Rheumatoid arthritis signs symptoms. Rheumatoid arthritis - symptoms, treatment, diagnosis in adults and children. Symptoms and signs

Rheumatoid arthritis is a systemic disease of unknown etiology with widespread damage to connective tissue, mainly in the joints, with erosive changes in them, with a chronic, often relapsing and progressive course. The trigger can be an infection, a cold, or an injury.

The pathological process leads to complete destruction of articular tissues, gross deformations and the development of ankylosis, which leads to loss of joint function and disability.

In severe cases, internal organs (heart, kidneys, lungs, blood vessels, muscles, etc.) can also be affected, which significantly worsens the prognosis for rheumatoid arthritis. We will discuss the symptoms, diagnosis and treatment methods in detail in this article.

Statistics

Prevalence of rheumatoid arthritis among the adult population of different climatic and geographical zones averages 0.6 – 1.3%. The annual incidence over the past decade has remained at 0.02%.

An increase in rheumatoid arthritis with age has been noted; women are more often affected than men. Among people under 35 years of age, the prevalence of the disease is 0.38%, and among people aged 55 years and older – 1.4%. A high incidence of the disease was detected in first-degree relatives of patients (3.5%), especially in females (5.1%).

What is it: causes of occurrence

Why does rheumatoid arthritis occur and what is it? Rheumatoid arthritis is an autoimmune disease, that is, a disease that occurs when the normal functioning of the immune system is disrupted. As with most autoimmune pathologies, the exact cause of the disease has not been identified.

It is believed that the provoking factors for the occurrence of the disease are:

Genetic predisposition– close relatives of patients with rheumatoid arthritis develop this disease much more often.
Infections – often arthritis occurs after a herpes infection, hepatitis B, mumps.
Adverse factors of the external and internal environment– hypothermia, exposure to toxic products, including occupational hazards, stress, as well as pregnancy, breastfeeding, .

Under the influence of these factors, cells of the immune system begin to attack the cells of the joint lining, which causes inflammation in them. This process causes the joints to become swollen, warm, and painful to the touch. Cells of the immune system also cause damage to blood vessels, which explains the so-called extra-articular symptoms of rheumatoid arthritis.

Juvenile rheumatoid arthritis

Juvenile rheumatoid arthritis (Still's disease) is an inflammatory disease of the joints, it is characterized by a progressive course with a fairly rapid involvement of internal organs in the process. This disease occurs in 5-15 people per 100,000 children.

The disease occurs in children under 16 years of age and can last for many years. The appearance of the disease can be the result of various influences - viral and bacterial influences, cooling, medications, increased sensitivity to certain environmental factors and many others.

First signs

Rheumatoid arthritis can begin acutely and subacutely, with the latter type of onset observed in most cases.

The first signs of RA:

chronic fatigue;
constant muscle weakness;
weight loss;
the appearance of muscle pain for no apparent reason;
sudden and causeless jumps in temperature to a subfebrile level (37-38ºС);
increased sweating.

As a rule, such manifestations of the disease remain unattended, and then articular syndrome and extra-articular manifestations of the disease develop.

Symptoms of rheumatoid arthritis: joint damage

In the case of rheumatoid arthritis, when studying the patient’s complaints, special attention is paid to the following symptoms:

Pain in the joints, their nature (aching, gnawing), intensity (strong, moderate, weak), duration (periodic, constant), connection with movement;
Morning stiffness in the joints, its duration;
Appearance of joints (swelling, redness, deformation);
Persistent limitation of joint mobility.

A patient with rheumatoid arthritis may also have other symptoms:

Hyperemia of the skin over the inflamed joints;
Atrophy of adjacent muscles;
With subluxations in the proximal interphalangeal joints, the hand has the appearance of a “swan neck”, with subluxations in the metacarpophalangeal joints – “walrus flippers”.

Upon palpation you can detect: an increase in skin temperature over the surface of the joints; soreness of the affected joints; “lateral compression” symptom; muscle atrophy and skin thickening; subcutaneous formations in the joint area, most often the elbow, so-called rheumatoid nodules; Patellar balloting symptom to determine the presence of fluid in the knee joint.

Depending on clinical and laboratory data, there are 3 degrees of exacerbation of RA:

Low (joint pain is assessed by the patient as no more than 3 points on a 10-point scale, morning stiffness lasts 30-60 minutes, ESR 15-30 mm/hour, CRP - 2 plus);
Moderate (pain – 4-6 points, stiffness in joints up to 12 hours after sleep, ESR – 30-45 mm/hour, CRP – 3 plus);
High (pain – 6-10 points, stiffness observed throughout the day, ESR – more than 45 mm/hour, CRP – 4 pluses).

In RA, peripheral joints are primarily affected, but we must not forget that this is a systemic disease, and any organs and tissues where connective tissue is present can be involved in the pathological process.

Extra-articular symptoms in rheumatoid arthritis

The development of extra-articular (systemic) manifestations is more typical for the seropositive form of rheumatoid arthritis with a severe long-term course.

Muscle damage manifested by atrophy, decreased muscle strength and tone, focal myositis.
Skin damage is manifested by dryness, thinning of the skin, subcutaneous hemorrhages and small focal necrosis.
Impaired blood supply to the nail plates leads to their fragility, striations and degeneration.
Presence of rheumatoid nodules- subcutaneously located connective tissue nodules with a diameter of 0.5-2 cm. They are characterized by a round shape, dense consistency, mobility, painlessness, less often - immobility due to adhesion to the aponeurosis.
The presence of rheumatoid vasculitis, which occurs in 10-20% of cases.

The most severe course of rheumatoid arthritis is characterized by forms that occur with lymphadenopathy, damage to the gastrointestinal tract (enetritis, amyloidosis of the rectal mucosa), nervous system (neuropathy, polyneuritis, functional autonomic disorders), involvement of the respiratory system (, diffuse fibrosis, pneumonitis, fibrosing alveolitis, bronchiolitis) , kidneys (glomerulonephritis, amyloidosis), eyes.

