Rheumatoid Arthritis is a long-term medical condition, mainly affecting women but can also affect men. There is no known cause for the symptoms to start. Rheumatoid Arthritis is classified as an auto immune condition, normally in our bodies the immune system helps defend any infections, with rheumatoid arthritis, the immune system will attack the lining of the joints. This causes the thin layer of the cells covering the joints to become sore and inflamed.
What are the symptoms of Rheumatoid Arthritis?
The symptoms of rheumatoid arthritis vary from person to person. They can come and go and may change over time.
Symptoms of rheumatoid arthritis that affect the joints include:
- Pain
- Swelling
- Stiffness
- Difficulty moving affected joints.
- Redness and heat around the joints
In some people, firm swellings called rheumatoid nodules also develop under the skin around affected joints. Other symptoms include lack of energy, having a high temperature, sweating, poor appetite and weight loss.
Rheumatoid arthritis normally affects the small joints of the body, but larger joints can also be affected. Depending on the activity during flare ups, it can debilitate the person who has the condition, and some may need total bedrest until the ‘flare up’ has eased. Pain and discomfort can increase with changing seasons, and Spring is generally considered the best time of the year as the weather is around the same temperature throughout this season.
Rheumatoid Arthritis attacks the joints, as the immune system works overtime and does not switch off. If you have an infection, the immune system activates to fight the infection, along with the help from antibiotics in some circumstance, and when the infection has gone, the immune system should become dormant. However, people who have Rheumatoid Arthritis the immune system does not become dormant and it actually attacks the body, so the body is always in fight mode, which can further increase if the condition has a ‘flare up’, where the symptoms will increase and rest is required until the ‘flare up’ recedes, back to a manageable level.
How is Rheumatoid Arthritis diagnosed?
If you are suffering from any of the above symptoms, I would advise you start to maintain a diary, taking into account when the pain is at its worst, are symptoms increased if you eat certain foodstuffs, does over the counter pain relief help reduce your symptoms, including Ibuprofen, and how does the pain, swelling or fatigue affect your normal day-to-day living activities.
Have you lost your grip when lifting a cup of tea/coffee, or lifting a saucepan from the cooker?
Do the symptoms affect you climbing the stairs, kneeling down, and difficulty with rising, walking?
Do you have any symptoms where it feels like you are walking on stones in your footwear?
Is there any swelling to joints in the hand, fingers or feet?
If there is swelling in the hand, can you make a fist?
If you document all the symptoms for a couple of weeks in a diary, journal etc, you can discuss them with your GP, who will have some information on what tests and investigations maybe required and possibly prescribe appropriate medication to help ease your symptoms, so your quality of life improves.
Rheumatoid Arthritis complications
Complications can arise if the disease is not well controlled or managed with individuals suffering from:
- Carpal tunnel syndrome – tingling and numbness in your hand and fingers.
- Inflammation in other parts of the body for example in the lungs or around the heart.
- Joint damage and deformity.
Individuals can also be at a higher risk of:
- Cardiovascular disease (CVD) – which can cause heart attacks or strokes.
How is Rheumatoid Arthritis treated?
The first consideration is for individual to be treated conservatively, as in non-surgical, with a combination of medications. These may include anti-inflammatories, disease modifying drugs and steroids. You may also have steroid injections into affected joints to try and reduce pain and swelling.
One thing to mention regarding these disease modifying drugs, is that some of them can make an individual immunosuppressed, which means they have a lower level of immunity. It may be advisable for a blood test to check Chickenpox immunity before starting these drugs to make sure you have appropriate immunity. You may wish to discuss this with the medical professional responsible for your care.
What your GP may do
From a personal experience, my son when he was in childhood had symptoms of limping but with no injury to account for this.
The GP ordered blood tests and once the results were received a follow up appointment was arranged to discuss the blood tests and any abnormality.
The GP may refer to a Specialist who has the title Rheumatologist, and I would still advise the diary is maintained, until the initial appointment.
They may undertake all the blood tests again and send you for X-Rays to the affected areas and possibly order an MRI Scan, for an in-depth investigation on what your joints look like, and this can also be used as a baseline, so they can see any degeneration which may occur.
The Rheumatologist may prescribe medication for you to take and advise your GP what to prescribe monthly. This medication may change, especially if the initial medication is not working and you have no improvement with your symptoms.
What support is there for Rheumatoid Arthritis patients?
As day-to-day living activities can be impaired some individuals are successful with receiving Personal Independence Payments (PIP) and a Blue Badge, providing they are in receipt of the Mobility Component of PIP.
Should the PIP benefit include the mobility component, Blue Badges can be obtained via the local council, they can also apply for a bus pass if they are below State Pension Age, and car tax is also free if they have their own car.
Children can also be affected, as previously mentioned, my son was diagnosed with the disease at 10 years old, following two severe throat infections which occurred nine months before the limping started, In children, it is called Juvenile Arthritis or Still’s disease, and they hope that the disease will leave the body by the time the child is 18 years old, sadly, this is not the case for some children, my son was not lucky, and he has the condition in adulthood, so he now has a confirmed diagnosis of Rheumatoid Arthritis. Some children are referred to Paediatrician’s who care for them until they become adults and if they still have the condition, they are referred to Rheumatologist’s to continue with the ongoing care which is likely to be required lifelong, from my personal experience.
Rheumatoid Arthritis Therapy Services
Physiotherapy and Hand Therapy are available for those suffering with Rheumatoid Arthritis, for gentle exercises and other treatment options such as wax baths, and your Rheumatologist will refer you as appropriate for these treatment options.
Occupational Therapy can also be involved for assessments of their home to help with everyday tasks. They may look at installing ramps into the home or rails on the stair, along with providing chunky cutlery, raised chairs, beds, and toilet seats. Further information on the different types of equipment available and whether VAT can be removed is available at: Get VAT relief on certain goods if you have a disability – GOV.UK.
Further Support
Living and working with rheumatoid arthritis can present a number of challenges, particularly during periods when symptoms flare up. Pain, stiffness, fatigue, reduced mobility, and difficulties with everyday tasks can all have an impact on an Employee’s ability to carry out their usual duties and may affect confidence, wellbeing, and attendance at work.
Occupational Health can support both Employees and Employers by helping to identify practical ways to manage the impact of the condition in the workplace. This may include discussing workplace adjustments, reviewing job demands, advising on suitable duties, supporting a phased return to work following periods of absence, and helping Employers understand how best to support an Employee while maintaining productivity.
Occupational Health can also work alongside treating healthcare professionals to ensure recommendations are appropriate for the individual’s needs and capabilities, helping to create a safe and sustainable working environment.
If you or a member of your team has been diagnosed with rheumatoid arthritis and would like advice, guidance, or support, please get in touch with Asclepius Occupational Health & Wellbeing. We are here to support both Employees and Employers in managing the condition and helping individuals remain healthy, safe, and productive at work.
