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Rheumatoid arthritis (RA) is an autoimmune disease that occurs when the body’s immune system attacks and damages the joints and, sometimes, other organs. RA is a chronic and inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints and other areas of the body.

Some people think that Rheumatoid Arthritis is just like any regular arthritis like osteoarthritis, which is caused by normal wear and tears and affects the cartilage in joints. The biggest problem in people getting it mixed up is that quite often people who have Rheumatoid Arthritis quite often develop Osteoarthritis.

Rheumatoid arthritis (RA) seems to affect more women than men probably because of the actions of female hormones in their body mechanisms. There is no clear-cut scientific reason why this is so, but some school of thought refers to the nature of women and their role in reproduction.

Most people who start with this disease are aged between 30-60. However, anyone can actually get RA but you find the older have it worse than the younger but that’s just because they have been living with the disease for longer.

RHEUMATOID ARTHRITIS AWARENESS WEEK – 13th – 19th September – Rheumatoid Arthritis Awareness Week (RAWW) is an annual campaign created by NRAS to raise awareness of the condition and eliminate misconceptions by educating and informing friends, family, and employers of those with RA and the general population about what rheumatoid arthritis truly is.

Since the National Rheumatoid Arthritis Society (NRAS) was founded in 2001, one of our key aims has been to increase public understanding and awareness of rheumatoid arthritis (RA) as distinct from other forms of arthritis. Whilst we have come a long way, there still remains a significant challenge in clarifying the misconceptions based on RA.

In 2013, NRAS started a campaign called Rheumatoid Arthritis Awareness Week (RAAW) to raise awareness of the condition and eliminate these misconceptions by educating and informing friends, family, employers of those with RA and the general population about what rheumatoid arthritis truly is. RA is very different to osteoarthritis (OA) in that it can strike at any age over 16. It is an auto-immune disease, which is a key differentiating factor to OA and means that in addition to joints, it can affect internal organs such as the heart, lungs, and eyes. There are very serious consequences to late diagnosis or lack of targeted appropriate treatment.

Touch Medical Media writes that although there is no cure for RA, early diagnosis and treatment mean that many people affected can go for longer periods without ‘flare-ups’ – sometimes months or years. As Peter C. Taylor notes, “There have been enormous advances in the development of effective treatments for this condition in recent decades and there are now many available medications.” 

Awareness of the condition and catching the signs early are integral to receiving the most effective treatment. NRAS’s aim is to spread greater awareness of what to look out for, so more people seek the right help sooner, and also to dispel myths surrounding RA through their 2022 #RAFactOrFiction campaign (get involved). 

touchIMMUNOLOGY supports Rheumatoid Arthritis Awareness Week (RAAW) and its global goal to find better treatments and improve the lives of people with RA. Learn more by delving into the content library of video interviews, conference highlights, journal articles and clinical trial updates.

Source: NRAS Back Pain Blog Touch Medical Media

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Ankylosing Spondylitis – This is a joint pain (arthritis) that affects the spine, causing irritation and pain. Individuals with AS frequently experience flare-ups which can be quite debilitating. The symptoms of AS flares can vary from person to person and among flares include:

  • fever
  • fatigue
  • stiffness and pain in the back
  • joint pain, often in the rib cage, shoulders, hips, or knees
  • enthesitis, which is swelling and pain of the connective tissue
  • depression or anxiety

Someone who may be suffering from an AS flare may have burning joints, muscle spasms, and flu-like symptoms, in addition to pain and immobility in the affected areas of the body.

Diagnosis for (AS) can be difficult to diagnose because the condition develops slowly and there’s no definitive test. Your GP may arrange blood tests to check for signs of inflammation in your body. If you are sent to see a rheumatologist they will carry out imaging tests to examine the appearance of your spine and pelvis, as well as further blood tests.

These may include:

an X-ray
MRI scan
an ultrasound scan

Treatment for AS includes nonsteroidal anti-inflammatory drugs (NSAIDs), gentle exercise, massage therapy, tens machines and hot and cold therapies.