On the part of the great vessels and the heart, endocarditis, pericarditis, myocarditis, arteritis of the coronary vessels, and granulomatous aortitis may occur in rheumatoid arthritis.

Complications

pathologies of the cardiovascular system;
nervous system dysfunction;
blood diseases;
damage to the respiratory system;
kidney diseases;
damage to the joints and musculoskeletal system;
skin lesions;
eye diseases;
gastrointestinal dysfunction;
mental disorders;
other pathologies.

How to distinguish RA from other diseases?

Unlike rheumatism, with rheumatoid arthritis the inflammation is persistent - pain and swelling of the joints can last for years. This type of arthritis differs from arthrosis in that the pain does not increase with load, but, on the contrary, decreases after active movements.

Diagnostics

American Rheumatological Association Diagnostic Criteria for Rheumatoid Arthritis (1987). The presence of at least 4 of the following signs may indicate the presence of the disease:

morning stiffness for more than 1 hour;
arthritis of 3 or more joints;
arthritis of the joints of the hands;
symmetrical arthritis;
rheumatoid nodules;
positive rheumatoid factor;
radiographic changes.

Indicates the presence of inflammation in the body: the appearance of special inflammatory proteins - seromucoid, C-reactive protein, and rheumatoid factor.

Making a diagnosis of rheumatoid arthritis is possible only by assessing the entire set of symptoms, radiological signs and laboratory diagnostic results. If the result is positive, treatment is prescribed.

Treatment of rheumatoid arthritis

In case of accurate diagnosis of rheumatoid arthritis, systemic treatment involves the use of certain groups of drugs:

basic drugs;
hormonal substances (glucocorticoids);
biological agents.

At the present stage of development of medicine, the following goals are set in the treatment of rheumatoid arthritis:

reduction and, if possible, elimination of symptoms of the disease,
prevention of destruction of joint tissue, disruption of its functions, development of deformations and adhesions (ankylosis),
achieving stable and long-term improvement in the condition of patients,
increase in lifespan,
improving quality of life indicators.

Treatment consists of a complex of methods of drug therapy, physiotherapy, nutritional therapy, surgical treatment, sanatorium treatment and subsequent rehabilitation.

Nonsteroidal anti-inflammatory drugs

This group of drugs is not included in the basic therapy of rheumatoid arthritis, since it does not affect the destructive process in the joints. However, drugs from this group are prescribed to reduce pain and eliminate stiffness.
in the joints.

Most often used:

Prescribed during periods of exacerbation of pain and severe stiffness. Prescribed with caution to patients with gastritis.

Basic drugs

In combination with hormones, they help reduce the activity of rheumatoid arthritis. The most common drugs for treatment currently are:

gold preparations;
leflunomide;
penicillamine;
sulfasalazine.

There are also reserve drugs: cyclophosphamide, azathioprine, cyclosporine - they are used when the main drugs do not give the desired effect.

Biological agents

Monoclonal antibodies to certain cytokines neutralize tumor necrosis factor, which in the case of rheumatoid arthritis provokes damage to its own tissues.

There are also studies suggesting the use of lymphocyte differentiation regulators as a treatment for rheumatoid arthritis. This will avoid damage to the synovial membranes by T-lymphocytes, which are incorrectly “directed” to the joints by the immune system.

Glucocorticoids

These are hormonal drugs:

dexamethasone;
methylprednisolone;
triamcinolol;

They are prescribed both in the presence of systemic manifestations of the disease and in their absence. Today, in the treatment of rheumatoid arthritis, treatment is practiced with both small and large doses of hormones (pulse therapy). Corticosteroids are excellent for pain relief.

Methotrexate for rheumatoid arthritis

According to reviews, methotrexate for rheumatoid arthritis is actively prescribed in Russia and European countries. This is a drug that inhibits cells of the immune system, prevents the occurrence of inflammatory processes in the joints and aggravates the course of the disease. Now it is used very widely.

The drug has several side effects, so it is used under the close supervision of the attending physician; during the course of treatment, the patient must regularly undergo blood tests. Despite this, methotrexate for rheumatoid arthritis is the most appropriate solution, and in some cases it is simply irreplaceable.

The price of the drug varies depending on the form of release in the range from 200 to 1000 rubles.

Physiotherapy

Only after the acute form of the disease has been relieved, blood tests and temperature are normalized - massage and other methods of physiotherapy for rheumatoid arthritis can be used. The fact is that physiotherapy has a stimulating effect and can intensify the inflammatory process.

These methods improve blood supply to the joints, increase their mobility, and reduce deformation. Phonophoresis, diathermy, UHF, ozokerite and paraffin, infrared irradiation, therapeutic mud, and balneotherapy at resorts are used. We will not dwell on these methods in detail.

Operation

Surgery can improve the health situation in the relatively early stages of the disease if one large joint (knee or wrist) is persistently inflamed. This surgery (synovectomy) removes the synovial lining of the joint, resulting in long-term relief of symptoms.

Joint replacement surgery is performed for patients with more severe joint damage. The most successful operations are on the hips and knees.

Surgical intervention has the following goals:

relieve pain
correct deformities
improve the functional condition of joints.

Rheumatoid arthritis is primarily a medical problem. Therefore, surgery is reserved for those who are under the supervision of an experienced rheumatologist or doctor.

Nutrition

The rules of the diet are as follows:

including enough fruits and vegetables;
reducing the load on the kidneys, liver and stomach;
exclusion of foods that cause allergies;
replacing meat with dairy and plant products;
consumption of foods high in calcium;
avoidance of foods that cause excess weight.

Rheumatoid arthritis treatment with folk remedies

Treatment with folk remedies involves the use of medicinal plants that have analgesic and anti-inflammatory properties.

