Getting a Third Dose of the COVID-19 Vaccine When You Have Rheumatoid Arthritis

From everydayhealth.com

Should everyone get it? Is it safe? We have answers.

In late August, the Centres for Disease Control and Prevention (CDC) recommended that people who are moderately or severely immunocompromised get a third dose of the Pfizer-BioNTech or Moderna mRNA vaccine. This group, which includes people on medications commonly used for rheumatic diseases such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA), remain vulnerable to contracting COVID-19 even after they’ve had their two shots, the agency said.

To help people understand what this means for those with these diseases, the American College of Rheumatology has again updated its clinical guidance for physicians.

People with RA have many questions about the COVID-19 vaccine, and especially about this newly added dose. To get answers to common questions, we spoke with Juan J. Maya-Villamizar, MD, a rheumatologist at the Rheumatology Centre of Palm Beach, in Lake Worth, Florida, and a medical adviser to the digital arthritis community CreakyJoints.

Everyday Health: Does the CDC’s recommendation that people who are immunocompromised get a third shot of their mRNA vaccines apply to everyone with rheumatoid arthritis?

Dr. Juan Maya-Villamizar: It isn’t the fact that people have an autoimmune condition like RA that is the issue, but rather that people with these diseases generally take immunosuppressive drugs. The need for the third shot covers people on most of the medications we use for RA with the exception of the drug hydroxychloroquine.

Some medications that trigger the need for a third dose include steroids, tumour necrosis factor inhibitors (TNFi), interleukin-6 inhibitors (IL-6), methotrexate, sulfasalazine, leflunomide, azathioprine, mycophenolate, and Janus kinase (JAK) inhibitors. People who are not on immunosuppressive drugs because they have low disease activity or who are only on hydroxychloroquine are not part of this group.

EH: Why will people on these meds benefit from that third shot?

JMV: The data so far are preliminary, but what it has shown is that antibodies against COVID-19 are often not generated after the second dose. In some studies, up to 50 percent of patients who are on an immunosuppressive medication did not make antibodies. By getting the third dose, the number of people who finally develop antibodies goes up. Even so, not everyone will make them.

EH: The CDC is not calling this a booster, but rather a third shot in the series. Why are they making that distinction?

JMV: They want to clarify that a booster is when someone gets an antibody response but then it starts fading, and the next shot is to regain the response. Here they are saying the third shot is part of the series of vaccines needed to create the response in the first place. Also, it emphasizes how important this third shot is for immunocompromised people in order to make the immunization effective.

EH: When should a person get the third dose?

JMV: The recommendation is to get the shot at least four weeks after the second shot of your Pfizer or Moderna vaccine. If possible, you should stick with the same one you had before. So if you had Moderna for your first two shots, you should try to get that for your third. The implication of the CDC’s words “if possible” is if you’re not able to get the same vaccine for some reason, you can get the other mRNA vaccine.

So far there is no official recommendation about another shot for people who initially got the Johnson & Johnson vaccine, but we expect that to be coming.

EH: Are there risks to getting an additional shot?

JMV: For immunocompromised patients there have not been any risks reported, other than reactions that are expected for any vaccine: localized arm pain or reactions, or symptoms like you get with a cold such as muscle aches, fever, or chills. If you had a reaction to your prior shots that doesn’t mean you will have one after the third shot, but it is possible.

People with RA may also get a little flare of joint pain. The recommendation is to use your typical medications, such as acetaminophen, ibuprofen, or Aleve. Be sure to talk to your rheumatologist if you feel you’re having a severe joint pain reaction.

Of course, with any type of intervention there is always a very small percentage of unexpected reactions. If something comes up that concerns you after you get the third shot, speak to your doctor.

EH: The American College of Rheumatology recommends that people briefly shift the timing of some of their medications when they get the first or second shot if their disease is stable. For example, they suggest that JAK inhibitors should be delayed for a week after each COVID-19 vaccine dose. Do these same recommendations apply for the third shot, too?

JMV: The task force agreed that certain medicines should again be held for one to two weeks around the vaccine, such as mycophenolate and JAK inhibitors. But they did not reach consensus about shifting medications around the third shot for many medicines, including steroids and most biologics. I myself am telling my patients whose disease is stable to follow the same recommendations as for the other shots, since this may help improve response to the vaccine. Everyone should talk to their doctor about their own treatment situation.

EH: Are there other things people with a rheumatic disease should know about the vaccines?

