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Early Warning Signs of Rheumatoid Arthritis Rheumatoid arthritis affects about 40 million Americans and 350 million people nationwide. But it’s easy to brush off symptoms as something else, such as temporary injury. If you notice any of the following symptoms, let your doctor know right away — don’t assume they’ll go away on their own. And never ignore one general feeling if you’re having it (no. 12). Your body feels stiff when you wake up When you’ve been sleeping for hours, you may find it tough to jump out of bed in the morning. While it’s common to need a minute before getting out of bed, general stiffness in the morning is a sign of arthritis. Depending on how long the stiffness lasts, the type of arthritis may vary. There are ways to minimize the morning stiffness you may feel from RA, but talk to your doctor about a diagnosis first. Next: One of these often signals an underlying medical problem. You’re running a low fever A low-grade fever is common with RA. But if this is one of your symptoms, expect your fever to be no more than 100 degrees. If it’s higher than 100 degrees, it is likely a sign of another illness. According to Everyday Health, fevers are common in RA patients because the body identifies swollen joints as foreign and signals the immune system to fight them. Plus, certain RA medications can weaken the immune system, leading to infection and fever. Next: This disease commonly occurs with RA. You’ve become anemic Doctors believe that about 60% of RA patients also have anemia, known as anemia of chronic disease (ACD). ACD is not well understood, but experts think inflamed tissues release proteins that prevent the creation of healthy red blood cells and prevent the body from properly using iron. If you have ACD as a result of RA, your doctor will likely supply an iron supplement to help ease any anemia symptoms. Next: If this lasts, talk to your doctor. You have lasting joint stiffness throughout the day If you have joint stiffness all throughout the day, it’s important to talk to your doctor because it could be RA. It typically happens in smaller joints, such as the fingers, but it can affect any joint. RA stiffness most commonly starts in the hands. The stiffness is usually the worst in the morning, but it can last throughout the entire day. It is due to inflamed tissue. Next: Your joints play a big role in your symptoms. Your joints have swelled Swollen joints are a strong sign of arthritis, and they’re one of the few physical symptoms of the disease. If you notice swelling, most commonly in your fingers, it’s possible it’s due to RA. Your joints tend to swell when they become too inflamed. The swelling is often minor yet noticeable, so you’ll still have use of your hands, but don’t let the symptoms go without discussing them with your doctor. Next: The physical temperature of your joints can say a lot. Your joints are physically warm When the joints swell, they might also feel warm to the touch. The warmth often means the joints are actively inflamed, which signals arthritis. But warm joints can mean several different types of arthritis, so it’s important to talk to your doctor about which one applies to you. Warm joints might mean something completely different too, such as Lyme disease, so always inform your doctor regardless of whether you believe it’s arthritis or not. Next: The way you walk could indicate RA. You’re walking with a limp If your friends and family have noticed you’ve been having trouble walking, don’t brush it off. You may want to blame it on the way you slept or a previous injury, but if you’re not sure of the cause for your pain, talk to your doctor, since it could be RA. Limping can be a symptom of many different ailments. If you can’t pinpoint exactly what the cause was, it’s always better to get to the doctor’s office. Next: If this is getting worse, talk to your doctor. Your range of motion is lower than it used to be With RA, your joints don’t work the way they used to. They’re stiff, inflamed, and in pain, which can limit your range of motion. The best way to help increase your range of motion is to do low-impact exercises. Exercising will help increase your mobility and flexibility. Try taking a walk or doing light yoga, but talk to your doctor first. Next: Pain — especially during this– is a sign. Your joints hurt — even while at rest Joint pain is another common sign of RA. When you have RA, your joints become stiff and inflamed, which can cause pain. If you’ve been writing for hours, it’s understandable you may have some joint pain, and it will likely go away on its own. But if you’re at rest and still notice a lot of pain, it could be a sign of RA. Joint pain when you haven’t used those joints much means they’re likely inflamed because of RA, so talk to your doctor as soon as you notice this symptom. Next: This weird feeling in your joints could signal RA. You have numbness or tingling in joints When your