The Causes, Risk Factors Occurrence of Rheumatoid Arthritis in United States - Research Paper Example

The Causes, Risk Factors Occurrence of Rheumatoid Arthritis in United States ABSTRACT Rheumatoid arthritis (RA) is a serious autoimmune disease that has restricted the free joint movement in patients. Synovium in the joint is one of the main point of attack and this result in inflamed and swollen joints. It is estimated that about 50 million adults in the United States have reported to have some form of artheritis and is projected that about 67 million adults above 18 years will suffer from RA by the year 2030. Though there is a need for further studies on the etiology of the disease, it is an autoimmune disease and several environmental and genectic factors are linked to the risk factores in RA. A combination of therapies that include medication, surgury, exercise and adequate rest can help the patients to reduce swelling and pain. This paper discusses the causes, risk factors, occurance in United States, treatment, and medications of rheumatoid arthritis. RHEUMATOID ARTHRITIS INTRODUCTION Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease. It is generally seen that the joints become swollen and there is severe pain that is experienced by the patients. Researchers have found that RA causes the immune system of a person to attack their joints. In RA, the autoimmune response can lead to permanent, painful changes in the joints. This disease is an autoimmune defect and it causes healthy cells to be attacked, releasing enzymes that attack surrounding tissues. One of these structures is the synovium in the joint. It becomes inflamed and causes swelling and pain. Researches have found that RA affects women three times more often than men. Typically, it affects the small joints first, including the joints of the hands and feet. More than one joint usually is affected, and symptoms often appear bilaterally. OCCURANCE Arthritis is a serious problem that is faced by many around the world and it is estimated that about 50 million adults in the United States have reported the doctors to have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia. Another estimation suggests that the problem of artheritis is so cronic that one in every five adults in the US report having doctor diagnosed arthritis. There are also projections that suggest that by the year 2030, 67 million Americans will have doctor-diagnosed arthritis at the age of 18 or older and those that are below the age of 18 an estimated 294,000 children will have some form of arthritis or rheumatic condition. In other words approximately 1 in every 250 children will suffer from this cronic disease all through there life. This points out that artheritis is not just the disease of the elderly, but it is a serious problem among children also. The figures in Florida according to this survey say that 3,903,200 children below the age group of 18 years are having artharitise (Sacks et al. 2007). In a recent survey it was estimated that about 1.5 million adults had rheumatoid arthritis in 2007 (CDC, 2010). According to another estimate in Florida, 27% of adults belonging to the age of 18 years and above have arthritis, and the percentage amplifies with age. Additionally, among this population of self-reported doctor-diagnosed arthritis and estimated 46% of them are not able to do any activity due to their arthritis, 17% of them reported that they are not able have good social participation, 28% suffer from severe joint pain, the working population (34%) have various other limitations due to their arthritis (CDC, 2011). CAUSES OF RHEUMATOID ARTHRITIS Even though the exact causes are indefinite, RA is thought to be the result problems in once own immune system. In other words, the self defense system of the human body attacks the healthy cells in the body and these results in RA and other autoimmune diseases. Researchers suggest that there is no age restriction for the initiation of RA and is linked with weariness and extended stiffness after rest. The swollen synovium leads to erosions of the cartilage and bone and in several cases result in deformed joints. It is very common to here complain of pain, swelling, and redness among these patients. Although the ultimate causes are mysterious, RA is thought to be the consequence of a defective immune reaction. RISK FACTORS There are several studies that point out that a range of environmental and genetic variables may paly an important role in the manufestation of RA such as hormonal exposures, tobacco use, dietary components, HLA genotype, and microbial exposures etc. However, none of these stuedes provide any concrete evidence. Among the environmental factors examined, many have linked the use of tobacco and RA. Among the hormonal exposture the role of estrogenic factors in RA etiology has been studied extensively. There are also genetic susceptibility markers such as the DR4 and DRB1 molecules of the major histocompatability complex HLA class II genes are linked with RA occurance. Additionlly, studies have provided strongest links between RA and the DRB10401 and DRB10404 alleles (CDC, 2009). Researchers from different parts of the world have found that the incidence of RA is in general two to