To relieve pain in rheumatoid arthritis, you should take equally elderberry flowers, parsley root, stinging nettle leaf and willow bark. Grind everything, and then brew 1 tablespoon of the mixture with 1 glass of boiling water, then boil for 5-7 minutes over low heat, then cool and strain. Take two glasses of decoction, morning and evening.
Flowers collected during chestnut flowering filled with high-quality vodka (you need to take one part of vodka for two parts of flowers). The mixture is infused for two weeks in a dark place, filtered and after that the tincture is ready for use. You need to take the tincture 5 drops three times a day an hour before meals.
Dissolves in one hundred grams of alcohol 50 grams of camphor oil and add 50 grams of mustard powder. Separately, beat the whites of two eggs and add them to the mixture. The resulting ointment is rubbed into the affected joint and relieves pain symptoms well.
Burdock will help relieve joint pain. It can be used in the form of tinctures. Grind the leaves of the plant in a meat grinder and pour in vodka (500 ml of vodka for 500 g of leaves). Shake the mixture and put it in the refrigerator. At night, apply gauze soaked generously in this solution to the sore spot. The pain goes away after several compresses. Treatment of rheumatoid arthritis with folk remedies can also be done by wrapping whole burdock leaves at night.

At home, you can make compresses, rub in homemade ointments, and prepare decoctions. It is important to follow the correct eating style, which helps restore metabolism in the body.

Prevention

Prevention of the disease and its exacerbations is aimed, first of all, at eliminating risk factors (stress, smoking, toxins), normalizing body weight and maintaining a balanced diet.

Compliance with these rules will help avoid disability and prevent the rapid progression of RA.

Forecast

Rheumatoid arthritis shortens life expectancy by an average of 3 to 12 years. A 2005 study by the Mayo Clinic found that the risk of heart disease is twice as high in those with rheumatoid arthritis, regardless of other risk factors such as diabetes, alcoholism, high cholesterol and obesity.

The mechanism by which the risk of heart disease increases is unknown; the presence of chronic inflammation is considered a significant factor. It is possible that the use of new biological drugs can increase life expectancy and reduce risks for the cardiovascular system, as well as slow down the development of atherosclerosis.

Limited studies demonstrate a reduction in the risk of cardiovascular disease, while an increase in total cholesterol levels is observed while the atherogenic index remains unchanged.

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by autoimmune damage mainly to small joints, ligaments, skin, blood vessels and internal organs.

Inflammation and subsequent destruction of the joints ultimately leads to early loss of ability to work and disability. Rheumatoid arthritis most often affects women, with the peak incidence occurring between 40 and 50 years of age. The onset of the disease is often associated with injury, hypothermia, a viral infection, or severe psycho-emotional stress. Timely diagnosis and adequate treatment are critical to the outcome of rheumatoid arthritis.

Causes of rheumatoid arthritis

The true causes of RA have not been established. Possible causes that contribute to the development of rheumatoid arthritis include:

family predisposition;
viral infections: Epstein-Barr virus, lymphotropic T-cell virus, parvovirus B19.

The development of the disease is based on excessive, improper functioning of the immune system, when immune cells begin to perceive their own tissues as foreign. Under the influence of external causes, immune cells actively produce special proteins (cytokines) that cause inflammation in the lining of the joints, blood vessels and cartilage. Subsequently, foci of chronic inflammation are formed, which leads to the slow destruction of connective tissue, which is the basis of cartilage, bones, blood vessels and the framework of internal organs.

Early symptoms of RA may include weight loss and low-grade fever (37-38C), morning stiffness, and joint tension or tenderness. All symptoms of arthritis are divided into articular and extra-articular manifestations.

Articular manifestations:

Morning stiffness and limited joint mobility, which goes away after physical activity.
Pain and swelling in the affected joints.
Weakening the grip force in the hand.
Subsequently, deformities, subluxations and ankylosis (immobility) of the joints develop.
When the laryngeal joints are involved in the process, deepening of the voice, shortness of breath, and swallowing disorders develop.
Bursitis (inflammation of the joint capsule) and tenosynovitis (inflammation of the synovial membrane of the tendon).

Symmetrical damage to the joints of the hands and feet is specific for rheumatoid arthritis. Isolated lesions of other joints are less common.

Extra-articular manifestations:

General symptoms: weakness, weight loss, fever and weight loss.
Cardiosclerosis is the proliferation of fibrous tissue in the heart, leading to chronic heart failure.
Rheumatoid nodules are subcutaneous painless foci of inflammation.
Cutaneous vasculitis is inflammation of small vessels of the skin. It is characterized by the appearance of rashes, ulcers, and in rare cases can lead to the development of gangrene.
Generalized amyotrophy (loss of muscle mass), myopathy (damage to muscle fibers).
Amyloidosis is a disorder of protein metabolism, characterized by the deposition in blood vessels and tissues of special protein complexes that disrupt the normal functioning of organs. The kidneys and heart are most often affected. One of the first manifestations of amyloidosis may be an increase in protein in the urine.
Neuropathy (nerve damage).
Generalized lymphadenopathy (enlarged lymph nodes), hepatosplenomegaly.
Pleurisy, pericarditis.
Glomerulonephritis (kidney disease).
Sjögren's syndrome, accompanied by dry mucous membranes.
Eye damage: scleritis, episcleritis, retinal vasculitis.
Raynaud's syndrome, accompanied by cold, bluish skin in the fingers, sometimes the development of gangrene.

The symptoms of rheumatoid arthritis are persistent and do not go away without treatment. Sometimes the course of the disease has a wave-like character with periods of improvement and deterioration.

Diagnosis of rheumatoid arthritis

To verify the diagnosis:

General examination and medical history. Mobility, pain or swelling of joints, skin condition are assessed, lymph nodes, liver and spleen are palpated. The patient’s information about possible injuries, stress and previous infections is clarified.