joints and tendons are inflamed, they can put pressure on the nerve endings around them. When this happens, you might feel numbness or tingling in your joints. This typically occurs with carpal tunnel syndrome, which is a syndrome that commonly happens alongside arthritis. You might also feel tingling in your feet, and squeaking sounds from the hands and feet are common. (This means the damaged cartilage is grinding against your joints.) Next: The color of your joints says a lot. Your joints appear red Redness in the joints is another obvious sign that something is wrong. And it most commonly signals arthritis. It is typically accompanied by other RA symptoms, such as joint stiffness and swelling. Redness can sometimes be the result of injury, so look for other RA symptoms as well. In very rare cases, redness of joints can also signal a tumor within the joint, so never overlook the symptom. Next: A general feeling you should never ignore. You feel a bit weaker than you used to General weakness can be a sign of many illnesses, and RA is no exception. As we get older, we tend to get weaker. But if you’ve noticed a quick decline in your physical strength or ability to do things with agility, it could be an early sign of RA. Weakness with age is common, but talk to your doctor if you notice your strength deteriorating quickly. Next: This is often associated with weakness. You’re unexplainably fatigued When you feel weak, it takes more energy to complete daily tasks. Rheumatoidarthritis.net suggests that fatigue affects anywhere from 40% to 80% of those with RA. But fatigue is another common symptom associated with many illnesses, so it isn’t always obvious it’s RA. Look for other symptoms on this list as well to see if the fatigue could be a result of arthritis. Next: The joint pain’s symmetry says a lot. The joint pain is on both sides of the body If you hurt a joint or wrote for too long, the pain would likely only happen on one side of the body (such as hurting your right knee or having a hand cramp in your writing hand). But if your joint pain is symmetrical, meaning it occurs in the joints of both sides of the body, it is probably due to an underlying condition, such as RA. If you notice joint pain in both hands, knees, etc. talk to your doctor. Next: Any visible changes warrant a trip to the doctor. Your joints look deformed If you notice visible changes in your joints, talk to your doctor immediately. Joint deformities are often a later symptom of arthritis, but if you’ve gone a while with other symptoms and haven’t gotten them checked out, this could be something you experience. If you notice earlier symptoms and get proper treatment, you likely won’t have to deal with joint deformity. It’s always important to get help at the first sign of any symptom to live the best possible quality of life with the disease. Next: This common sypmtom can be a sign of many ailments, including RA. You’re experiencing unexplained weight loss A loss of appetite or unexplained weight loss is typically a sign it’s time to see your doctor. Rheumatoid arthritis can sometimes cause flu-like symptoms, including decreased appetite and unintended weight loss. If you’re experiencing decreased appetite or weight loss in combination with any other symptoms of rheumatoid arthritis, you might want to get examined by your doctor. Check out The Cheat Sheet on Facebook!
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Polovica bolesnika izgubi radnu sposobnost tijekom deset godina od postavljanja dijagnoze bolesti. U Hrvatskoj od reumatoidnog artritisa pati približno 45 tisuća osoba. Reumatoidni artritis češći je u žena nego muškaraca u odnosu 3:1. Iako se najčešće razvija u dobi od 30 do 60 godina, učestalost raste sa starenjem. Rizik je povećan u obiteljima s povijesti reumatoidnog artritisa. “Kod mlađih osoba natečeni i kruti zglobovi mogu biti znak reumatoidnog artritisa (RA), dok starije osobe često svoje probleme sa zglobovima znaju pripisati artritisu. Ali ono što mnogi ljudi ne znaju je činjenica da postoji nekoliko vrsta artritisa. Ako bolovi u zglobovima traju dulje od šest tjedana to je razlog za posjetu liječniku”, kaže dr. Vivian Bykerk, reumatologinja iz New Yorka. “Reumatoidni artritis je autoimuna bolest, što znači da može nastati iz bilo kojeg razloga – vjerojatno neka kombinacija genetskih i okolišnih čimbenika ili čak hormonalnih promjena i kod oslabljenog imuniteta. Kod oboljele osobe bijela krvna zrnca (stanice imunološkog sustava) čija je osnovna uloga zaštita organizma od zaraznih bolesti i stranih tvari napadaju zdravo tkivo oko zglobova. Taj proces uzrokuje upalu zglobova i kasnije bolove te simptome”, kaže dr. Bykerk. “Simptomi RA mogu se pojavljivati i nestajati, što može otežati, barem u početku da osoba shvatiti što joj tijelo poručuje. Bolest može započeti s boli u ramenu ili drugim zglobovima i trajati nekoliko tjedana pa onda nestati, i opet se iznenada pojaviti nakon nekog vremena. Karakterističan simptom