Rheumatoid arthritis is believed to affect about 1% of the global population. It’s a progressive disease so early detection and treatment is an effective way to slow down its development and relieve the painful symptoms. Discover more as Bloom, together with leading medical health partner, Momentum Health4Me provides a comprehensive guide about rheumatoid arthritis.

What is Rheumatoid Arthritis?

Rheumatoid arthritis is a chronic autoimmune disease that is systemic in nature, which means it can affect the entire body. The disease causes debilitating inflammation, swelling and pain in the joints and internal organs. Commonly affected areas are the hands and fingers, knees and ankles. 

Like many autoimmune diseases, rheumatoid arthritis, or RA, is caused when the immune system mistakenly identifies healthy tissue for foreign invaders and subsequently responds by attacking the lining of the joints, causing inflammation in target tissue areas, like the lungs or heart. Ordinarily, the immune system would fight pathogen invaders, like viruses or bacteria, but an autoimmune disease identifies the healthy cells as invaders and produces inflammatory chemicals. 

The inflamed joint lining gradually becomes thicker, making it extremely painful and reducing the affected person’s range of mobility. If left untreated, the cartilage can be completely destroyed. Tendons and ligaments that hold the joints together also become weakened, which causes the joint to lose its natural shape.

Symptoms of arthritis

RA is a chronic condition with periods of flare-ups and remissions. The severity of symptoms can vary in intensity. And because the illness is progressive, it is characterised by early tell-tale signs, which worsen as time goes on. Some of the common symptoms of the disease include: 

1. Slight or mild fever. The typical RA inflammation often causes the individual to feel feverish. This is one of the first, early symptoms that precede any major effects on the joints.
2. Stiffness. This will start off as mild and may only occur in one or two small joints, like the fingers. The stiffness can last a few days. There may also be a feeling of overall body stiffness, in addition to specific joints. This is often experienced early in the morning or when the individual sits for a long period of time.
3. General fatigue. Another one of the early signs of rheumatoid arthritis is fatigue. This lack of energy can interfere with daily tasks and day-to-day living.
4. Motion range impairment. An early-onset symptom is the loss of a range of movements, like bending your ankle up and down. Progressive inflammation and irreparable damage to the joints will eventually affect the ligaments and tendons to such an extent that the individual will battle to bend or straighten the affected joints at all. 
5. Unexplained weight loss. Some people who are presenting with the early signs of rheumatoid arthritis will experience a sudden and unexplained loss of weight. 
6. Tender joints. The areas that commonly show the first signs of joint tenderness are your hands and feet. The joint in the middle of your fingers and the base of your toes may feel a bit tender during movement. Some people may even walk on their heels so as not to put their toes on the ground. 
7. Joint pain. As the condition progresses, and the inflammation in the lining of your joints becomes thicker, it becomes even more painful. The most affected areas are usually in your fingers and feet. This is because the inflammation increases the production of joint fluid, which irritates nerve endings.
8. Joint swelling. The swelling of joints is a typical early sign of rheumatoid arthritis. It begins with a slight swelling, which gradually becomes worse and more prominent. 
9. Discolouration. Affected joints appear red, especially on your hands and feet. This happens because the inflammation causes blood vessels in the skin to widen. 
10. Numbness or tingling in your hands and feet. This is an early sign of inflammation. It causes nerve compression and a loss of sensation in the afflicted areas.

Health implications of arthritis

While this autoimmune disease primarily affects the joints, it can also have wide-ranging health implications that extend to other complications. Some of these include: 

• Heart damage due to inflammation around the heart muscle area
• Impaired vision as your eyes become dry and inflamed, resulting in light sensitivity 
• Oral problems such as inflammation that affects your gums, resulting in severe pain or infections 
• Skin problems can occur called rheumatoid nodules where lumps form under the skin over the bony areas of the body
• Lungs can become inflamed and scarred, leading to lung disease
• Blood and blood vessels are affected as the inflammation decreases the number of red blood cells, leading to nerve and organ damage
• Joint damage and deformities. Rheumatoid arthritis leads to progressive joint damage, which eventually results in the loss of joint function and mobility. This can severely impair an individual’s mobility and their ability to perform basic or routine tasks, like driving, dressing, walking, bathing or using the bathroom.

• Systemic inflammation. This has serious health implications because it affects multiple organs and systems throughout your body, leading to other health conditions, like heart disease, stroke and diabetes. This is because the persistent response can cause tissue damage and impair organ function. Other areas that are affected include the lungs, kidneys and eyes. Chronic inflammation is also linked to anaemia.

• Increased risk of osteoporosis. Rheumatoid arthritis and the use of medication to treat the disease can increase an individual’s risk of developing this brittle bone condition, making you more prone to breaks and fractures. 
• Increased risk of other autoimmune disease. Individuals with RA have a higher risk of developing other autoimmune conditions, like lupus. 
• Emotional and psychological impact. Living with RA can be challenging due to the chronic pain, loss of mobility and other health implications. Subsequently, many people develop depression and anxiety.

Who is at risk for developing arthritis?