JMV: Without question everyone should get vaccinated. Recent data show that most hospital admissions for COVID-19 are in unvaccinated patients. It’s clear that getting vaccinated decreases your risk of a hospital admission and prevents you from getting stronger forms of the disease. Staying out of the hospital has additional benefits for immunocompromised people because of all the other infections that live there.

If you have specific concerns that are holding you back from being vaccinated, be sure to share them with your doctor.

Even after you get the three shots, it’s still important for people who are immunocompromised to diligently follow other COVID-19 prevention measures, such as wearing a mask; avoiding large gatherings, especially in poorly ventilated spaces; and maintaining at least six feet of distance from other people.

https://www.everydayhealth.com/rheumatoid-arthritis/getting-a-third-dose-of-the-covid-19-vaccine-when-you-have-rheumatoid-arthritis/

How to Exercise for Psoriatic Arthritis Pain Relief

From self.com

You don’t have to completely avoid being active

Exercise for psoriatic arthritis can be a complex subject. The inflammatory autoimmune condition causes painful, stiff, and swollen joints, in addition to fatigue—all very understandable reasons to avoid working out.

But if you have psoriatic arthritis, maintaining a consistent exercise routine can actually be one aspect of your care plan—as long as you don’t push yourself too hard, according to Joshua Bilsborrow, M.D., MHS, instructor of rheumatology at Yale School of Medicine. (Overdoing it can create not just the muscle soreness you’d expect from a challenging workout, but it can also increase symptoms like joint pain and swelling.) Although your exact workout routine should be based on your abilities and interests, Dr. Bilsborrow recommends stretching, cardio, and strength training as part of any well-rounded program for people with psoriatic arthritis.

Although you probably often hear that it’s a good idea to listen to your body, it can be confusing for a person with chronic pain to figure out the best way to do that when working out, since exercise often includes some level of discomfort naturally. Here’s how experts say you can safely exercise for psoriatic arthritis.

1. Work with a physical therapist if you can.

If you have this condition, we don’t have to tell you how tricky it can be to exercise for psoriatic arthritis. Dr. Bilsborrow says working with someone who understands what you’re dealing with can be really beneficial. A certified personal trainer may have the skills to safely coach someone without psoriatic arthritis, but they typically aren’t trained in the pathology of different conditions and may not know what’s best for you, according to Maura Iversen, DPT, MPH, who is dean of the College of Health Professions and professor of physical therapy, movement science, and public health at Sacred Heart University in Fairfield, Connecticut. Physical therapy can be expensive and may not be an option for everyone. If you have insurance, you can check with your provider to see if your plan covers it. 

If working with a physical therapist is an option for you, consider asking your doctor for recommendations of clinicians familiar with psoriatic arthritis, since even some physical therapists may not have the advanced training or experience to fully understand how it can affect your ability to work out. Otherwise, your physician may be able to recommend specific workouts, online resources, or even support groups in your area that can help.

2. Work out at times when you feel your best.

You might try to schedule your workouts first thing in the morning before life has a chance to interfere with your plans. But working out when you feel your best is usually more doable when you have psoriatic arthritis, according to Dr. Iversen. 

For many people, exercising is easier later in the afternoon because they’re too sore and stiff in the morning, Dr. Iversen says. You may be more motivated to exercise when your body feels its best, plus you can focus on your form when you’re not distracted by any (or as much) pain. Some individuals find that light movement in the morning, such as stretching, can help ease tightness. Dr. Iversen suggests doing some gentle movements before you even get out of bed, then doing a little more while you’re standing under warm water if you shower in the morning.

Walking is one way to exercise for psoriatic arthritis. TravelCouples/GettyImages

3. Prioritize proper form.

The experts we spoke with emphasized the importance of paying attention to proper form when doing any activity, whether it’s lifting, running, swimming, or anything else. Doing so will lower your risk of injury and help you get more out of each movement by properly engaging your muscles.

If you’re able to, working with a specialist like a physical therapist can help you learn proper techniques. However, that’s not always possible, and there are many videos and articles explaining how to do exercises correctly. You can browse through SELF’s fitness section for tutorials or the American Council on Exercise database. Beyond that, performing movements slowly and focusing on how you’re moving can help you with form.

4. Try low-impact cardio if you’re new to working out.

Michael Humphrey, CSCS and physical therapist at Northwestern Medicine in Illinois, says cardio is a great entry point for people who are just starting a fitness program or are jumping back into one after a hiatus. Beginning with a short, gentle, low-impact workout that you can consistently complete may help you build momentum.