reumatoidnog artritisa je jutarnja ukočenost koja traje najmanje pola sata”, kaže dr. Bykerk. Simptomi na koje treba odmah reagirati Bol u zglobovima – bol je rani simptom reumatoidnog artritisa. Često počinje u malim zglobovima prstiju, zglobovima (ramena, koljena, kukovi) i gležnjevima. Bol je često simetrična, ali može biti žešća na jednoj strani, ovisno o tome koja se ruka češće koristi. Kod RA bol može biti konstantna ili povremena, lokalizirana ili široko rasprostranjen. Bol je važan simptom kod dijagnosticiranja RA. Krutost zglobova – krutost koja traje pola sata ili više klasični je znak reumatoidnog artritisa, uglavnom, iako nije pravilo ta krutost se javlja odmah nakon buđenja. Kod nekih pacijenata jutarnja se ukočenost smanjuje tijekom dana, a zatim ponovno počinje navečer. Čak i dugo sjedenje može uzrokovati da se zglobovi ukoče. Otečenost – osoba ima dojam natečenosti puno prije nego što to postane vidljivo drugim ljudima. Zahvaćeni zglobovi se povećavaju i brzo deformiraju. Zglobovi mogu ostati u jednom položaju, prsti se primiču prema malom prstu što mijenja položaj tetiva. Oteklina ručnog zgloba može uzrokovati sindrom karpalnog tunela. Čvorići na zglobovima – oko 30 do 40 posto ljudi s reumatoidnim artritisom imaju tvrde izbočine (čvoriće, nodule) točno ispod kože u blizini zahvaćenog zgloba. Toplina u zglobovima – ponekad su upaljeni zglobovi topli na dodir. Ako je zglob topliji od kože nad obližnjom kosti to može biti znak RA. Disfunkcija – RA može ometati svakodnevne aktivnosti poput rezanja kruha, otvaranja kutije žitarica ili rada na tipkovnici. Ako su zahvaćena koljena, osoba može imati poteškoće prilikom penjanja uz stepenice. Umor – gotovo svi oboljeli od RA osjećaju umor, koji je uobičajen simptom mnogih autoimunih stanja. Dobra vijest je što se umor smanjuje kada se bolest stavi pod kontrolu. Gubitak mišića – je ozbiljna komplikacija RA. Kada su istraživači sa Sveučilišta u Pennsylvaniji ispitali CT, otkrili su “značajne deficite u mišićnoj masi i gustoći mišića” kod osoba s RA u usporedbi sa zdravim pojedincima. Ako, primijetiš gubitak mišićne mase ili značajno smanjenje snage, važno je obavijestiti liječnika. Bykerk kaže da gubitak mišića može utjecati na pacijente s RA u roku od godine dana od razvoja stanja. Depresija – i kronični stanja obično idu ruku pod ruku, a reumatoidni artritis nije iznimka. U stvari, studije ukazuju da je depresija dva do četiri puta češća kod pacijenata s RA nego kod opće populacija. No, za razliku od nekih drugih uvjeta, depresija je specifična za rani simptom RA, a ne nešto što se razvija zbog problema sa zdravljem. Iritacija očiju ili usta – ponekad ljudi s reumatoidnim artritisom razvijaju simptome nekog drugog autoimunog stanja zvanog Sjogrenov sindrom, koji napada žlijezdu slinovnicu. U osoba s RA, poznato je kao sekundarni Sjogrenov sindrom. Osim klasičnih simptoma RA, osobe sa sekundarnim Sjögrenovim sindromom mogu doživjeti upalu suznih te i žlijezda slinovnica. To može uzrokovati suhoću usta i očiju, kaže dr. Shlotzhauer. Ali, to je mnogo manje ozbiljno od primarnog Sjogrenova sindroma. Oštećenja živaca, kože ili organa – RA može uzrokovati srednje povišenu tjelesnu temperaturu i ponekad upalu krvnih žila (vaskulitis) koja dovodi do oštećenja živaca i kože potkoljenice (ulcer). Upala ovojnice pluća (pleuritis), srca (perikarditis) može uzrokovati bol u prsnom košu, otežano disanje i poremetiti rad srca. RA također može potaknuti razvoj metaboličkog sindroma: povišeni krvni tlak, povišeni šećer u krvi i abnormalne razine kolesterola – koje povećavaju rizik od moždanog udara, dijabetesa i bolesti srca. Visoka tjelesna temperatura – Stillova bolest je oblik reumatoidnog artritisa u kojem je visoka tjelesna temperatura prvi simptom. Liječenje Ne postoji lijek za RA, ali postoje lijekovi i strategije za ublažavanje simptoma koji se odnose na dugoročno smanjenje upalnog procesa, sprečavanje oštećenja kostiju i ligamenata zglobova, očuvanje pokretljivosti. Važno je da se oboljeli kod prve pojave simptoma odmah obrati liječniku jer su prognoze za tretiranje znatno bolje. Za liječenje se koriste nesteroidni antiinflamatorni lijekovi, uglavnom za ublažavanje bolova, zatim antireumatici polaganog djelovanja kod pacijenata s umjerenim do teškim RA. Koriste se kortikosteroidi koji smanjuju upalu i usporavaju oštećenja zglobova. Kortikosteroidi mogu poboljšati stanje, ali ako se primjenjuju više mjeseci ili godina, mogu izgubiti na učinkovitosti i izazvati ozbiljne nuspojave. Ostali lijekovi koji se koriste su imunosupresivi i blokatori faktora tumorske nekroze. Ovi preparati mogu uzrokovati teške nuspojave, kao što su povećana osjetljivost na infekcije i oboljenja. Oboljelima se uz lijekove preporučuje i promijene načina života, pod čim se podrazumijeva: redovita tjelovježba, kontrola težine, zdrava prehrana, tehnike opuštanja i uzimanje preporučenih lijekova. Izvori za tekst: MSD Medicinski priručnik za pacijente, Prevention. com, Health.com, arhiva Zdrave Krave