While genetics does play a part, there are a number of other factors that are proven to contribute to your risk of developing this condition. This includes:

• Advanced age. The condition tends to affect the elderly. The early signs of rheumatoid arthritis begin to present when people are in their 60s. 
• Gender. Women are three times more likely to develop rheumatoid arthritis than men. Hormones are believed to contribute to this as women who undergo menopause tend to experience a general activity decline, which can play a role in disease progression.
• Smoking. Studies have found a correlation between smoking and an increased risk of developing rheumatoid arthritis. 
• Obesity. A high body mass index can also increase one’s risk for rheumatoid arthritis.
• Certain types of infections, like HIV, hepatitis B or C, or parvovirus can compromise the immune system and trigger the development of RA.
• Gut bacteria. Certain types of bacteria found in one’s intestines can play a role in the development of inflammation and, in doing so, can trigger the development of the disease.

Living healthy: how to prevent, manage and treat arthritis

Certain lifestyle practices can help reduce your risk of developing RA. One of these preventative measures is by watching your diet. Eat a nutritious, balanced diet and be sure to include the following:

• Fatty fish, like pilchards, which are high in omega-3 fatty acids
• Fresh fruit and vegetables
• Healthy monounsaturated fats, like olive oil and avocado
• Nuts and seeds
• Whole grains, which are a great source of fibre and help boost heart health
• Legumes, like beans
• Low-fat dairy, like milk and yoghurt 
• Leafy greens, like spinach and kale
• Lean animal protein, like chicken

Many superfoods have anti-inflammatory properties, including: tomatoes, spinach, kale, walnuts, salmon, blueberries, strawberries and oranges. It’s also recommended to avoid or limit your intake of the following foods:

• Red meat and processed meat
• Refined carbohydrates, like white bread or pasta
• Fried food
• Margarine 
• Alcohol
• Carbonated soft drinks 

Other preventative measures you can take to decrease your risk of developing rheumatoid arthritis include: 

• Quit smoking. Smokers are twice as likely to develop the disease than non-smokers. This is because tobacco smoking has a negative impact on the body’s immune system, creating oxidative stress and triggering inflammation. 
• Keep your bones healthy and strong. Rheumatoid arthritis is often associated with bone density loss and osteoporosis. It’s essential that one prevents bone loss by exercising, watching one’s diet and taking supplements, if necessary.
• Good oral health care. Keep your teeth and gums in good condition by practising good oral hygiene with frequent brushing and flossing. 
• Exercise. Regular, low-impact exercise can decrease the progression of and even relieve the symptoms of the disease. Try yoga, stretching, swimming and strength training to stay in shape. 

If you have been diagnosed with rheumatoid arthritis, you will need to embark on a treatment and management plan under the guidance of a healthcare professional. They will probably recommend a combination of the following treatments: 

• Medication, like corticosteroids, helps reduce inflammation and pain. Unfortunately, some drugs can cause side effects, like stomach ulcers, high blood pressure and liver problems. So make sure you monitor the effects so that the dosage can be adjusted or the medication discontinued, if necessary.
• Occupational therapy and physiotherapy. An occupational therapist can assist in showing one how to accomplish certain tasks that will minimise the impact on the joints. They can also advise on an exercise plan and the use of aids, like a walking cane.
• Low-impact exercise activities. Some forms of exercise, like swimming, can help alleviate joint and muscle muscle pain and preserve joint flexibility. 
• Surgery. Certain surgeries can be performed to correct deformities and reduce pain. Arthroplasty, for instance, is a total joint replacement procedure.

Takeaway: What do we cover?

Bloom is committed to healthy living. You will need specialist medical care and services if you have a serious chronic condition or disease, like rheumatoid arthritis. Make sure you and your family are covered for chronic benefits and get the right healthcare coverage. 

We have a wide portfolio of healthcare options that will suit your medical needs and budget. Choose from:

1. Health Insurance. We have partnered with the respected Momentum Health4Me provider for health insurance that provides top-quality, affordable plans to people on a budget, including;

• Health4Me Gold. This is our most popular and premium, yet affordable health insurance option.
• Health4Me Silver is a balanced health insurance option that brings you high-quality and competitively priced private healthcare. 
• Health4Me Bronze is our entry-level health insurance option that provides you with quality healthcare at an affordable premium.

2. Medical aid. Together with our partner, Momentum, we also offer affordable medical aid solutions across three categories. Take a look at the benefits to decide which plan best suits your particular medical needs.

• Ingwe is an affordable, entry-level medical aid plan that’s perfect for first-time earners and students. You will receive hospital coverage, and day-to-day and chronic illness benefits using the network providers. 
• Custom includes cover for hospitalisation in private hospitals. The Custom option provides cover for a range of day-to-day benefits such as preventative screening tests, specific check-ups and more. 
• Evolve is for digitally savvy individuals looking for affordable hospital cover and virtual GP visits, with the ability to manage their membership from their devices in the comfort of their homes.

3. Gap cover. This option takes care of medical expense shortfalls. Many healthcare services charge above medical scheme rates, which means that you would need to cover the difference out-of-pocket. Let Gap Cover assist with these extra expenses. Compare: 

• Gap Core is the affordable answer to extra medical expenses. It covers the gap between what your medical aid covers and what hospitals and specialists charge.
• Gap Max is the premium and comprehensive answer to unexpected medical expenses. This option covers the shortfall between what your medical aid covers and what hospitals and specialists charge, with many added benefits

Momentum Health4Me Gold will cover the cost of your chronic medication and services for rheumatoid arthritis provided that it has been approved and prescribed by a network GP from the list of 26 chronic conditions. Once you’ve received approval and authorisation, simply fax or email your prescription to a Medipost Pharmacy and let them know where to deliver it. You can fax through to 0866 82 33 17 and email to mhealth@medipost.co.za