Humphrey suggests choosing activities like walking, swimming, water aerobics, or the elliptical to elevate your heart rate without pounding your joints. Biking can be a great low-impact activity if you don’t have psoriatic-arthritis-related sacroiliac joint pain, according to Dr. Iversen. (The sacroiliac joints connect the lowest part of your spine with the two sides of your pelvis.) If you need something gentler, she recommends yoga or tai chi.

Dr. Bilsborrow says you may be able to run or do other high-impact workouts if you enjoy them and your symptoms are well-controlled. It’s safest to consult a physical therapist or rheumatologist first to discuss whether these may be harmful to your joints, Dr. Iversen says.

5. Consider adding resistance training.

You may worry about putting any sort of weight on joints that can already be painful. However, strength training is a good way to build muscle (which helps support your joints) and reduce your arthritis pain—as long as your form is good and you’re not exacerbating your symptoms, according to Dr. Bilsborrow. To develop a strength-training routine that won’t put too much strain on your joints, all the experts we spoke to suggested working closely with a professional if you are able to.

To avoid injuries, it’s really important to consider your particular situation when adding weights. According to Dr. Iversen, psoriatic arthritis often affects the DIP joints (the small finger joints, closest to your nail beds), which can make it really difficult to safely lift a heavy barbell. In that case, you may want to lift lighter dumbbells if you can tolerate them, or use weighted resistance cuffs that encircle your ankles and wrists, Dr. Iversen says. (The Fragraim Ankle Weights are one popular option on Amazon, $21.)

If you experience a lot of fatigue, Humphrey recommends being strategic with your workout by focusing on compound exercises that involve using multiple joints. These target multiple muscle groups at once, offering more bang for your buck.

Deadlifts, squats, and push-ups are all good examples of compound movements.

6. Stretch throughout the day (including before and after strength training).

Dr. Iversen encourages people to stretch and move throughout the day because that can help with joint stiffness, especially if your lifestyle involves sitting at a computer for hours every day. “Studies have shown that it’s very important to change position often, meaning every hour or so if you can, whether it’s to get up and get a glass of water or change your position at your desk,” Dr. Iversen says.

Even if you’re active throughout the day, it’s really important to stretch and warm up if you’re going to do strength training, Dr. Iversen says. She explains that when you have joint pain, you tend to flex your joints by default. The problem is, this creates tightness in your extensor muscles (such as triceps, quads, and back extensors), which can impact your form and increase your risk of injury. The specific stretches she recommends vary from person to person. “I tend to have people focus on what’s bothering them the most,” Dr. Iversen says.

For instance, you might start by doing 10 minutes of gentle cardio for your warm-up followed by a few yoga poses for tight hips if they feel stiff. After that, you can start your strength-training session.

7. Listen to your body and scale back when you need to.

“Paying careful attention to your body’s signs and symptoms is critical,” Dr. Iversen says. Over-exercising can result in tendon inflammation, or enthesitis, a condition associated with psoriatic arthritis. Using a perceived exertion scale to measure your effort can help you determine how difficult your workout feels, according to the Centres for Disease Control and Prevention. If you’re using a 0–10 scale to do this, working out at a 5 or below will help keep you from overtraining, according to Dr. Iversen.

Keeping a workout diary to track how you feel after your workouts can also be helpful, according to Dr. Bilsborrow. For example, if you notice that you experience any pain that’s worse on one side of your body or a sharp increase in joint pain or swelling during a particular workout, that’s a good sign you need to slow down or try something new, Humphrey says.

Dr. Iversen recommends avoiding high-impact or very strenuous workouts if you have a flare-up of symptoms. “You could still do some light aerobic exercise such as walking, aquatics, or walking in the pool, just to keep things going,” she says.

8. Use cold therapy post-workout if you can handle it.

After a workout, Dr. Bilsborrow suggests icing your joints affected by psoriatic arthritis for up to 20 minutes if you can tolerate it. (It helps to wrap your ice pack in a towel to protect your skin.) Cold therapy can help reduce pain and joint swelling, according to the Mayo Clinic. Although icing is generally considered safe, Dr. Iverson says some people find it makes their bodies feel stiff; if that’s the case for you, you may want to skip it.

Finding a routine that works for you can take some time, but regular workouts can help you manage your condition and move with less pain.

https://www.self.com/story/exercise-for-psoriatic-arthritis

Psoriatic Arthritis and the Flu

From verywellhealth.com

Psoriatic arthritis is a chronic autoimmune disease that causes inflammation in the joints. Psoriatic arthritis occurs alongside a skin condition called psoriasis which causes itchy red patches of skin. Roughly one-third of people with psoriasis develop psoriatic arthritis.

