ByDr Sajjan Shenoy

October 12, 2021 (IANSlife) Rheumatoid arthritis (RA) is a chronic inflammatory auto-immune disease that involves predominantly joints but also other systems of the body. Affected patients develop severe joint pains with swelling involving the finger joints, wrists, shoulders, knees and feet with significant night pain and early morning increase in pain and stiffness of the joints.

If not appropriately diagnosed and treated on time, it is a disabling and debilitating disease with the majority of the patients ending up with damaged and deformed joints. They find it difficult to carry out even the basic activities of daily living. The disease also affects the cardiovascular system leading to an increased risk of heart attacks and stroke. In fact, such events remain the most common cause of mortality in such patients. RA is an autoimmune disease – one in which there is an immune system response and attack to one’s own tissues.

RA also occurs more often in women (8 out of 10 patients with RA are women). The exact cause for this process is unknown but current theories of disease origins point towards the presence of genetic predisposing factors (which by themselves are not sufficient to produce the disease) which interact with environmental factors – possibly infections, diet, hormonal changes and lifestyle-related factors. No single theory has been proven to be accurate but accumulating scientific data over the years have been supportive.

In view of the lack of definitive knowledge on the development of RA, preventive measures are often empirical and not of proven benefit. However, it is certain that some lifestyle-related factors significantly increase the risk of the development of RA. It may be worthwhile to put in a conscious effort to improve them and avoid the development of such disorders and also to improve disease control if one has been unfortunate enough to have developed the disease already.

• Exercise: Regular exercise is well known to improve the musculoskeletal health and hence has an important role in the prevention of many diseases. RA may not be an exception. Aerobic exercises for at least 30 minutes a day for a minimum of 5 days per week is recommended. Range of motion exercises, which help maintain or improve flexibility in joints and the surrounding muscles and strength training, which builds muscle and tendon strength to stabilize and support joints, can help people with pre-existing RA. Walking, cycling, swimming and yoga are recommended since these help in increasing the endurance levels significantly.
• Alcohol Intake: Alcohol in all forms has to be limited. Medications used to treat RA may increase the risk of liver injury in patients who consume alcohol on a regular basis.
• Quit Smoking: Evidence for incriminating tobacco smoking in the development of RA is very strong. Hence, people with predisposing familial factors must strongly consider stopping smoking. Continuing to smoke once the disease onset has happened increases the disease activity and the risk of significant joint damage.
• Diet: No particular diet is known to increase the risk of RA. However, a balanced diet with generous portions of fruits, vegetables that have anti-oxidant properties is recommended. Pro-inflammatory diets like meat, purified sugars, processed foods including fast food, saturated fats are best avoided.
• Stress: The need to reduce mental stress cannot be overemphasized. Persistent mental stress is well known to increase inflammatory processes in our body. Avoiding stressful situations, taking breaks in between work schedules, nurturing a fulfilling hobby, spiritual inclination and spending time with friends and family help in reducing stress and related problems.
• Weight: Being overweight adds to the load that joints (especially the back and lower limb joints) have to bear in day-to-day activities. This may add to the pain and early wear and tear of joints. Keeping a check on weight by appropriate diet and exercises is very important. Consult your rheumatologist Do not hesitate to consult your rheumatologist if you have joint pains, swelling which requires attention. Early diagnosis is the key to such disorders. Appropriate treatment coupled with lifestyle changes can give such patients a near-normal life.

(Dr Sajjan Shenoy is MD; DM Consultant Rheumatologist and Immunologist at KMC Hospital, Mangaluru.)

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