three times higher in women when compared to men. Hoverer among those who are RA positive, the incidence of RA in both women and men peaks in their sixties. Though RA may not directly be linked to the reasons for death, there are several other reasons that may result in the death. For instance, almost 50 % of RA patients die due to cardiovascular disease (CVD) as people with RA have greater support of sub-clinical atherosclerotic disease (CDC, 2009). There are also cases where infections have played crucial role in mortality among people with RA. Studies suggest that infections may be responsible for one-quarter of deaths. Additionally, an amplified frequency of lympho-proliferative malignancies such as leukemia and multiple myeloma are also been reported among people with RA. Further studies are required in identification of risk factors and in the treatment of RA (CDC, 2009). TREATMENT In medical science, there is no complete cure for RA, however new drugs are available today that can help the patients to manage their conditions. Further there is also surgery, good self-management, including exercise, that can be useful in pain management and reducing disability (NCBI, 2011). Treatment of RA is a combined team effort of the patient, the podiatrist, the doctor, nurses and a rheumatologist. There are drugs that can delay the progression of the disease. The severe pain that is experienced by the RA patient can be reduced with the help of some stretching exercises and corticosteroid injections. However, these steroidal injections tend to lose their efficiency over a period of time and have long term side effects. There is a need for a combination of therapies that can help the patients in managing pain as well as reducing its proliferation. RA usually requires lifelong treatment, including medications, physical therapy, exercise, education, and possibly surgery (NCBI, 2011). It is expected that an early intervention and aggressive treatment for RA can delay joint destruction. MEDICATIONS Disease modifying antirheumatic drugs (DMARDs): In the initial stages of the disease patients are put on these drugs. Additionally, the patients are required to take good rest, and also take up strengthening exercises, and anti-inflammatory drugs. The commonly used DMARDs are Methotrexate (Rheumatrex), Leflunomide (Arava) and sulfasalazine. These rugs are also having serious side effects and should be used only on prescription. Anti-inflammatory medications: the main drugs that fall in this category are aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naprosen. The long term use is known to cause other health problems such as ulcers and bleeding, and possible heart problems. Corticosteroids: Though these drugs are among the favorites of the RA patients as it gives much relief as it reduces joint swelling and inflammation, its long term use is not recommended (NCBI, 2011). SURGERY: today with the advancement in this area of medicine, it is occasionally used in order to correct severely damaged joints. For instance, surgery to removal of the joint lining (synovectomy) or total joint replacement in extreme cases of RA such as total knee, hip replacement, ankle replacement, shoulder replacement, and others joints replacements (NCBI, 2011). PHYSICAL THERAPY: Exercise is one of the most important segments in the treatment of RA. There are a variety of joints related exercises and exercise programs approved by a physical therapist that help in the delayed loss of joint function and strengthen muscles. Additionally, there are uses of special equipment to produce heat or electrical stimulation to lessen pain and recover joint movement. Most importantly, adequate rest (8-10 hours) is a must in RA patients (NCBI, 2011). CONCLUSION Rheumatoid arthritis is a serious problem faced by many especially in the old age. There are many who are crippled due to this disease. Though there is no cure for this disease, it is possible to maintain a good joint health using specific drugs, exercise and adequate rest. Though there is no age restriction for the occurrence of this disease, elderly people above forty are mostly affected and women are almost three times more affected than men. Further research is needed especially in the area of the etiology as well as the treatment of rheumatoid arthritis. References Centers for Disease Control and Prevention (CDC), (2009) Rheumatoid Arthritis. Retrieved from http://www.cdc.gov/arthritis/basics/rheumatoid.htm Centers for Disease Control and Prevention (CDC), (2010) Arthritis. Retrieved from http://www.cdc.gov/arthritis/data_statistics/arthritis_related_stats.htm. Centers for Disease Control and Prevention (CDC), (2011) Arthritis- State Program Descriptions: Florida Arthritis Program. Retrieved from http://www.cdc.gov/arthritis/state_programs/programs/florida.htm National Center for Biotechnology Information (NCBI), (2011) Rheumatoid Arthritis. Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001467/ Sacks, J. J., Helmick, C. G., Luo, Y.-h., Ilowite, N. T. and Bowyer, S. (2007), Prevalence of and annual ambulatory health care visits for pediatric arthritis and other rheumatologic conditions in the United States in 2001–2004. Arthritis Care & Research, 57: 1439–1445. Read More