Psoriatic arthritis occurs due to a faulty immune response, in which the immune system wrongly attacks the joints and skin. The exact cause of psoriatic arthritis is unknown, but scientists believe that a combination of genetic and environmental factors are at play.

People with psoriatic arthritis are at increased risk during flu season. People with the condition often take certain medications that affect their immune system, which can make them more vulnerable to influenza. The flu can also cause flares of psoriatic arthritis symptoms. 

Learn more about psoriatic arthritis and the flu.

Medication and Immune System Effects

People with psoriatic arthritis often take a variety of medications to manage their condition, and some of these medications can make them more vulnerable to infections, including influenza.

Biologics are a type of drug that is sometimes prescribed to treat psoriatic arthritis. These drugs lower inflammation in the body to treat psoriatic arthritis symptoms, but they also suppress the immune system.

Using biologics weakens the body’s immune system and makes it harder for the body to fight off germs. During flu season, people taking biologics are at an increased risk of being infected with the influenza virus. If someone with psoriatic arthritis gets influenza, they might have to stop taking their medications until they get better. 

Getting sick with the flu or another illness can also trigger a flare-up of psoriatic arthritis symptoms. 

Flu Complications

People with psoriatic arthritis are also at a greater risk of flu-related complications if they get the virus because they have a suppressed immune system.

Complications of the flu that people with psoriatic arthritis might be more likely to develop include:

• Bronchitis
• Ear infections
• Sinus infections

People with psoriasis and psoriatic arthritis are also at a higher risk of getting other respiratory infections and flu-related pneumonia.

How to Avoid the Flu

There are several ways that people with psoriatic arthritis can protect themselves and reduce their chances of getting sick during flu season.

Wash Your Hands Frequently

Frequent, proper handwashing can remove germs and help keep them from spreading. The Centres for Disease Control and Prevention (CDC) advises washing your hands with soap and water. 

The steps of proper handwashing are:

1. Wet your hands with clean running water from the tap.
2. Apply soap.
3. Lather the soap by rubbing your hands together.
4. Make sure to get the soap on the backs of your hands, between fingers, and under your nails.
5. Continue lathering for at least 20 seconds.
6. Rinse your hands with water.
7. Dry your hands completely.

If you are in a situation where you cannot wash your hands with soap and water, using an alcohol-based hand sanitizer is OK.

Get a Flu Shot

Getting a flu shot every year will help protect you against influenza, as well as reduce the risk of flu-related complications if you do get sick.

People with psoriatic arthritis should follow the CDC guidelines and get a flu shot by early October every year. People who live in the same house as someone with psoriatic arthritis or another high-risk condition should also be vaccinated.

People taking biologics and immunosuppressive medications can still get the flu shot, but it is recommended that they do not get a live flu vaccine in the form of a nasal spray (which should not be given to people who are immunocompromised).

The flu vaccine will not give you the flu. Research has also found that flu shots do not appear to directly trigger flares. If you are worried about having a flare-up after getting a vaccine, talk to your doctor.

Other Flu-Prevention Tips

Other steps you can take to avoid becoming infected with influenza include:

• Avoid close contact with others (especially people who are sick).
• Do not touch your nose, eyes, and mouth.
• Disinfect surfaces in your home, at work, and at school.
• Get regular exercise.
• Get enough sleep.
• Manage your stress levels.
• Stay hydrated.
• Eat a nutritious diet

If You Get the Flu

People with psoriatic arthritis who get influenza should speak with their doctor about the best way to manage their medications while they are sick.

In most cases, people with psoriatic arthritis who have the flu will need to stop taking their biologics while they are recovering from influenza. 

A doctor can prescribe antiviral medications to treat flu illness. It is important that these drugs be started as soon as possible when a person that is immunocompromised—including someone with psoriatic arthritis—gets the flu.

When to See a Healthcare Provider

People with psoriatic arthritis should contact their doctor if they have flu-like symptoms. Their doctor will let them know if they should stop taking their regular medications, and they may prescribe antivirals to help them get better. 

Summary

People living with psoriatic arthritis are at increased risk of getting influenza. They are also at risk for complications related to the flu, including pneumonia. Taking steps like regular handwashing and getting the flu shot will lower the risk of infection and serious flu illness. 

A Word From Verywell

If you have psoriatic arthritis, you are at a higher risk of getting the flu and having flu-related complications. There are steps that you can take to protect yourself, such as getting a flu shot.

