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The Basics of Rheumatology and Rheumatoid Arthritis

A subspecialty of internal medicine, rheumatology focuses on diagnosing and treating disorders that are characterized by degeneration of connective tissue and inflammation. These disorders are sometimes referred to as arthritis and rheumatic-related diseases.

Those diseases and conditions which primarily affect tendons, joints, bones, ligaments and muscles are considered rheumatic disorders and conditions. Symptoms of someone suffering from a rheumatic disorder include inflammation, such as redness, swelling, heat and pain. There can also be a loss of function among one or more supportive or connective tissues of the body. Rheumatic disorders can also affect internal organs such as the heart, skin, kidneys and lungs.

The most common rheumatic disorder is rheumatoid arthritis. The symptoms for this condition develop slowly over a period of weeks or months and are characterized by stiffness and fatigue followed by weight loss and a low-grade fever.
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There are also symptoms in the joints such as joints which are painful, swollen, stiff and tender. The hands, wrists, elbows, ankles and knees are most affected. There can also be stiffness in the morning or after long periods of sleeping or sitting. About one-third of those who suffer from rheumatoid arthritis also experience bumps or nodules over pressure points such as the knuckles, spine and lower leg bones. These bumps can range from the size of a pea to the size of a mothball.

Rheumatoid arthritis has no known path to prevention but early and aggressive treatment can stop or slow the progression of the condition. A multi-faceted approach is used to treat rheumatoid arthritis and can include medications, occupational or physical therapy and regular exercise.
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To start, one of the most commonly used medications for the treatment of rheumatoid arthritis is a non-steroidal anti-inflammatory drug, otherwise known as NSAID. As these can reduce the inflammation and pain but do not slow the progression of rheumatoid arthritis, those who have more severe rheumatoid arthritis usually are prescribed additional medications so as to prevent damage to the joints.

Ibuprofen and naproxen sodium are available over-the-counter but they can also be made available by prescription which offers a higher dose and lasts longer so that fewer doses are required during the day. NSAIDs can cause stomach irritation and all prescription NSAIDs can increase the risk of stroke and heart attack.

To help slow or stop the progression of rheumatoid arthritis, disease-modifying anti-rheumatic drugs or DMARDs are prescribed, the most common of which is methotrexate. Methotrexate is known to have produced dramatic improvements in severe rheumatoid arthritis and can help preserve joint function.
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When other medications not been successful in stopping the inflammation of rheumatoid arthritis, biologics are sometimes prescribed. They are genetically engineered proteins that inhibit those parts of the immune system which cause the inflammation of rheumatoid arthritis. They can slow or stop the progression of rheumatoid arthritis by blocking an inflammatory protein produced by the body of those suffering from the condition. However, they can result in severe infections so should be used with caution.

Rheumatoid arthritis is not fatal but life span can be shortened with complications from the disease. It cannot be cured but it can become less aggressive overtime and its symptoms can improve.