A number of laboratory tests are prescribed:

Complete blood count (evaluate the number of red blood cells, leukocytes and platelets, hemoglobin level, ESR).
General urine analysis.
Urinalysis according to Nichiporenko (if indicated).
Biochemical blood test (assess ALT, AST, urea, creatinine, alkaline phosphatase, total protein, cholesterol, bilirubin, glucose, C-reactive protein).
Determination of rheumatoid factor in blood serum.
Determination of antibodies to cyclic citrullinated peptide (ACCP).
Coagulogram.
ELISA or PCR diagnosis of infections (hepatitis, HIV, chlamydia, gonorrhea, Trichomonas, Epstein-Barr virus).

Conduct instrumental research:

X-ray of the hands and feet, pelvic bones and other joints as indicated.
Ultrasound of joints and joint puncture followed by assessment of joint fluid.
Arthroscopy (examination of the joint cavity using a special device) with a biopsy and subsequent morphological examination of the tissue.
X-ray of the chest organs.
ECHO-KG and ECG.
Ultrasound of the abdominal organs and kidneys.
FGDS.
CT and MRI.

If necessary, consultations with other specialized specialists (ophthalmologist, traumatologist-orthopedist) are carried out.

Treatment of rheumatoid arthritis

Treatment of rheumatoid arthritis is aimed at reducing the severity of the disease, preventing joint destruction and reducing their function, improving quality of life and increasing life expectancy.

Non-drug treatment:

Purpose of a balanced diet: sufficient consumption of foods containing polyunsaturated fatty acids (fish oil, olive oil, etc.) is necessary.
Physiotherapy.
Physiotherapy: ultrasound, laser therapy, etc.

Drug treatment is the main treatment for rheumatoid arthritis.

cytostatic drugs, immunosuppressants, etc. The result of treatment with these drugs develops slowly (over 2-6 months or more), but is very stable.
Biotechnological preparations (R – Mab) are high-tech biological preparations that have a powerful anti-inflammatory effect, exerting a targeted effect on any link in the process of inflammation.
Targeted synthetic drugs also have a targeted effect on a specific inflammatory mechanism.
Glucocorticosteroids - have a strong anti-inflammatory effect, act quickly, but the therapeutic effect is unstable.
Non-steroidal anti-inflammatory drugs. They have a rapid analgesic effect, but their anti-inflammatory effect is weak. Prescribed at an early stage of treatment of the disease to correct symptoms in combination with basic anti-inflammatory treatment. In addition to the systemic administration of drugs, their intra-articular administration is possible.

Starting treatment at an early stage of the disease allows you to achieve good results, maintain ability to work and quality of life. To achieve the best effect from therapy, it is necessary to give up bad habits (smoking, drinking alcohol), try to avoid psycho-emotional stress, and prevent infections.

I never thought that I would go to doctors so much in search of the cause of my ill health. By my specialty, I am a nurse, and I hoped that by rotating in a medical environment, I would be able to cope with any abnormalities in the body. But making my correct diagnosis proved difficult even for experienced doctors.

It all happened 2 years ago. For a year I was painfully ill. Periodically, the joints on my legs became inflamed to the point of being unable to stand on my feet, my ankles became swollen, and then pain appeared in my spine, and this pain spread throughout my body. My hands became swollen and began to go numb. The pain was concentrated in the left hand, 3 fingers on it went numb. I turned to a massage therapist, who often saved me from exacerbation of osteochondrosis, I thought that was the reason. But there was no effect from the massage.

I went to see a therapist, who prescribed tests for me and referred me to a cardiologist. The cardiologist, in turn, did not find any cardiological abnormalities and sent me to a surgeon. The surgeon goes back to the therapist. In the district consultation, I walked in circles, trying to find the cause of my condition. As a result, I was admitted to the cardiology department because my blood pressure had risen. There were no effects from treatment in the hospital.

Desperate, I even turned to an oncologist. My torment would have continued for a long time if one of the doctors had not advised me to go to a rheumatologist, which I did.

Finally, the rheumatologist made the correct diagnosis - rheumatoid arthritis. At this moment I was very worried about aching muscle pain. The joints of the feet and wrists were inflamed. There was constant pain in the joints, I could not even walk. The doctor prescribed treatment for 4 months, after which I felt better. Then life circumstances developed in such a way that there was no time to continue treatment for rheumatoid arthritis, and I felt so much better that I thought about healing. However, it turned out that this was my mistake, since rheumatoid arthritis is a chronic disease. If it appears once, you must always be on guard. The result of forgetting about my illness was a complication in the elbow and shoulder joints, the spine, with pain in which I now live constantly.

What is rheumatoid arthritis

Modern diagnostics can now easily identify rheumatoid arthritis in the early stages. However, in district consultations it is often suggested at the very last moment, when there is already deformation of the joints.

Rheumatoid arthritis is a systemic connective tissue disease. The disease is chronic, infectious-inflammatory in origin, which affects both peripheral small joints and large joints such as our spine. In addition, the destructive processes are so strong that the joints can cease to perform their function until they become completely immobile. Among other things, rheumatoid arthritis can be considered an autoimmune disease. That is, the body’s defense system perceives its cells as foreign. She reacts to her own cells, like viruses and bacteria, directing her aggression towards her own body.

For many years, both in our country and abroad, they have been looking for ways to combat rheumatoid arthritis. It can have an acute onset or proceed in a sluggish form. Has no seasonality, i.e. appearance can be expected at any time of the year. Rheumatoid arthritis cannot be infected.

What can cause rheumatoid arthritis?

Injuries.
Various infectious diseases (sore throat, acute respiratory infections, any viral diseases - for example, herpes, rubella, hepatitis).
Decreased immunity, which is facilitated by acute and cumulative stress and depression.