If you do have flu-like symptoms, it’s important to tell your doctor right away. If you do have the flu, you might need to stop taking your medications until you get better. Your doctor might be able to prescribe antivirals to help you get better sooner.

https://www.verywellhealth.com/psoriatic-arthritis-and-flu-what-you-need-to-know-5196164

What You Need to Know About Having Arthritis on One Side of the Body

From verywellhealth.com

Arthritis refers to a group of diseases that cause inflammation and swelling of one or more joints. There are more than 100 types of arthritis, with the most common types being osteoarthritis, rheumatoid arthritis, and psoriatic arthritis.

Symptoms vary depending on the type of arthritis, but usually include joint pain and stiffness. Joint pain can either occur symmetrically, affecting both sides of the body, or asymmetrically, causing unilateral symptoms, which only affect one side of your body.

Types of Arthritis That Cause Unilateral Joint Pain

Osteoarthritis

Osteoarthritis (OA), also called degenerative joint disease, affects more than 30 million Americans. While many people associate osteoarthritis with the wear and tear that the body’s joints endure over time with aging, more than half of Americans affected by osteoarthritis are under the age of 65.

Osteoarthritis can affect any joint, although it is most common in the back and spine, hips, knees, neck and shoulders, and fingers and hands. Anyone who overuses their joints, including athletes, military personnel, and those with physically demanding jobs, may be at an increased risk of developing arthritis.

Cartilage is a form of connective tissue that covers the end of each bone in the body and provides cushioning and shock absorption to the joints, allowing them to move smoothly. In OA, cartilage breaks down over time, causing pain and increased difficulty moving the joints.

Bones may begin to break down with worsening arthritis, resulting in painful bone growth called bone spurs, or osteophytes, which can cause further damage to the cartilage.

In severe osteoarthritis, the cartilage wears down so much that bone rubs directly against bone with movement of the joints, causing increased pain, inflammation, and joint damage.

Osteoarthritis often begins unilaterally, affecting one side of the body, but it can progress to both sides of the body over time. The side that you develop OA on may either be your weaker side or the side that you use more often with movements and daily activities, especially your dominant hand.

Psoriatic Arthritis

About 30% of patients with psoriasis, an inflammatory condition of the skin, develop an autoimmune, inflammatory form of arthritis called psoriatic arthritis where the body produces autoantibodies that attack its own joints. Psoriatic arthritis can affect the joints of the entire body and result in permanent joint damage if left untreated.

Psoriasis affects 74 million adults in the United States, and 30% of patients diagnosed with psoriasis will develop psoriatic arthritis. Of these cases, asymmetric psoriatic arthritis, also called asymmetric oligoarthritis, makes up about 60% of all cases of psoriatic arthritis.

Symptoms of psoriatic arthritis can be either symmetric or asymmetric, and joint pain most commonly occurs in the hands, feet, and low back. Sometimes symptoms start on one side and then progress to affect both sides of your body.

Medications may help reduce symptoms of psoriatic arthritis like joint pain and inflammation and prevent disease progression. Treatment is aimed at promoting remission and preventing joint damage.

                                                          SasinParaksa / Getty Images

Diagnosis

The prognosis for those diagnosed with arthritis becomes worse the longer your condition goes untreated, so it is important to seek medical attention if you think you have symptoms of arthritis.

Inflammatory arthritis like psoriatic arthritis, ankylosing spondylitis, and rheumatoid arthritis are treated by a rheumatologist, while osteoarthritis treatment can be from multiple providers in areas such as primary care, rheumatology, orthopaedic surgery, and physiatry.

A physical exam combined with a review of your medical history, symptoms, and X-ray imaging are used to confirm a diagnosis of arthritis and identify the affected joints. MRIs can give your doctor a clearer look at your cartilage and other parts of the affected joints.

Your doctor may perform joint aspiration, where a needle is inserted into the joint to extract synovial fluid, a thick liquid between your joints. The results of this test can help rule out other conditions or forms of arthritis.

Your doctor may check for symptoms of psoriasis to determine if you have psoriatic arthritis. Signs of psoriasis often appear on the skin first before joint symptoms begin and include: 

• Scaly, itching skin patches
• Nail changes
• Pain and swelling within joints
• Tendon and ligament pain
• Chronic fatigue
• Inflammation of the eyes called uveitis
• Digestive symptoms, such as abdominal pain, bloating, constipation, and diarrhoea
• Organ damage from inflammation of the heart, lungs, or kidneys

Blood tests that examine your erythrocyte sedimentation rate and levels of C-reactive protein can help confirm a diagnosis of psoriatic arthritis since these markers are typically elevated with this condition.

