Rheumatoid Arthritis: 'New Treatments Can Ease Symptoms'

Rheumatoid arthritis can completely change your life and make even simple activities, such as turning a door knob, difficult or even impossible. It occurs when your immune system mistakenly attacks your body's own healthy tissues — primarily the joints — causing pain, swelling and stiffness. Left untreated, the disease can eventually lead to joint damage, deformities and disabilities.

“There is no cure for rheumatoid arthritis. But recent discoveries and new types of treatments have dramatically helped to relieve symptoms, restore quality of life and prevent the progressive damage that previously led to disability,” rheumatologist Stuart Weisman, MD, of Boulder Medical Center said during a free health lecture held on Sept. 11 at the Boulder Jewish Community Center.

“Today, most people can do really well with rheumatoid arthritis. We are in a much better place than we were just a few years ago,” he said.

It Can Happen to Anyone
Rheumatoid arthritis affects about 1.5 million Americans. The autoimmune disease can happen to anyone, but is more common in people ages 50 to 75 years. Nearly three times as many women have the disease as men.

“Although we don’t yet understand what causes the immune system to go awry, there is scientific evidence that genetics, hormones and environmental factors can play a role in rheumatoid arthritis,” Dr. Weisman said. “Having a family member with the condition increases the odds of getting it. Yet most people with rheumatoid arthritis have no family history of the disease.”

Symptoms
Rheumatoid arthritis causes chronic inflammation of the joints and other areas of the body. It most commonly affects the hands, feet, wrists, elbows, knees and ankles. The signs include:

• joint pain and swelling
• joint stiffness
• fatigue

Dr. Weisman explained, “It’s usually symmetrical, affecting joints on both sides of the body, for example, both hands or wrists. Symptoms are often worse in the morning or after inactivity.”

Sometimes rheumatoid arthritis affects more than just joints. It can also damage the skin, eyes, lungs, heart and blood vessels.

Latest Treatments
Treatment for rheumatoid arthritis usually includes medication, lifestyle changes and alternative therapies.

“The goal of treatment is to relieve pain and fatigue, restore quality of life and prevent joint damage and disability. We also want to prevent whole body complications from the inflammation such as early coronary artery disease,” Dr. Weisman explained.

• Diet – Although there is limited scientific data on diet, preliminary studies have found that foods higher in omega fatty acids – such as flaxseed oil, walnuts, tofu, shrimp, kale, turnips, spinach, squash – might help reduce inflammation.
• Exercise – Resistance or low-impact cardiovascular aerobic exercise can be helpful, including aquatic exercises, cycling, lifting weights and walking.
• Supplements – Omega-3 fatty acids in fish oil and flaxseed have been found to be promising in decreasing joint tenderness and stiffness. Also, studies show that GLA (Omega-6 fatty acid), turmeric and Boswellic acids have anti-inflammatory properties.
• Acupuncture – Although studies on acupuncture have had conflicting results, many people use this therapy to reduce the pain.

Dr. Weisman said there are medications to ease the symptoms and prevent or slow the progression of the disease:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) – Over-the-counter analgesics NSAIDs include ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). They can help relieve pain and reduce inflammation. Stronger NSAIDs are available by prescription.
• Analgesics – These drugs, including acetaminophen (Tylenol), tramadol, opioids (hydrocodone, oxycodone, morphine) or marijuana (cannabinoids), can help relieve the pain.
• Steroids – Corticosteroid medications, such as prednisone, can be very helpful in reducing inflammation and pain, as well as slowing joint damage. Yet, there are extensive potential side effects and doctors often recommend short-term use and low doses, if possible.
• Disease-modifying antirheumatic drugs (DMARDs) – DMARDs such as Plaquenil, Azulfidine or Arava can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage.
• Biologic DMARDs – This newer, advanced class of DMARDs targets the parts of the immune system that trigger inflammation and cause joint and tissue damage. They are very effective in relieving symptoms; however, they also increase the risk of rare but potentially serious adverse effects such as infection.

Sometimes surgery is needed if medications fail to prevent or slow joint damage and a joint becomes badly damaged.

In conclusion, Dr. Weisman said, “Many non-medication and medication options now exist. But the earlier treatment is started, the less joint damage is likely to occur.”

If you suffer from rheumatoid arthritis, schedule an appointment with Stuart Weisman, MD, by calling 303-440-3000.

Click here to view PowerPoint slides from Dr. Weisman’s lecture on “Relieving rheumatoid arthritis pain.”

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