Symptoms of rheumatoid arthritis

The disease begins differently in each case. Rheumatoid arthritis can begin acutely or subacutely (when one or 2 joints suddenly swell).
Appears joint pain, especially when walking. It may occur in the morning and especially in the evening.
Often the joints become inflamed symmetrically. It happens that pain appears in one or another joint, while in the first it has stopped.
Muscle pain in rheumatoid arthritis they are of a long-term aching nature. The patient often tries to rub the muscles with warming ointments, but the effect is insignificant.
In the latent period of rheumatoid arthritis, it manifests itself severe fatigue, weakness, malaise. Stiffness in movements in the morning. A person can hardly clench his hand into a fist.
May appear fever(presence of unmotivated jumps in body temperature).
Sweating.

In later stages of rheumatoid arthritis appear:

Extra-articular lesions in rheumatoid arthritis

Rheumatoid arthritis is not only a joint disease. It affects connective tissue, that is, problems arise in all organs and systems where it is present. These include muscles in any organ and blood vessels. That is, the respiratory, cardiovascular system, and kidneys suffer.

It happens that doctors rarely pay attention to extra-articular lesions. It must be said that it is in vain, since very often these disorders are more serious for the patient than joint lesions.

Thus, with rheumatoid arthritis, one disorder is layered on top of another. It seems that the body is falling apart, which is not far from the truth. The problem is that people believe that these are different diseases. In fact, these are manifestations of the same disease - rheumatoid arthritis.

Why is rheumatoid arthritis so scary? secondary amyloidosis . Amyloid is a pathologically altered protein. When amyloid is deposited in various organs, it destroys them. The most serious complication is renal amyloidosis. Most often this leads to kidney failure.

Treatment of rheumatoid arthritis

Early treatment helps prevent the irreversible consequences of rheumatoid arthritis. Currently, there are many good drugs that are successfully used for arthritis. There is one important rule in the treatment of rheumatoid arthritis: if such a diagnosis is made, treatment and prevention of exacerbations must be constantly addressed, once every six months by contacting a rheumatologist.

Drug treatment is prescribed by a doctor and only by him.

Herbal medicine will help support the body with rheumatoid arthritis. Meeting with a competent herbalist greatly alleviated my condition. I am now sharing this information with you, dear readers.

Herbs for rheumatoid arthritis

Tinctures that are taken in a course of 21 days are very effective:

Elecampane tincture 25%, 30 drops 3 times a day.
Burdock tincture 20%, 30 drops 3 times a day.
Baikal skullcap tincture 25%, 10 drops 3 times a day.
Calamus tincture 20%, 20 drops 3 times a day
Thyme tincture 10% 10 drops 3 times a day

Water extracts (infusions and decoctions) of lingonberry, lemon balm, St. John's wort, bearberry, string, orthosiphon, agrimony, sweet clover, astragalus, and elderberry support the body well. Separately, tansy can be distinguished, with infusions of which they take baths and take a 5% infusion orally. Tansy has immunomodulatory, antibacterial and anti-inflammatory effects. But we must not forget that tansy is poisonous, so it is important not to overdo it in doses.

Cranberry juice, lemon juice and tea with honey are useful.

Medicinal herbs are used to make infusions that are even more effective than the herbs individually. These preparations should have an anti-inflammatory effect and can be taken during hospital treatment.

For rheumatoid arthritis, many herbs are used that can be combined with each other in preparations:

Meadowsweet (meadowsweet)- immunomodulator, reduces blood viscosity, cholesterol levels, improves blood circulation, antiviral and antibacterial agent.
St. John's wort- a good antiseptic and at the same time a sedative, relieves pain.
Knotweed (knotweed) grass- cleanses the kidneys.
Birch leaves(especially May) - puts the kidneys in order, cleanses the body.
Stinging nettle(mayleaf) is a source of vitamins, affects blood circulation, relieves inflammation, but all infusions with nettle should be used on the day of production, because become toxic when stored.
Ledum shoots is a potent remedy, so a minimal amount is added to preparations. Ledum is a strong analgesic component.
White willow bark contains aspirin. Shavings of this bark can even replace cardiomagnyl or aspirin-cardio.
Wormwood, herb- cleanses the body, in particular the liver, restores normal metabolism. This is a very important component, since many drugs used for arthritis have a very aggressive effect on the liver. In this case, wormwood acts as a detoxifying component, i.e. removes poisons.
Also effective for rheumatoid arthritis juniper fruits in the form of a decoction sage, strawberry herb, silverweed (gurley).
Has a good anti-inflammatory effect creeping wheatgrass (cat grass roots).
Licorice naked acts as a hormone-like agent. Burdock is useful for rheumatoid arthritis both in the form of infusion and tincture. Forest geranium (joint, cinquefoil - not to be confused with cinquefoil!) is used in tinctures. But cinquefoil is a powerful anti-inflammatory agent and is widely used to make dietary supplements and ointments for arthritis.
Among other things, plants containing vitamins are very useful (rose hips, mountain ash, buckwheat, wild strawberries, creeping clover). These plants are good to add to preparations for rheumatoid arthritis.
Can be used pine needles and heather. A little about heather: it calms the nervous system, relieves inflammation, heals the kidneys, and relieves pain.
Usage horse chestnut in the form of a tincture for rubbing has long been used for rheumatoid arthritis.

It must be said that Chinese medicine, unlike European medicine, considers rheumatoid arthritis to be a treatable disease. For this, an extract of mountain ants is used, which is designed to regulate the immune system in case of autoimmune disorders, and a mushroom called cordyceps.

In conclusion from the author

If you have a suspicion of rheumatoid arthritis, if you feel that you are not suffering from the flu, but you have a fever, pain in the joints, your heart is acting up, your blood pressure is rising, you should definitely consult a specialist. From my own experience, I was convinced that the rheumatologist should be one of the first doctors to visit, and not the last, as in my case. Delay leads to the fact that we waste the time that is needed to stop rheumatoid arthritis in the initial stage, and not lead to its more complex manifestations and complications.