You may also have bloodwork that examines your rheumatoid factor to rule out a diagnosis of rheumatoid arthritis, an autoimmune type of arthritis that usually occurs symmetrically on both sides of the body.

You may be referred to a rheumatologist, a specialized internal medicine doctor who treats inflammatory conditions of the joints, if you are suspected to have psoriatic arthritis or rheumatoid arthritis.

Treatment

Symptoms of arthritis can worsen over time if left untreated. If you have been experiencing chronic joint pain, stiffness, decreased mobility, or swelling for more than three months, it is important that you see a doctor to address your symptoms.

Management of your condition is crucial to preventing disease progression and worsening of symptoms, which can significantly impact your ability to move your joints and complete your day-to-day activities.

Treatment options for managing your arthritis symptoms include:

• Rest: Resting your arthritic joints by limiting activity and avoiding repetitive movements can help ease pain and inflammation. 
• Immobilization: Wearing a hand splint to immobilize the finger joints can reduce pain and inflammation with arthritis of the hands and fingers, especially if it is aggravated by activity.
• Heat: Heat therapy is best used for chronic arthritis to help loosen and relax tight muscles and stiff joints.
• Ice: Applying ice to arthritic joints can help relieve pain and inflammation, especially if swelling is present.
• Medication: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help with symptoms and pain.
• Topical pain relievers: Over-the-counter creams and ointments, especially those containing capsaicin, an extract derived from chili peppers, can be applied topically to joints to help relieve pain by decreasing the intensity of pain signals sent along nerve pathways.6
• Paraffin: Warm paraffin wax application to the hands and fingers can help decrease arthritis pain and joint stiffness.
• Exercises: Stretches and exercises can help ease pain, improve range of motion and joint mobility, and increase strength of the muscles surrounding your joints.
• Prescription medication: Higher-strength medications may be prescribed to reduce pain and inflammation, including disease-modifying antirheumatic drugs (DMARDs) and biologics like TNF-inhibitors if you have psoriatic arthritis. 
• Rehabilitation: Your doctor may refer you to physical or occupational therapy to improve the mobility of your joints, increase the strength and flexibility of surrounding muscles, and apply therapeutic modalities to alleviate pain, stiffness, and swelling.
• Corticosteroid injections: Your doctor may suggest administering a corticosteroid injection into your arthritic joints to help decrease inflammation and relieve pain if other methods are not effective at improving symptoms.
• Surgery: Surgery is used as a last resort to manage severe arthritis when other methods have failed to relieve symptoms. Arthroscopies, commonly called “scopes,” may be used to debride joints and remove torn pieces of cartilage. When severe arthritis has significantly worn away cartilage, especially in the hips, knees, or shoulders, joint replacement surgery may be considered to reduce pain and improve your overall level of physical functioning.

Management

Aside from treatment options that can be performed at home or under the care of a healthcare provider, maintaining healthy lifestyle habits can help manage your arthritis symptoms by decreasing inflammation throughout your body and promoting a healthy environment for healing.

Tips for a healthy lifestyle include: 

• Prioritizing getting enough sleep at night—at least seven to eight hours—to promote healing
• Eating a healthy diet and managing a healthy weight
• Staying adequately hydrated
• Maintaining a positive attitude and learning how to cope with and manage stress
• Following an exercise program as prescribed by a physical therapist
• Exercising and staying active

Summary

Some forms of arthritis like osteoarthritis and psoriatic arthritis may affect only one side of your body. For osteoarthritis, you may develop symptoms on the side of your body that you use more often, like your dominant hand, because the condition is caused by repetitive overuse of your joints. For psoriatic arthritis, symptoms can affect one or both sides of your body.

A Word From Verywell

Strengthening the muscles surrounding arthritic joints is essential for decreasing strain on your joints and preventing arthritis from progressing.

It is important that you seek medical attention if you have been experiencing joint pain, stiffness, or swelling for more than three months.

If you have been experiencing other symptoms such as fatigue, tendon pain, and changes to your nails, skin, or eyes, you may be referred to a rheumatologist.

Frequently Asked Questions

Why do I have arthritis on one side of my body?

You may have arthritis on one side of your body if the muscles on that side are weaker and cannot adequately support your joints, leading to increased joint pressure and cartilage breakdown. Alternatively, arthritis may also develop on one side of your body if you repetitively use one side more than the other, especially your dominant hand, since repetitive activities put chronic stress on joints that can wear down cartilage over time.

