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Rheumatoid Arthritis

   Before we talk about rheumatoid arthritis proper,let's take a little review of the bones and joints and how the joints function normally.

  •  Bones provide support for the body and aid in its movement
  • The place where two or more bones meet is called a joint. 
  • Joints maybe immovable, slightly movable and freely movable. 
  • A synovial membrane surrounds moveable joints.
  •  Inside the membrane synovial fluid lubricates and nourishes joint tissue such as cartilage.
  • Cartilages help the joint moves freely without friction.
  • Joints give the body flexibility, precision of movement and help in weight support.

          Arthritis is any disorder that affects joints. It can cause pain and inflammation.
Rheumatoid arthritis is the second most common form of arthritis. The joints most commonly affected are the wrists, hands, knees, ankles and feet.
It typically occurs on the same joint on both sides of the body(e.g if it affects the right wrist, it will definitely affect the left wrist). It can also affect other organs of the body such as the eyes, skin, heart, lungs kidneys and digestive tract.
      Rheumatoid Arthritis is an autoimmune disorder. This means the body attacks itself by mistake. In rheumatoid arthritis, the immune system attacks joints and organ tissues.
A brief description of how this happens is detailed thus;

  • The white  blood cells of the immune system move into the joint and they release chemicals called cytokines which attack the cells of the synovial membrane 
  • These chemicals cause synovial cells to release other destructive substances and cause the synovial membrane to produce new blood vessels and form a thickened area around the joint called a pannus. 
  • Overtime, as the pannus grows, it invades and Destroys areas of cartilage and bone inside the joint. 
  • Inflammation causes fluid build up in the joint, making the joint swell. 
  • Eventually, without treatment, the joint space narrows and ankylosis(fusion or growing together of bones in the joint) can occur. 
  • This results in the loss of the ability to move the joint. 
Treatment /Management 
There is no cure for rheumatoid arthritis. However, doctors commonly prescribe various combinations of the following medications that when taken together, can reduce inflammation and pain and slow down joint damage. These include ;
  • NSAIDS (Non steroidal Anti-inflammatory Drugs) e.g Ibuprofen 
  • Steroids e.g prednisolone
  • Standard DMARDS(Disease Modifying Antirheumatic Drugs) e.g Methotrexate
  • Biologic DMARDS e.g rituximab. 
Other forms of treatment include;
  • Physical therapy 
  • Occupational therapy 
  • Low impact exercises which can help increase muscle strength and help keep the joints movable. 
For more information talk to your Pharmacist or health care provider


Written by Pharm Edidiong Orok (B.Pharm) 

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