Nature has given us a large number of remedies that can support the body with rheumatoid arthritis and protect against the negative effects of drug therapy, which cannot be avoided. We must not forget about the disease “rheumatoid arthritis,” as happened to me; we must try to use all means for rehabilitation in order to prevent further destruction of joints and other organs. And, of course, you shouldn’t give up and be lazy about brewing all this and accepting it in a disciplined manner.

I wish everyone who is faced with the same illness as me to relentlessly act in preventing complications and exacerbations of rheumatoid arthritis.

Good health!

Honey. sister Lyudmila Karpova, Vladimir

Rheumatoid arthritis is a disorder in which the immune system attacks the body's joints and causes them to become inflamed. What are the first signs of this condition?

Symptoms of rheumatoid arthritis (RA) usually affect the hands and feet. Early recognition of RA makes it possible to conduct an early diagnosis and begin treatment in a timely manner.

Proper management of arthritis in its early stages can prevent joint damage and potential disability.

In this article, we will talk about the early signs of rheumatoid arthritis, as well as discuss risk factors and explain when to see a doctor.

The content of the article:

What is rheumatoid arthritis?

Rheumatoid arthritis is characterized by inflammation of the joints that occurs due to improper functioning of the immune system

Rheumatoid arthritis results from problems with the immune system. When a person's immune system is healthy, it helps the body fight infections. In people with RA, the immune system mistakenly attacks healthy cells in the lining of the joints, causing the joints to become inflamed and painful.

People with rheumatoid arthritis usually don't experience symptoms every day. Periods of time when symptoms worsen are called flares in medicine.

There are currently no therapeutic strategies that can completely cure rheumatoid arthritis, but proper treatment and light physical activity usually help people control flare-ups. If RA is left untreated, changes can occur in the joints, cartilage and bones that the body may not be able to reverse in the future.

Early signs

The main symptoms of rheumatoid arthritis are joint pain and stiffness. Before these symptoms begin to appear, a person may observe early signs of the disease.

Some early signs are related to a person’s general well-being, while others are specific to the joints. Symptoms that affect joints are more likely to indicate rheumatoid arthritis, especially if they occur in more than one joint or occur symmetrically.

If a person recognizes these warning signs, he can receive treatment at the earliest possible stage of the disease. Below are the most common early signs of rheumatoid arthritis.

Fatigue

Before developing any other symptoms of rheumatoid arthritis, people may experience severe fatigue and lack of energy. Sometimes these symptoms are also accompanied by depression.

Feeling exhausted can prevent a person from:

daily life activities;
maintaining and building relationships with others;
sexual activity;
At work.

Experts suggest that people with rheumatoid arthritis feel tired as a response to joint inflammation.

slight fever

The inflammation associated with RA can cause problems with well-being and a slight increase in body temperature. A low-grade fever may be an early sign of rheumatoid arthritis. This symptom sometimes occurs along with fatigue. It may precede any noticeable changes in the joints.

Weight loss

The third early sign of rheumatoid arthritis is unexplained weight loss. It is possible that this effect also represents a direct consequence of inflammatory processes.

If a person has a fever and is constantly tired, he may lose his appetite, which causes weight loss.

Stiffness

Joint stiffness and tenderness are early signs of rheumatoid arthritis.

The next warning sign of rheumatoid arthritis is stiffness. Stiffness may initially appear in one or two small joints. Often this symptom begins to develop on the fingers. It can bother a person for several days.

In addition to the stiffness that affects individual joints, in the early stages of rheumatoid arthritis, a person may experience a feeling of stiffness throughout the body. This symptom usually occurs after a long period of inactivity and is characterized by morning stiffness, which is a common complaint among people with rheumatoid arthritis.

Joint tenderness

Tenderness in the joints of the hands and feet is a typical early sign of rheumatoid arthritis.

The joints located at the base and middle of the fingers may become painful when pressure is applied or when a person moves them.

On the feet, the joints located at the base of the toes become sensitive. Because of the soreness, people may walk on their heels or lift their toes when walking.

Joint pain

Pain in the joints of the fingers, wrists and feet is an early sign of rheumatoid arthritis. Due to developing inflammation, the synovial membrane of the joints thickens and the production of joint fluid increases.

Both of these factors put pressure on the capsule surrounding the joint and irritate the nerve endings contained there. All this causes pain.

Swelling of the joints

Joints that look swollen are a typical sign of rheumatoid arthritis. Joint swelling is usually more noticeable in later stages of the disease, but can sometimes be an early sign of RA.

Redness of the joints

Inflammation in the joints can make them appear red. More precisely, the skin that covers the joints becomes red. Redness of the skin in the joint area is another early sign of rheumatoid arthritis.

The skin turns red because inflammation causes the blood vessels in the skin to dilate. Dilated vessels allow large volumes of blood to approach the affected area, causing the skin to take on a reddened appearance.

Warming of the joints

Warming of the joints is an early sign of RA, which also results from inflammation. This symptom may occur before redness and swelling develop.

Numbness and tingling

Numbness and tingling in the hands and feet may be one of the first signs of rheumatoid arthritis. These symptoms occur because inflammation of the joints causes pressure on the nerves, causing the limbs to lose sensation.

Decreased mobility

In the early stages of rheumatoid arthritis, people may experience difficulty bending the wrist to either side.

As the disease progresses, damage to the joints can affect the ligaments and tendons, making them more difficult to function.

Joints affected on both sides of the body

People with rheumatoid arthritis usually experience symptoms in the same joint on both sides of the body. However, such symmetry is not typical for every case.

Complications

You should always tell your doctor if your symptoms are getting worse, as this may indicate complications are developing.

If left untreated, rheumatoid arthritis can cause permanent damage to the joints, surrounding cartilage, and nearby bones. As a result of such damage, the joint may become deformed.

