Managing daily life with rheumatoid arthritis!

What is rheumatoid arthritis? 

Rheumatoid arthritis is a type of chronic inflammatory rheumatism. It is an autoimmune disease that affects the joints of the limbs.

It results in inflammatory pain and swelling of the joints, which is caused by synovitis, an inflammation of the synovial membrane. The synovial cells multiply and synovial fluid then leaks into the joint, causing swelling and pain. This can lead to damage of cartilage, ligaments and muscles and even to the destruction of the joint. As in other chronic conditions, rheumatoid arthritis symptoms may worsen from time to time, causing periods of flare-ups.

Rheumatoid arthritis is the most common form of inflammatory rheumatism. It is estimated that more than 430,000 people in the UK are affected, the majority of whom are women. The first symptoms appear around the age of forty.

This disease is due to multiple factors and the causes are still poorly understood. 30% of these factors are genetic: patients most often carry an HLA DR4 and/or HLA DR1 antigen. Other factors are thought to be hormonal, infectious or environmental (e.g. smoking, diet, emotional shock, etc.).

The diagnosis of rheumatoid arthritis is based on :

• clinical examination,
  

• medical imaging examinations, X-rays of the hands, feet, affected joints and spine. An ultrasound or MRI scan is sometimes performed,
  

• biological tests: measurement of inflammatory markers (ESR and CRP), testing for the presence of ACPA autoantibodies and autoimmune markers called rheumatoid factors and determination of the HLA-DR genotype.

The earlier rheumatoid arthritis is diagnosed and managed, the more effective the treatment. The treatment is first and foremost symptomatic, used to reduce pain and inflammation. Then there is disease-modifying treatment which limits inflammatory attacks in the long term and preserves the joints as much as possible. There are also non-medicinal treatments such as rehabilitation, surgery and psycho-social support which help to combat the progression of the inflammation and its consequences.

Rheumatoid arthritis can slowly destroy the joints and cause disability. This means that there is a significant impact on the daily life of those affected.

How can you improve your daily life with rheumatoid arthritis? 

Rheumatoid arthritis can have an impact on : 

• Intimate, family and social life,
  

• Professional life,
  

• Physical and leisure activities,
  

• Morale
  

To limit this impact, it is essential to well manage your condition, i.e. to follow your treatment plan, go to medical appointments, know your symptoms and keep yourself regularly informed about therapeutic methods (sometimes multidisciplinary) and news related to the disease. If a person with rheumatoid arthritis smokes, he or she should stop, as it reduces the effectiveness of the treatment.

Here are some tips on how to live better with rheumatoid arthritis:

Take up a suitable physical activity 

Incorporating movement into your daily routine helps to maintain and improve the mobility of your joints. This can be walking, cycling, a short gym session or swimming. By targeting specific joints, movement helps to maintain flexibility and muscle strength. But it is also important to respect your body, determine your body's limits and adapt to them.

Eat healthy food

There are many hypotheses about the role of diet in the onset and maintenance of rheumatoid arthritis. It is recommended that certain dietary rules be observed.

A diet rich in calcium and an adequate supply of vitamin D may help to prevent muscle wasting and osteoporosis often associated with this disease, in addition to regular physical activity.

No single diet has an impact on slowing down or worsening the progression of the disease. However, certain types of food, such as those found in the Mediterranean diet, can help reduce swelling and joint pain.

It is also essential to watch your weight in order to avoid gaining too much, which can be harmful to the joints and spine.

Rest when you experience a flare-up 

During a flare-up, the affected joints must be kept at rest. Inflammation makes the joint more fragile and it can become deformed during exercise.

Make sure that inflamed joints are not overworked and that they are rested in the correct position at night in order to preserve their function. Do not walk on hard surfaces and do not lift heavy weights.

Preventing morning stiffness 

Many patients with inflammatory joint diseases wake up feeling stiff in the morning. To start the day, they need to go through a morning routine to deal with joint stiffness and swelling. This includes gentle stretching and taking a warm shower.

Accept help 

Inform yourself on what kind of help and assistance you are entitled to.

This assistance can be technical or financial.

Join a patient association or support group 

Talking to people affected with the same condition can be beneficial. Patient support groups provide an opportunity to meet other patients who understand the difficulties you go through and are sometimes able to give valuable advice on how to live better with the disease on a daily basis. It is also a way to break the isolation that the disease can cause, and to raise awareness of the condition.

For rheumatoid arthritis, you can contact, for example:

• National Rheumatoid Arthritis Society
• Versus Arthritis
• Arthritis Action
• Carenity, etc.

Today, research remains active in order to offer new therapeutic options for the treatment of rheumatoid arthritis. Some clinical trials are quite promising: immune response inhibitors are being tested, a therapeutic vaccine is being studied, cell therapies are being developed and work on the microbiota is revealing immune anomalies in patients.