What are the first signs of psoriatic arthritis?

Most people notice symptoms of psoriasis, particularly dry, scaly skin plaques, before symptoms of psoriatic arthritis. If you have already been diagnosed with psoriasis, the first signs of psoriatic arthritis typically include joint pain, warmth, and swelling, especially in the hands and feet; nail changes such as pitting and separation; and accompanying fatigue.

What’s the difference between psoriatic arthritis and rheumatoid arthritis?

While both conditions are autoimmune, inflammatory types of arthritis, psoriatic arthritis develops only in patients who also have psoriasis, an inflammatory condition of the skin that causes dry, scaly plaques. Psoriatic arthritis also often affects your nails, eyes, and tendons. Unlike psoriatic arthritis, rheumatoid arthritis often causes elevated levels of rheumatoid factor in the blood, and symptoms usually present on both sides of the body.

https://www.verywellhealth.com/arthritis-on-one-side-of-body-5192279

Psoriatic Arthritis of the Elbow

From healthline.com

Inflammatory arthritis happens when the immune system doesn’t function properly. This leads to inflammation in joint tissue and symptoms like pain, swelling, and stiffness.

Psoriatic arthritis is a type of inflammatory arthritis. It can impact any joint in the body, including the elbow.

Read on to learn more about psoriatic arthritis of the elbow, including symptoms to look out for, and how it’s diagnosed and treated.

What is psoriatic arthritis?

Psoriatic arthritis (PsA) is a type of inflammatory arthritis that impacts people with the skin condition psoriasis. It’s estimated that 20 to 30 percent of those with psoriasis develop PsA.

PsA affects all sexes equally. It typically develops after the age of 30, although it can sometimes happen in younger individuals as well.

It’s possible that PsA can affect any joint in the body, including the elbow. Many times, multiple joints are impacted.

People with PsA can also experience occasional flare-ups. During a PsA flare-up, the symptoms of PsA temporarily get worse.

How does psoriatic arthritis affect the elbow?

If you have PsA in your elbow, you may notice that one or both of your elbow joints:

• are tender or painful
• appear swollen
• are stiff, particularly in the morning
• have a decreased range of motion
• feel warm to the touch

Some people with PsA also experience something called enthesitis. This is inflammation in the area where tendons and ligaments connect to bone. Enthesitis can cause pain and may happen in the heel of the elbow.

In addition to having symptoms in the area of your elbow, you may also experience additional symptoms in other areas of your body. These can include:

• skin symptoms of psoriasis, which can affect your elbows, but may also be present in other areas
• nail changes, such as pitting, cracking, or separation from the nail bed (onycholysis)
• painful swelling in the fingers or toes (dactylitis)
• fatigue

What causes psoriatic arthritis of the elbow?

In PsA, the immune system mistakenly attacks the tissues of the joints. This leads to PsA symptoms like pain and swelling.

It’s not known what exactly causes the immune system to behave in this way. Researchers believe that a combination of genetic and environmental factors can contribute to the development of PsA.

PsA can run in families. In fact, about 33 to 50 percent of people with PsA have at least one close family member that has psoriasis or PsA. Additionally, researchers have been able to identify genes associated with PsA.

Several environmental factors may also lead to the development of PsA in people that are genetically predisposed to the condition. These may include injuries, certain infections, and physical or psychological stress.

In addition to genetic and environmental factors, other things also increase an individual’s risk of developing PsA. These include:

• having psoriasis
• having psoriasis that:
  • is severe
  • impacts the scalp or buttocks
  • occurs along with nails changes like pitting or cracking
  • happens with eye inflammation (uveitis)
• having obesity 
• smoking

How is psoriatic arthritis of the elbow diagnosed?

When diagnosing PsA of the elbow, a doctor will need to rule out other conditions that can cause similar pain, swelling, or stiffness. These include:

• injuries like dislocations or fractures
• overuse injuries, such as tennis elbow or golfer’s elbow
• tendinitis
• bursitis
• osteoarthritis
• other types of inflammatory arthritis, such as:
  • rheumatoid arthritis
  • juvenile idiopathic arthritis
  • arthritis due to lupus

Medical history

Your doctor will typically begin their diagnosis of your condition with a review of your medical history. They’ll ask questions about things like:

• your symptoms, their severity, and when they started
• any underlying health conditions that you may have
• if you have a family history of any health conditions
• which medications or supplements you’re taking

Physical exam

After completing a review of your medical history, your doctor will examine your elbow for signs of injury or symptoms like swelling, redness, or decreased range of motion.

