The incidence of women is up to 5 times higher...What are the treatment and living rules?
Feb 04, 2025
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The major symptoms, treatment, and management methods of rheumatoid arthritis, which have increased 72% over 10 years as of 2020, were summarized with Professor Lee Eun-young of the Department of Rheumatology at Seoul National University Hospital.
- What is rheumatoid arthritis?
▶Rheumatoid arthritis is an autoimmune disease caused by chronic inflammation of the synovial membrane that makes up the joint. It causes cartilage damage and bone erosion, leading to joint destruction, and in severe cases, can cause physical dysfunction. The incidence rate of women is three to five times higher than that of men, and it can occur in all age groups.
-What are the symptoms of rheumatoid arthritis?
▶ Prodromal symptoms of rheumatoid arthritis appear over several weeks due to fatigue, loss of appetite, general weakness, and ambiguous pain in muscles and joints, followed by synovitis and swollen joints.
When inflammation invades the joint, pain and swelling occur. It occurs in various areas such as fingers, wrists, shoulders, elbows, ankles, and knees, and usually appears symmetrically on both sides. After waking up, joints can become stiff and hard to move in the morning. Most stiffness lasts more than an hour, and it improves over time.
In addition, anemia can occur depending on the activity and degree of inflammation of the disease, and if systemic invasion such as lung, blood vessels, and heart occurs, the progress is poor.
-What is different from degenerative arthritis?
▶Degenerative arthritis caused by aging of the joint mainly causes pain in the fingertips. On the other hand, rheumatoid arthritis caused by an autoimmune reaction causes pain in the middle finger joint, the start area, and the wrist.
In addition, rheumatoid arthritis after wake-up lasts more than an hour of stiffness that makes it impossible to clench a fist, while degenerative arthritis lasts less than 5-10 minutes of stiffness of the finger joints.
-How to diagnose rheumatoid arthritis?
▶Rheumatoid arthritis is diagnosed when ▲ joint invasion pattern ▲ blood test ▲ acute phase reactant test ▲ symptom duration 4 items are added together and the total score is 6 or higher.
The pattern of joint invasion is evaluated as 0 points for invading one large joint such as shoulder, elbow, ankle, and knee, and 1 point for 2 to 10 violations. It is evaluated as 2 points for 1 to 3 small joints such as fingers and wrists, and 3 points for 4 to 10 small joints. If you invade more than 10 joints, including at least one small joint, it is evaluated as 5 points.
Blood tests are evaluated as 0 points for negative, 2 points for weak positivity (less than 3 times the upper limit of the threshold), and 3 points for strong positivity (more than 3 times the upper limit of the threshold) through rheumatoid factor and anti-CCP antibody tests.
In acute-phase reactants, if the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels are high, one point is added.
If symptoms persist for more than 6 weeks, one point is added to the duration of symptoms.
-What are the complications of rheumatoid arthritis?
▶Rheumatoid arthritis can invade other organs and cause complications. Typically, it can increase the risk of cardiovascular diseases such as arteriosclerosis and angina, so it is necessary to actively treat chronic inflammation itself and reduce the risk of cardiovascular diseases by improving lifestyle such as smoking cessation. The second is interstitial lung disease, which can cause shortness of breath or chronic cough when walking a little faster or climbing stairs. These lung diseases can be accompanied by 1 to 10% of rheumatoid arthritis patients, and management such as smoking cessation and infection prevention is necessary.
- How to treat rheumatoid arthritis?
▶Rheumatoid arthritis is mainly treated with medication. Since it is difficult to cure, the primary goal is to relieve symptoms and delay joint damage through inflammatory control, but recently, treatment strategies aimed at complete remission have been used.
Nonsteroidal anti-inflammatory drugs are mainly used to reduce inflammation and pain, and due to side effects of the digestive system, drugs that protect the stomach are prescribed together. Steroids have a strong anti-inflammatory effect in a short period of time and are effective in relieving acute symptoms. It is recommended to use a small amount within 6 months because long-term use of high doses can lead to side effects. However, these two drugs cannot inhibit the progression of the disease.
Anti-rheumatic drugs suppress immune cells or inflammatory cells to relieve symptoms or control disease progression, and the earlier they start, the better the progress. In the case of classical antirheumatic drugs, the effect appears more than 1 to 3 months later, and there are individual differences. Taking two or more drugs is more effective.
Recently developed biological or synthetic targeted therapy targets several inflammatory substances or hyperactivated immune cells that cause the continuation and exacerbation of arthritis and are widely used worldwide. It is used when classical antirheumatic drugs do not work well, and drugs with different mechanisms have been developed to control the degree and course of arthritis depending on the individual.
Surgical treatment can be considered if joint destruction and deformation are severe and interfere with daily life. However, joint deformation can also affect adjacent joints, requiring in-depth consultation with a specialist.
-What is the non-drug treatment of rheumatoid arthritis?
▶Rheumatoid arthritis is a chronic disease, so non-drug treatment such as nutritional supply, physical therapy, exercise, and rest is also important. In acute periods, rest should be prioritized and excessive movement should be avoided. Resting the joints helps reduce inflammation, but if you don't move too much, it can become stiffer, so it's helpful to keep the joint's range of motion within the range of not applying force. Exercise is recommended when the inflammation subsides. It is important to fully bend and stretch the range of motion of the joint more than three to four times a day, and after inflammation and pain improve, light walking, swimming, aquarobics, cycling, and stretching are recommended. It is recommended to avoid intense exercise or squatting that causes a big impact on the joints.
Professor Lee Eun-young said, `Rheumatoid arthritis is a chronic incurable disease, but if medication and non-drug treatment are properly combined, it can prevent joint deformation and relieve pain to improve the quality of lifeIt is important to understand the types and functions of prescribed drugs and to take them well for drug treatment. There is no special diet, but it is necessary to pay attention to weight control to reduce the joint burden.'
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This article was translated by Naver AI translator.
