There is a kind of pain called rheumatoid arthritis pain, which is called the "immortal cancer"!

Author: Mu Rong, Chief Physician, Peking University Third Hospital

Reviewer: Wu Xueyan, Chief Physician, Peking Union Medical College Hospital

When people get old, they will always have various kinds of pain in their bodies. There is a kind of pain called rheumatoid arthritis pain. This kind of pain makes people feel that "life is worse than death", so people call it "immortal cancer!"

According to epidemiological surveys in my country, the incidence of rheumatoid arthritis in my country is moderate, generally between 0.2% and 0.4%. The latest epidemiological survey data conducted in Beijing showed 0.28%.

1. What is rheumatoid arthritis?

Rheumatoid arthritis is a typical autoimmune disease, and its pathogenesis is still unclear.

However, from clinical experience, patients with rheumatoid arthritis have one common characteristic. Because of their autoimmune dysfunction, the synovial membrane of the joints is stimulated by external inflammation and causes hyperplasia. Under a microscope, the synovial membrane of patients with rheumatoid arthritis is no longer a thin layer, but is covered with tumor-like, hyperplastic synovium. These hyperplastic synovium can cause joint swelling. As the disease progresses, the bones will be destroyed and joint deformation will occur.

Rheumatoid arthritis may affect all joints in the body. The most common site of onset is the small joints, especially the proximal interphalangeal joints, metacarpophalangeal joints, wrists, etc. Generally speaking, the chance of rheumatoid arthritis affecting the distal interphalangeal joints before the last segment of the fingers is not high.

Figure 1 Original copyright image, no permission to reprint

There are many medical studies on rheumatoid arthritis, but its exact pathogenesis has not yet been clarified.

Most people think that damp and cold weather is most likely to cause rheumatoid arthritis. However, according to a survey of rheumatoid arthritis in the north and south of my country, the incidence rates in the north and south are very similar, and the incidence rate in humid areas is not prominent. Therefore, there is no definite medical data to show that there is a direct relationship between humidity and rheumatoid arthritis. Of course, many patients say that the symptoms of rheumatoid arthritis do get worse on rainy days. But in general, the weather does not have much impact on the onset of the disease.

Whether rheumatoid arthritis is hereditary is a very complicated question. First of all, it is caused by multiple factors and the genetic loci are also complex. For most people, the chance of inheritance is not high.

Rheumatoid arthritis is more common in women before and after menopause, which may be related to changes in hormone levels in the body. Foreign studies have found that rheumatoid arthritis is more common in smokers, but this research result has not been verified in Asian populations, and there may be differences in race and environment.

2. What are the symptoms of rheumatoid arthritis?

The early symptoms of rheumatoid arthritis are swollen and painful joints, especially in the hand joints. Some patients may feel the joint surface is hot when the disease develops rapidly. Swollen and painful joints, high joint surface temperature, and joint dysfunction are the most common first symptoms of rheumatoid arthritis.

Figure 2 Original copyright image, no permission to reprint

In addition to joint symptoms, rheumatoid arthritis may also cause vasculitis, which has many symptoms, such as lower limb gangrene, skin surface ulceration, rheumatoid nodules, etc. Rheumatoid nodules can appear on the surface of joints, or in internal organs such as the lungs and heart valves.

In summary, rheumatoid arthritis is a group of diseases that may affect all organs of the body. Therefore, in addition to joint swelling and pain, rheumatoid arthritis can also cause disability. According to epidemiological survey results, nearly 40% of rheumatoid arthritis patients are unable to work normally after the disease. When the disease is serious, they cannot take care of themselves and need special care, which is a heavy burden for many families.

Nowadays, medical standards are constantly improving, and the means and concepts of treating rheumatoid arthritis are also constantly updated. Rheumatoid arthritis can be completely controlled. Therefore, we hope that every rheumatoid arthritis patient can actively receive treatment as early as possible, strive to control the disease, and try to avoid or reduce the impact of the disease on life.

3. What should we pay attention to when treating rheumatoid arthritis?

The goal of rheumatoid arthritis treatment is to completely relieve the condition and control the disease. Anti-rheumatic drugs that inhibit synovial hyperplasia, control inflammation, and improve the condition must be used in sufficient quantities. Do not just use painkillers or hormones. If you take a little painkiller today and get better, but the condition recurs tomorrow, this cannot be considered relief.

Which drug or drug combination is the best should be determined based on the condition and the reaction after taking the drugs. When the patient is in the active stage, he should visit the hospital for follow-up every 1-3 months so that the drug can be adjusted in time. After the condition is relieved, he can visit the hospital every 3-6 months. Clinically, it is found that without close follow-up, the patient's prognosis is often poor, so regular follow-up and monitoring are very important.

So, can you stop taking medication after rheumatoid arthritis symptoms are relieved? For most people, long-term medication is required. There was a study abroad that found that if you gradually stop taking medication after the symptoms are relieved, most of the patients will relapse within a year after stopping the medication. If you continue to treat after the relapse, the original medication may not be effective, and the difficulty of treatment will increase by two times.

Therefore, it is not recommended to reduce or stop medication at present, especially for patients with a long course of illness. Of course, the dosage can be slowly reduced after the condition has improved, and the lowest dosage can be used to maintain treatment. This can be done by most people. Completely stopping medication is still unrealistic for most people.

4. What should patients with rheumatoid arthritis pay attention to in daily life?

Patients with rheumatoid arthritis can do finger exercises and joint exercises to relieve morning stiffness, improve symptoms, and keep the joints functioning normally. Joint function training is a very important part.

When joint swelling and pain are obvious, do not do strenuous exercise, as it will aggravate joint swelling and pain.

Do not apply hot compress during the acute phase. Hot compress on the joints will cause blood vessels to dilate and the inflammation will worsen.

Many patients believe that they cannot use air conditioning in the summer after suffering from rheumatoid arthritis. Currently, it has not been found that blowing cold air will aggravate rheumatoid arthritis. As long as it is not too cold, there are generally no taboos.

We hope that patients with rheumatoid arthritis can live like normal people, quit smoking and drinking, maintain a normal weight, and not place too many restrictions on themselves.