Psoriatic Spondylitis – This causes similar symptoms to AS and includes:

  • back pain
  • stiffness in the back or neck that improves when moving around
  • stiffness made worse by periods of staying still, such as sleep
  • trouble bending or moving the back
  • fatigue

These symptoms can cause extreme pain and some people experience difficulty in their daily lives. Left untreated, the inflammation can cause long-term damage to the spine and joints.

The symptoms of PS may seem to come and go. When symptoms get worse, this is known as a flare. The location of pain and swelling may also change over time. Certain infections, such as strep throat, may trigger the overactive immune response that causes psoriatic spondylitis. However, psoriatic spondylitis is not contagious.

Diagnosis of PS involves a GP who will make a diagnosis based on symptoms and medical history, and by ruling out other conditions. Usually, a blood test will be carried out to test for rheumatoid factor (the antibody found in rheumatoid arthritis). This is usually negative in people with psoriatic arthritis, although a positive result can be due to causes other than rheumatoid arthritis. A doctor may also use X Rays, ultrasounds or other scans, such as an MRI to look at the patient’s joints. These scans often show inflammation or areas of new bone growth with poorly-defined edges in people with psoriatic arthritis. The criteria are inflammatory arthritis, the presence of psoriasis, and a blood test negative for rheumatoid factor.

Treatment for PS is similar to AS and includes nonsteroidal anti-inflammatory drugs (NSAIDs), immunosuppressants, and biologic medications, such as TNF inhibitors. Gentle exercise, massage therapy, tens machines and hot and cold therapies.

Spondylitis (also called spondyloarthritis) refers to a group of inflammatory conditions that affect the spine. The most common type is ankylosing spondylitis, but there are other forms that have links to other inflammatory diseases, such as psoriasis.

According to the Spondylitis Association of America, 20 percent of people with psoriatic arthritis (PsA) will develop psoriatic spondylitis. This means that you have PsA with spinal involvement.

Keeping a strict diary of your symptoms will really help your GP to decide if he thinks you may have one of these conditions. You can find out lots more details on these two conditions on the Arthritis website.

Source: Arthritis, NHS ,Medical News Today Psoriasis Association Healthline

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As my readers know I have been having a ‘pain-free‘ time after having bilateral sacroiliac injections for my SIJ pain. On week six from having the injections, I started to feel some of the symptoms coming back but only on my right side.

Pain after walking mainly in my hip, pain putting my right shoe on, pain while standing, pain getting out of the car but only on the right side, pain doing housework and worst of all pain in the night when I turn onto my right side ( my favourite sleeping side).

Yesterday I had my follow up appointment and I was keen to tell him how successful it has all been until week six. He was delighted with the results and said if it all came back like it was before then his next procedure would be the Radio Frequency Ablation of my sacroiliac joints rather than a steroid injection.

He then asked me more about the pain I was experiencing and remembered he had ordered an MRI of my right hip the last time I saw him after an examination of me showed that area to be particularly painful.

When he looked at the results of the MRI it showed I had degeneration of the hip (Osteoarthritis) and Bursitis which he explained would definitely be the reason for my pain in that area. He said he could refer me for a steroid injection into my hip, or refer me directly to see a hip consultant.

I declined both offers as I feel I have had lots of steroid injections for my low back over the last 12 months and I am just not ready to deal with more investigations for another problem. I asked if he felt “Aqua Aerobics” would be a good thing for me to try and he could not praise this type of exercise enough for anyone with joint/nerve problems.

I have felt a bit weary this morning knowing I have yet another painful condition to deal with but I’m just going to get back onto my pain medication like before(which I had got right down to very little) and remind myself that my problems are not life-threatening I just need to make a few life-changing things to help with the pain.

My friend who is a nurse explained to me that anything ending in ‘itis’ means inflammation so she suggested taking some anti-inflammatories as well. I will have a chat with my GP first though.

