Rheumatoid arthritis (RA)

Can we reverse the finger deformities due to RA and how? 

Is that the only solution is corrective surgery?

• Leena Rai Kalra 

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Rheumatoid arthritis (RA) can cause finger deformities due to joint damage, inflammation, and tissue changes. 

While it may not be possible to reverse the damage caused by RA, there are several treatment options that can help manage the symptoms and slow down the progression of the disease.

Some non-surgical options for managing finger deformities due to RA include:

1. Medications: Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and biologic agents can help reduce inflammation and slow down joint damage.

2. Physical therapy: Exercises and physical therapy can help improve range of motion, flexibility, and strength in the fingers and hands.

3. Hand splints: Custom-made hand splints can help reduce pain and inflammation and prevent further joint damage.

4. Occupational therapy: An occupational therapist can teach you how to use adaptive devices and techniques to perform daily tasks without putting too much strain on your fingers.

In some cases, corrective surgery may be necessary to address severe finger deformities due to RA. Surgery can help realign the joints, remove damaged tissue, and improve hand function. 

However, it is important to note that surgery is not always the best option, and it should be considered carefully after weighing the potential risks and benefits.

In summary, while it may not be possible to reverse finger deformities due to RA, there are several treatment options available that can help manage the symptoms and slow down the progression of the disease. Corrective surgery may be necessary in severe cases, but it should be considered carefully after evaluating other non-surgical options.

▪️Is that the only solution is corrective surgery?

No, corrective surgery is not always the only solution for finger deformities due to RA. In fact, surgery is usually considered as a last resort when non-surgical options have been exhausted and the deformity is severe enough to significantly affect hand function and quality of life.

Non-surgical treatments, such as medications, physical therapy, hand splints, and occupational therapy, can be very effective in managing symptoms and slowing down the progression of the disease. These treatments can help reduce pain, inflammation, and stiffness, and improve hand function and mobility.

In some cases, a combination of non-surgical treatments may be necessary to achieve the best results.

▪️RA.... Causes

Rheumatoid arthritis (RA) is an autoimmune disease that occurs when the immune system attacks the body's own tissues, particularly the synovial membrane that lines the joints. 

The exact cause of RA is not fully understood, but it is thought to be a combination of genetic, environmental, and lifestyle factors.

Some potential causes of RA include:

1. Genetics: RA tends to run in families, suggesting that there may be a genetic component to the disease. Certain genes, such as HLA-DRB1, have been linked to an increased risk of developing RA.

2. Environmental factors: Exposure to certain environmental factors, such as smoking, air pollution, and infections, may increase the risk of developing RA.

3. Hormones: Women are more likely to develop RA than men, and hormonal changes may play a role in the development of the disease.

4. Age: RA can occur at any age, but it is more common in older adults.

5. Obesity: Being overweight or obese may increase the risk of developing RA.

6. Lifestyle factors: Certain lifestyle factors, such as a sedentary lifestyle, poor diet, and stress, may also contribute to the development of RA.

▪️Symptoms 

The symptoms of rheumatoid arthritis (RA) can vary from person to person, but they generally include:

1. Joint pain: RA often causes pain and stiffness in the joints, particularly in the hands, wrists, feet, and knees. The pain may be worse in the morning or after a period of inactivity.

2. Joint swelling: Inflammation in the joints can cause swelling, warmth, and redness.

3. Joint stiffness: Stiffness in the joints, especially in the morning or after sitting for a long time, is a common symptom of RA.

4. Fatigue: RA can cause fatigue, a feeling of exhaustion, weakness, or tiredness.

5. Loss of appetite: People with RA may experience a loss of appetite and weight loss.

6. Low-grade fever: Some people with RA may experience a low-grade fever.

7. Rheumatoid nodules: These are firm lumps that form under the skin, typically around the elbows or fingers.

8. Decreased range of motion: RA can cause a decreased range of motion in the affected joints.

9. Deformities: Over time, RA can cause joint deformities, particularly in the hands and feet.

▪️Diagnosis 

The diagnosis of rheumatoid arthritis (RA) usually involves a combination of medical history, physical examination, blood tests, and imaging tests. The diagnostic process typically involves the following steps:

1. Medical history: Your healthcare provider will ask about your symptoms, medical history, and family history of RA.

2. Physical examination: Your healthcare provider will perform a physical examination, including examining your joints for swelling, redness, warmth, and tenderness.

3. Blood tests: Blood tests can help diagnose RA by measuring certain markers, such as rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) antibodies, and C-reactive protein (CRP) levels. However, it's important to note that some people with RA may not have these markers in their blood, and some people without RA may have elevated levels of these markers.

4. Imaging tests: X-rays, ultrasounds, and MRI scans can help detect joint damage and inflammation in people with RA.

5. Other tests: In some cases, other tests such as joint fluid analysis, bone scans, or biopsies may be necessary to help diagnose RA.

▪️Treatments 

The treatment for rheumatoid arthritis (RA) typically involves a combination of medications, lifestyle changes, and in some cases, surgery. The goals of treatment are to reduce inflammation, relieve pain, prevent joint damage, and improve function. Some common treatments for RA include:

1. Medications: There are several different types of medications used to treat RA, including nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), biologic agents, and corticosteroids. These medications work in different ways to reduce inflammation and improve symptoms.

