Understanding rheumatoid arthritis and its impact on quality of life

Often, rheumatoid arthritis (RA) is simply thought of as a condition that affects one’s “kasu-kasuan” or joints. But this systemic autoimmune disease, where the immune system mistakenly attacks the body’s own tissues, has far more impact on one’s body and quality of life—from creating chronic joint inflammation that limits movement and affecting mental well-being to damaging other parts and organs of the body.

Rheumatology Specialist Ana Monica D. Estrella, MD from Makati Medical Center (MakatiMed) explains that rheumatoid arthritis is typically characterized by inflamed joints. Meaning, they are swollen, stiff, and painful as well as warm and tender to touch, which she underlines affects mobility and day-to-day activities.

“Daily living with rheumatoid arthritis can be challenging as inflamed small joints are usually found in the fingers and the hands such as the knuckles and the wrists as well as in some limbs and in the feet. These joints are essential to allow us to be mobile and do the things we need to do,” says Dr. Estrella.

She further emphasizes that RA is distinct from other forms of “rayuma” and degenerative arthritis because it is a persistent, chronic condition—plus, it is often bilateral, meaning it affects both the left and the right side of the hands or feet.

“Usually, patients with rheumatoid arthritis complain of swelling early in the morning, along with stiffness or pain that can last for more than an hour before gradually lessening throughout the day. This prolonged morning stiffness is a key characteristic that differentiates rheumatoid arthritis from other types of rayuma or joint pain. With rheumatoid arthritis, these specific symptoms typically start in the morning and improve as the day progresses,” explains Dr. Estrella.

“Almost every day, patients with rheumatoid arthritis experience pain and swelling, which can lead to joint damage. In fact, some individuals may already present with visible joint damage or deformities. So, it is crucial to understand that this is a lifelong condition.”

Apart from limiting movements and experiencing joint pain at the very start of the day, other common constitutional symptoms of this chronic autoimmune disease are fever, fatigue, generalized weakness, and weight loss or loss of appetite. The MakatiMed doctor adds that the condition could also affect a patient’s mental wellness.

“Definitely, the impact transcends physical pain. Mood and mental well-being are also significantly affected, with many patients experiencing depression and other psychological challenges,” reveals Dr. Estrella, emphasizing that effects of rheumatoid arthritis can also go beyond the joints.

“It is not only limited to arthritis or the joints. Rheumatoid arthritis sometimes goes beyond the joints, affecting other parts of the body like the eyes, the skin, the heart, the lungs, and even the blood vessels.”

Rheumatoid arthritis may also cause dry eyes, glaucoma, and conjunctivitis; rashes and ulcers in the skin as well as slow wound healing; hardened arteries and heart attack; as well as scarred lungs and lung nodules.

This is why Dr. Estrella strongly suggests a holistic, multimodal approach and early diagnosis in dealing with this chronic autoimmune condition. In her practice, the MakatiMed doctor says that among the top risk factors for rheumatoid arthritis include family history, being, age as it predominantly affects the middle aged (although a subset of elderly patients is also observed), smoking, and sedentary lifestyle.

Diagnostic tests include a complete blood count to check for anemia and high platelet count as they could indicate inflammation as well as blood tests that measure inflammatory markers like ESR (Erythrocyte Sedimentation Rate) and CRP (C-Reactive Protein) that usually elevated for people with rheumatoid arthritis. Dr. Estrella says these markers are what rheumatology specialists monitor to see if the body is responding to treatments.

Other tests doctors may order include a check on specific antibodies like Anti-CCP (cyclic citrullinated peptide) and rheumatoid factor (RF), which are both autoantibodies that can be found in the blood of individuals with rheumatoid arthritis.

Imaging tests such as X-ray of the areas involved to check the damage in the muscles and the joints as well as ultrasound and magnetic resonance imaging (MRI) scan particularly in the early stages to find signs of inflammation may also be ordered to further assess the extent of the condition.

“In advanced cases of rheumatoid arthritis, destructions and deformities of the joints are more visible. They already look crooked, and these destructions and changes are irreversible. This is what we are trying to prevent, so early diagnosis of the disease is still the key to preventing joint destruction,” underlines Dr. Estrella.

Given rheumatoid arthritis’ impact on your quality of life, Dr. Estrella emphasizes that it is a must to see a specialist to help you properly manage the disease. Specialists usually prescribe non-steroidal or steroidal anti-inflammatory medications and disease modifying anti-rheumatic drugs (DMARDs) to slow down the progression of the disease and ensure mobility.

Taking supplements such as calcium and Vitamin D and keeping to a healthy, balanced diet are also recommended since the condition increases risk of osteoporosis and certain medications may affect blood sugar levels.

A holistic approach to managing rheumatoid arthritis may also involve physical and occupational therapists who can craft exercises specific to a patient’s particular condition, with the goal to improve flexibility, prevent contractures, and strengthen muscles.