Advanced rheumatoid arthritis also leads to the formation of hard subcutaneous tubercles in the area of the affected joints, which are called. These nodules are usually the first visible sign in people with rheumatoid arthritis.

In addition to joint deformation and the appearance of rheumatoid nodules, RA can lead to the following:

carpal tunnel syndrome;
inflammation in other areas of the body, including the eyes, heart, and lungs;
increased risk of heart attack and stroke.

You can read more about the effect of rheumatoid arthritis on the body.

Risk factors

Doctors don't know what causes the immune system to attack healthy joints.

However, researchers have been able to identify some factors that may increase the risk of developing rheumatoid arthritis. Such factors include the following.

Floor. Women have an increased risk of developing RA compared to men. In 2011, American scientists conducted a study and found that every twelfth woman suffers from rheumatoid arthritis and only every twentieth man.
Smoking. A 2009 study by Hungarian researchers provided solid evidence that smoking increases the risk of developing rheumatoid arthritis and may cause it to progress more rapidly.
Excess weight. In 2016, Swedish scientists published the results of a study showing that obesity does not significantly increase the risk of developing RA.

Certain factors may prevent rheumatoid arthritis from developing. Such factors include the following.

Moderate alcohol consumption. In 2012, Swedish researchers found that moderate alcohol consumption was associated with a reduced risk of developing rheumatoid arthritis.
Lactation. According to a 2014 study by Chinese scientists, women who breastfeed also have a reduced risk.

When should you see a doctor?

If a person experiences early signs or symptoms of rheumatoid arthritis, they should see a doctor. The specialist will conduct an examination and, if the diagnosis is confirmed, prescribe appropriate treatment.

Early diagnosis and early treatment of rheumatoid arthritis reduce the risk of developing serious complications.

Scientific editor: Strokina O.A., therapist, functional diagnostics doctor.
November, 2019.

Rheumatoid arthritis is an inflammatory disease characterized by symmetrical damage to the joints and inflammation of the internal organs.

Prevalence and causes

As of 2018, about 300 thousand patients with rheumatoid arthritis were recorded in Russia (~0.61% of the adult population). In the world as a whole, the percentage of patients ranges from 0.5 to 2%.

Women suffer 3 times more often than men. The peak incidence of rheumatoid arthritis is 40-55 years, but it also occurs at younger ages. Half of the patients lose their ability to work in the first 3-5 years of the disease.

The cause of rheumatoid arthritis is unknown. Recently, researchers have been inclined to believe that the leading cause of the development of rheumatoid arthritis is a combination of internal factors (genetics, production of sex hormones) and environmental factors (bacterial and viral infections, occupational hazards, stress).

It has been proven that smoking is a leading external factor in the development of pathology. The results of a large-scale study have been published showing that passive smoking in childhood also significantly increases the risk of developing rheumatoid arthritis in adulthood.

Symptoms of rheumatoid arthritis

The development of the disease occurs gradually. First, general symptoms and mild symptoms of joint damage appear.

General signs

Fatigue - usually appears several weeks or months before other symptoms develop. Fatigue can be either constant or periodic.
A slight increase in body temperature in combination with joint symptoms (temperatures above 38C are usually not typical for rheumatoid arthritis).
Eye problems (itching, inflammation or discharge) - Sjögren's syndrome.
Losing weight.

Rheumatoid nodules are dense subcutaneous formations, in typical cases localized in areas that are often subject to trauma (for example, in the area of the olecranon, on the extensor surface of the forearm). Observed in 20-50% of patients. Very rarely found in internal organs (for example, in the lungs).

In some cases, an enlarged spleen is observed.

Also, with rheumatoid arthritis, signs of osteoporosis (this is bone loss) and amyloidosis may appear.

Ulcers on the skin of the legs and inflammation of the arteries are common.

Photo: localization of rheumatoid nodules

Joint damage

Symmetry of joint damage is an important feature of rheumatoid arthritis (for example, the right and left elbow joints or the right and left knee joints are affected)

Fatigue is one of the "debilitating" symptoms of rheumatoid arthritis (as with many other autoimmune diseases). The problem of combating fatigue and fatigue in autoimmune diseases has recently received increasing attention; according to a 2018 study, pathological fatigue is one of the reasons for decreased performance in people with rheumatoid arthritis.

Photo: target joints and mechanism of joint damage in early stage rheumatoid arthritis.

Nonspecific blood parameters

Anemia due to a slowdown in iron metabolism in the body caused by impaired liver function;
Decrease in the number of platelets, neutrophils.

Common patterns of onset of the disease

Rheumatoid arthritis can start in different ways. The most common joint symptoms characteristic of the onset of the disease are described below:

Pain and stiffness increase gradually, most often in the small joints of the hands. Typically, manifestations are not related to the time of day. Symmetrical joints are necessarily affected. The duration of the increase in symptoms is several months.
Pronounced stiffness of the joints of the hands and feet in the morning. In this case, early detection of rheumatoid factor in the blood is typical.
Recurrent tenosynovitis, especially often in the area of the wrist joints (inflammation of the tendon, characterized by swelling, pain and a distinct creaking sound during movement).
Inflammation of the knee or shoulder joints, followed by rapid involvement of the small joints of the hands and feet.

It is also worth keeping in mind that in a significant proportion of patients, rheumatoid arthritis begins with uncharacteristic manifestations, for example, with inflammation of large rather than small joints.

Photo: deformed joints with rheumatoid arthritis

Diagnostics

Important signs

American Rheumatological Association Diagnosis Criteria for Rheumatoid Arthritis. Presence of at least 4 of the following:

morning stiffness for more than 1 hour;
arthritis of 3 or more joints;
arthritis of the joints of the hands;
symmetrical arthritis;
rheumatoid nodules;
positive rheumatoid factor;
radiographic changes.