2. Lifestyle changes: Making certain lifestyle changes can help manage symptoms of RA, such as regular exercise, maintaining a healthy weight, and getting enough rest. Occupational therapy can also help teach techniques to conserve energy and protect the joints during daily activities.

3. Physical therapy: Physical therapy can help improve joint function, increase strength and flexibility, and reduce pain.

4. Surgery: In some cases, surgery may be necessary to repair or replace damaged joints.

5. Complementary and alternative medicine (CAM): Some people with RA find that complementary and alternative medicine (CAM) treatments, such as acupuncture, massage, and dietary supplements, can help reduce inflammation and improve symptoms.

▪️Natural way treatment

While medications are often the mainstay of treatment for rheumatoid arthritis (RA), there are some natural approaches that can be used to help manage symptoms and improve quality of life. These include:

1. Exercise: Regular exercise, such as low-impact aerobics, strength training, and stretching, can help improve joint flexibility, reduce pain and stiffness, and improve overall physical function.

2. Diet: A healthy diet that is rich in fruits, vegetables, whole grains, lean protein, and healthy fats can help reduce inflammation and improve overall health. Some studies suggest that omega-3 fatty acids, found in fish and some nuts and seeds, may have anti-inflammatory properties.

3. Hot and cold therapy: Applying heat or cold to the affected joints can help reduce pain and inflammation. Hot therapy can help relax muscles and increase circulation, while cold therapy can help reduce swelling and numb pain.

4. Mind-body techniques: Mind-body techniques such as meditation, yoga, and tai chi can help reduce stress, improve relaxation, and increase physical and emotional well-being.

5. Acupuncture: Some people with RA find that acupuncture can help reduce pain and improve joint function.

▪️Is this curable completely? 

At this time, there is no known cure for rheumatoid arthritis (RA). However, with proper treatment and management, it is possible to achieve remission or low disease activity. This means that symptoms can be well-controlled, joint damage can be prevented or minimized, and quality of life can be improved.

The treatment plan for RA typically involves a combination of medications, lifestyle changes, and in some cases, surgery. The goals of treatment are to reduce inflammation, relieve pain, prevent joint damage, and improve function. With proper treatment, many people with RA are able to lead active, fulfilling lives.

▪️Hospitals in India for treatment:

There are many hospitals in India that provide treatment for rheumatoid arthritis (RA). 

Some of the well-known hospitals for the treatment of RA in India include:

1. All India Institute of Medical Sciences (AIIMS), Delhi

2. Fortis Hospital, Delhi

Kokilaben Dhirubhai Ambani Hospital, Mumbai

3. Medanta - The Medicity, Gurugram

4. Apollo Hospitals, Chennai

Jaslok Hospital and Research Centre, Mumbai

5. Max Super Speciality Hospital, Delhi

6. Manipal Hospital, Bengaluru

7. Sir Ganga Ram Hospital, Delhi

▪️In Delhi 

There are several hospitals in Delhi that provide treatment for rheumatoid arthritis. 

Some of the well-known hospitals for the treatment of RA in Delhi include:

1. All India Institute of Medical Sciences (AIIMS), Delhi

2. Fortis Hospital, Vasant Kunj, Delhi

3. Max Super Speciality Hospital, Saket, Delhi

4. Indraprastha Apollo Hospital, Sarita Vihar, Delhi

5. BLK Super Speciality Hospital, Pusa Road, Delhi

6. Sir Ganga Ram Hospital, Rajinder Nagar, Delhi

7. Medanta - The Medicity, Defence Colony, Delhi

8. Batra Hospital and Medical Research Centre, 9. Tughlakabad Institutional Area, Delhi

10. Primus Super Speciality Hospital, Chanakyapuri, Delhi

11. Apollo Spectra Hospitals, Karol Bagh, Delhi

These hospitals have rheumatologists and other healthcare professionals who are experienced in the diagnosis and treatment of RA.

▪️Doctors' list for the treatment in India 

There are many experienced rheumatologists and doctors who specialize in the treatment of rheumatoid arthritis (RA) in Delhi. Some of the well-known doctors for the treatment of RA in Delhi include:

1. Dr. Sanjiv Kapoor, Fortis Hospital, Vasant Kunj

2. Dr. Anoop Jhurani, Max Super Speciality Hospital, Saket

3. Dr. Anand Malaviya, Apollo Hospitals, Sarita Vihar

4. Dr. Vikas Aggarwal, BLK Super Speciality Hospital, Pusa Road

5. Dr. Rajiv Gupta, Sir Ganga Ram Hospital, Rajinder Nagar

6. Dr. Sarvajeet Pal, Medanta - The Medicity, Defence Colony

7. Dr. Latika Gupta, Batra Hospital and Medical Research Centre, Tughlakabad Institutional Area

8. Dr. Manoj Kumar, Primus Super Speciality Hospital, Chanakyapuri

9. Dr. Jasvinder Singh, Apollo Spectra Hospitals, Karol Bagh

10. Dr. Subhashish Agarwal, Indraprastha Apollo Hospital, Sarita Vihar