodies to components in the nucleus of cells. This is very nonspecific test that is commonly positive in healthy individuals (up to 25 percent at low levels!), but may provide additional clues that you have RA, or another condition such as lupus.

       Human leukocyte antigen tissue typing (HLA) checks for a genetic marker that indicates an increased likelihood for developing an immune-related condition like RA, reactive arthritis, or ankylosing spondylitis. HLAB27 is the test most commonly ordered, but is not routinely needed to evaluate someone for RA.

      In addition, your doctor may perform the following tests:

       Joint aspiration (arthrocentesis): The doctor inserts a needle into your affected joint(s) to remove some of the synovial fluid, which is examined under a microscope for evidence of infection or inflammation.

       Imaging tests: A standard X-ray of your joints may be taken to check for bone and cartilage loss and/or serve as a baseline for comparison of future X-rays.However, X-rays aren’t sensitive enough to detect joint damage in the early stages of the disease. Magnetic resonance imaging (MRI) and ultrasound images may be helpful in detecting early signs of RA when the diagnosis is not clear since they can provide more information than X-ray, but aren’t always needed to make an RA diagnosis. Computerized technology (CT scans) are rarely used to detect RA because, although they show bone damage, they lack the sensitivity to reveal soft-tissue changes.

       Biopsy of rheumatoid nodules: Rheumatoid nodules are rubbery lumps under the skin that often form near the joints in people who have RA. Occasionally, a biopsy will be done to rule out other conditions, like infections or gout. However, this is not a very common procedure.Unless the rheumatoid nodules cause pain or impair your range of motion, they usually don’t need to be treated. But since other bumps and lumps can look and feel like RA nodules, your doctor may want to take a piece of tissue from one of them and examine it under a microscope to confirm the diagnosis. After carefully cleansing the skin and injecting a local anesthetic, the doctor makes a tiny cut near the nodule and, if possible, shaves off a piece of tissue. Or they may push a thin, hollow needle into the nodule and, using suction, pull out a tissue sample.

Treating Rheumatoid Arthritis

      Although RA is often a chronic disease, most people respond well to treatment and lead active, productive lives. A few years back, a victim of RA could look forward to a dreary life spent bedridden or in a wheelchair. But today, they have a better prognosis: Only about one in ten patients progresses to the point of disability, and in a full 70 percent of the cases, symptoms are relieved or controlled for long periods of time.

      

Treatment begins with immunosuppressive medications. Not all people respond to the same medicines, so there may be some trial and error while you and your provider find the treatment that works for you and your RA. Sometimes, surgery is needed for permanent deformity, but the goal is to get RA under control before you get to that point. While RA is considered a chronic, lifelong condition, our current treatments can bring about dramatic improvements in the signs and symptoms of the disease.

      Relying on rest during a flare

Resting the affected joints during a flare is a must, because using them tends to increase inflammation. Regular rest periods should be worked into the daily schedule, and at times, total bed rest may be necessary during a flare. Immobilizing a severely affected joint with a splint may help, but the joint should be moved from time to time to keep it from locking up. You may want to wear a splint during the most active times of the day, and take it off during the least active times — for example, 12 hours on and 12 hours off.

      

Mental outlook appears to affect RA symptoms. Stress tends to make flares worse, whereas a positive outlook can help keep complications at bay.

      Delving into your diet

      What you do and don’t eat can make a difference to the arthritis disease process and how much pain you feel. Because many forms of arthritis and arthritis-related conditions involve inflammation, eating foods that help reduce the inflammation response (like fatty fish and fish oil) may make a positive difference. Eating plenty of fruits, vegetables, and whole grains supplies ample amounts of antioxidants like vitamins C and E and selenium, which can fight the cellular damage that contributes to arthritis. (See Chapter 11 to find out more about how what you eat may affect how you feel.)

      Easing into exercise and physical therapy

      A good overall exercise program helps strengthen joint-supporting structures, increases endurance, and maintains or improves flexibility. Even inflamed joints should be exercised a little to prevent them from freezing up. A physical therapist can provide exercises that gently take the joints through their full range of movement. Exercising in water, especially during flares, may be easier than exercising on land, because it’s low impact and the cool water may help ease inflammation. (See Chapter 12.)

      Protecting your joints

      Not only do you make your mom happy when you stand up straight, but you reduce the pressure on your joints. Maintaining proper posture while walking, standing, and sitting can go a long way toward easing joint stress. And understanding how to lift or move heavy objects correctly is also a must. (See Chapter 13.)

      Applying hot or cold compresses

      Applying hot or cold packs to inflamed joints may ease the pain and help reduce inflammation. Use heat to ease sore muscles and increase circulation, and try cold to dull the pain and reduce inflammation. (See Chapter 10.)

      Taking medication

      Many drugs can be used to combat RA symptoms. The following subsections give you the details on the five types of medication commonly prescribed.

      Non-steroidal anti-inflammatory drugs (NSAIDs)

      NSAIDs (pronounced n-seds) reduce swelling, relieve pain, and are the most commonly used drugs СКАЧАТЬ