Laboratory research

In general and biochemical blood tests:

anemia,
increase in ESR,
increased levels of C-reactive protein.

Rheumatoid factor (antibodies to immunoglobulins class M) is positive in 70-90% of cases.

High values of ACCP (antibodies to cyclic citrullinated peptide).

The joint fluid is cloudy, with low viscosity, and the number of leukocytes and neutrophils is increased.

Instrumental studies

If the X-ray results are ambiguous, the doctor may prescribe an MRI of the joints, because MRI is a more sensitive method.

According to indications, an ultrasound of small joints or radiography of large ones may be prescribed. If lung damage is suspected, a CT scan is prescribed.

Treatment of rheumatoid arthritis

Drug therapy includes the use of three groups of drugs:

basic drugs
non-steroidal anti-inflammatory drugs (NSAIDs)
glucocorticoids

Basic drugs

The main drugs for basic therapy of rheumatoid arthritis are:

Methotrexate
Leflunomide
Sulfasalazine
Hydroxychloroquine

In Russia, the standard of treatment is therapy with methotrexate or its combination with sulfasalazine and hydroxychloroquine. Basic drugs should be started as early as possible.

Basic drugs that are ineffective for 1.5-3 months should be replaced or used in combination with hormones in small doses, which can reduce the activity of rheumatoid arthritis.

Six months is a critical period from the onset of symptoms of joint damage, no later than which effective basic therapy must be selected.

During treatment with basic drugs, disease activity and side effects are carefully monitored. It is necessary to monitor indicators of general blood count, AST, ALT and creatinine.

Important! During treatment with methotrexate, to reduce the risk of adverse reactions, it is recommended to take folic acid, at least 5 mg per week. It is taken 24 hours after taking methotrexate.

Nonsteroidal anti-inflammatory drugs

The most commonly used NSAIDs are:

diclofenac,
nimesulide,
meloxicam,
ketoprofen,
celecoxib.

These drugs have minimal side effects and retain high anti-inflammatory and analgesic activity.

At the beginning of treatment, when the inflammatory process is active, meloxicam (Movalis) is prescribed at 15 mg/day, and later switched to 7.5 mg/day. as maintenance therapy.

Nimesulide is prescribed at a dose of 100 mg twice a day.

Celecoxib (Celebrex) is prescribed 100-200 mg twice a day.

For elderly people, selection of the dosage of the drug is not required. However, in patients with a body weight below average (50 kg), it is advisable to start treatment with the lowest recommended dose.

The combination of two or more non-steroidal anti-inflammatory drugs should be avoided as their effectiveness remains unchanged and the risk of side effects increases.

Glucocorticosteroids (hormones)

With a high degree of inflammation activity, hormones are used, and in cases of systemic manifestations of rheumatoid arthritis - in the form of pulse therapy (hormones alone or in combination with a cytostatic - cyclophosphamide), without systemic manifestations - in the form of a course of treatment. Prednisolone is usually used.

Hormones are also used as maintenance anti-inflammatory therapy when other medications are ineffective.

In some cases, hormones are used as local therapy.

Ointments, creams, gels based on non-steroidal anti-inflammatory drugs (ibuprofen, piroxicam, ketoprofen, diclofenac) are used in the form of applications to inflamed joints.

To enhance the anti-inflammatory effect, applications of the above-mentioned ointment forms of drugs are combined with applications of a dimethyl sulfoxide solution at a dilution of 1:2-1:4.

Complementary therapy

In the absence of a response to standard drug treatment in patients with highly active rheumatoid arthritis, plasmapheresis and lymphocytapheresis are used.

An important point in the treatment of rheumatoid arthritis is the prevention of osteoporosis - restoration of the disturbed calcium balance in the direction of increasing its absorption in the intestines and reducing excretion from the body.

This is what diet is used for. with a high calcium content.

Sources of calcium are dairy products (especially hard cheeses, as well as processed cheese; to a lesser extent cottage cheese, milk, sour cream), almonds, hazelnuts and walnuts, etc., as well as calcium supplements in combination with vitamin D or its active metabolites.

A drug that can be classified as a basic antiosteoporetic agent is myacalcic. It is available for intramuscular administration at 100 IU and as a nasal spray; is prescribed according to the regimen together with calcium preparations (calcitonin) and vitamin D derivatives.

Laser therapy is also used in the treatment of rheumatoid arthritis. Especially for severe exacerbations of rheumatoid arthritis, extracorporeal treatment methods (primarily hemosorption and plasmapheresis) have been widely used in recent years.

Laser therapy is especially indicated at an early stage of the process. The course does not exceed 15 procedures.

In order to reduce pain and eliminate spasm of periarticular tissues, cryotherapy (cold treatment) is used for a course of 10-20 procedures.

In order to influence allergic processes, improve tissue nutrition and eliminate inflammation, other physical treatment methods are also used.

If more persistent changes in the joints appear and in the absence of signs of high activity, hydrocortisone phonophoresis, magnetic therapy, and pulsed currents are prescribed.

Physical therapy and massage are prescribed to all patients in order to relieve muscle spasms and quickly restore joint function.

All patients with rheumatoid arthritis should be systematically observed and examined by a rheumatologist.

Patients with a slowly progressive course without damage to internal organs should see a rheumatologist once every 3 months. If there is damage to internal organs, patients are examined by a rheumatologist once every 2-4 weeks.

Spa treatment for patients with rheumatoid arthritis is recommended annually outside the exacerbation phase.

In case of a benign course of the process without pronounced changes in the joints, the use of radioactive baths in Tskhaltubo and Belokurikha is indicated; with a typical progressive process - treatment with hydrogen sulfide baths in Sochi, Sernovodsk, Pyatigorsk, Kemeri; for severe deformities and contractures - treatment with mud applications in Evpatoria, Saki, Pyatigorsk, Odessa.