Osteoporosis is the most common type of arthritis, is a degenerative joint disease. It results from wear and tears in the joints. In hip osteoarthritis, the cartilage in the hip joint thins over time, reducing the protective layer between bones, leading to bone-on-bone rubbing and the formation of new bone spurs. These changes contribute to the symptoms of hip osteoarthritis—which include pain and stiffness in the groin, buttocks, and knee.

Osteoarthritis is a progressive disease, with sequential stages. Your treatment will depend on the stage of your hip osteoarthritis.

The symptoms start with dull, aching pain in the groin, outer thigh, knee, or buttocks. Pain that is worse in the morning or after sitting or resting for a while, but lessens with activity. Increased pain and stiffness with vigorous activity. Pain in the joint is severe enough to cause a limp or make walking difficult. Any pain, swelling, or tenderness in the hip joint.

The causes of osteoarthritis of the hip are not known. Factors that may contribute include joint injury, increasing age, and being overweight.

Treatments could include taking supplements like glucosamine and chondroitin. You should also make sure you get enough calcium and vitamin D. ( I am already on a supplement for this after being diagnosed with Osteopenia a couple of years ago).

Walking, dancing, aqua aerobics are the types of exercise that work directly on the bones in your legs, hips and lower spine to slow mineral loss which is important if you have Osteoporosis. The main goal of treating osteoarthritis of the hip is to improve the person’s mobility (ability to get around) and lifestyle. I am really pleased I got down to the correct BMI during the last lockdown as it is obvious being overweight can play a big part in this condition.

Bursitis (bur-sigh-tus) is a condition that makes the area around a joint or bone painful, red and swollen. It can affect both adults and children.

It commonly affects the feetshoulderselbowsknees and hips. However, you can get it in or around any joint, and it can stop you from being able to move that part of your body properly.

Symptoms include:

  • red or swollen area
  • hot and sore
  • painful – usually with a dull, aching pain
  • sensitive and painful if you try to press on or move it.

Bursitis is caused by inflammation in a thin pocket of jelly-like fluid that sits between your bones and tendons. When it’s working properly, this fluid protects your joints and bones from knocks, falls, bumps and injuries.

This fluid cushion is called a bursa (bur-sa), or bursae (bur-sigh) if more than one is involved.

When your bursae are working normally, they act as lubricants for your bones and the soft tissue that supports them. This allows them to slide easily over one another.

Bursae also help to reduce friction. An example of this would be your shoe rubbing your foot. This creates friction, which is absorbed by the bursae instead of your bones or tendons.

Your body can also create a new bursa if it thinks a certain joint or limb needs added protection from friction. For example, if your shoe keeps rubbing the same area, or you regularly lean on the same elbow, your body will create added cushioning there. This will either be with an extra bursa or by increasing the fluid in the bursae that are already there.

Versus Arthritis suggest that if lying down is uncomfortable, then try to avoid sleeping on the side that hurts. A pillow placed behind your back can stop you from rolling onto the painful side and should help you sleep better.

The NHS say the best way to treat bursitis yourself is to help bring down swelling and pain and the best way to do that is to –

  • rest – try not to move the joint too much and avoid activities that put pressure on it
  • use ice – gently hold an ice pack (or a bag of frozen peas) wrapped in a tea towel on the area for around 10 minutes at a time and repeat every few hours during the day
  • take painkillers, such as paracetamol or ibuprofen, to ease any pain

It may also help to put extra cushions around the affected joint while you sleep, to help protect and support it.

Other treatments are –

  • steroid injection may be given into the affected joint to reduce the swelling – this will not be done if bursitis is caused by an infection
  • if bursitis is severe or keeps coming back, the inflamed bursa may need to be surgically drained or even removed (but this is rare)

Source: Very Well, WebMD, Versus Arthritis, NHS, BPB Health Disclaimer, Healthline