If they suspect PsA, they’ll also check for other PsA symptoms like itchy skin patches, nail changes, or dactylitis (a painful swelling of the fingers).

Diagnostic tests

Your doctor may also run some tests to help with their diagnosis, including:

• blood tests that check for signs of inflammation, such as a C-reactive protein test and erythrocyte sedimentation rate test
• blood tests for rheumatoid factor (RF) or anti-cyclic citrullinated peptide (anti-CCP) antibodies, which are associated with rheumatoid arthritis and are absent in most people with PsA
• imaging tests, such as X-rays, ultrasound, or MRI, to check your elbow joint for signs of inflammation or damage

How is psoriatic arthritis of the elbow treated?

Prompt treatment of PsA is important to prevent it from progressing and causing additional joint damage. Other goals of PsA treatment include:

• lowering inflammation levels
• easing pain and tenderness
• boosting range of motion
• improving quality of life

There are several potential treatment options for PsA, from medications and physical therapy to surgery and lifestyle changes.

Medications

A variety of medications can be used to treat PsA, including:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs can be taken by mouth and may help with PsA that’s mild. Some examples of NSAIDs include ibuprofen (Advil, Motrin) and naproxen (Aleve). Topical forms are also available.
• Corticosteroids. Corticosteroids can reduce inflammation and can be injected into the area of your elbow. However, due to potential side effects, they’re typically only used sparingly.
• Disease-modifying antirheumatic drugs (DMARDs). Traditional DMARDs work to suppress the activity of the immune system. They’re often taken by mouth. Examples are methotrexate (Trexall).
• Biologics. Biologics target certain molecules in the inflammatory process. As such, they’re more specific than DMARDs. Biologics are given by injection. Examples of biologics for PsA are adalimumab (Humira) and secukinumab (Cosentyx).
• Targeted DMARDs. Similar to biologics, targeted DMARDs focus on specific parts of the inflammatory process. They’re taken by mouth. Apremilast (Otezla) is an example of a targeted DMARD for PsA.

Physical therapy

Physical therapy can help with improving strength, flexibility, and range of motion in your elbow and other affected joints. It may also help to reduce pain.

Surgery

Surgery isn’t typically used for PsA. However, if joint damage has become severe, your doctor may recommend a surgical procedure to repair it.

Lifestyle changes

In addition to the treatments discussed above, several lifestyle changes may also help with PsA:

• Harnessing hot and cold. A warm compress may improve circulation in your elbow and help with stiffness. A cool compress has the opposite effect on circulation and can work to reduce swelling.
• Exercising. Getting regular exercise can help to improve joint health as well as things like flexibility and range of motion. Be sure to ask your doctor about exercises that are appropriate for you.
• Focusing on anti-inflammatory foods. Try to implement more anti-inflammatory foods into your diet. A few examples include:
  • berries
  • avocados
  • broccoli
  • fatty fish
  • spices like turmeric or ginger
• Avoiding inflammatory foods. Avoid consuming foods that can cause inflammation. These can include foods that are processed, have trans fats, or contain refined carbohydrates.
• Cutting down on alcohol. Consuming alcohol heavily or frequently may impact the way your PsA medications work, so try to drink in moderation.
• Reducing stress. Stress can cause PsA to flare up, making your symptoms worse. Because of this, try to find ways to lower your stress levels. Some examples of things to try out are:
  • yoga
  • meditation
  • breathing exercises
  • taking a walk outside
  • listening to soothing music
• Protecting your skin. Skin damage or injury can cause PsA flare-ups as well. Care for your skin by:
  • regularly moisturising
  • applying sunscreen when you’re going outside
  • promptly treating any cuts, scrapes, or bug bites
• Not smoking. Smoking is a risk factor for many autoimmune conditions. It may also lead to a PsA flare-up.

Takeaway

PsA can impact any joint in your body, including your elbows. If you have PsA in your elbow, you may notice that your elbow is swollen, tender, or warm. You may also find that it feels stiff or has a reduced range of motion.

PsA of the elbow may resemble several other conditions that can impact the elbow, such as rheumatoid arthritis, osteoarthritis, or overuse injuries. Your doctor will work to rule these out when making a diagnosis.

There are many treatment options available for PsA. It’s important to start treatment as soon as possible to prevent progression of the condition, so be sure to see your doctor if you’re concerned that you may have PsA.

https://www.healthline.com/health/psoriatic-arthritis/psoriatic-arthritis-elbow

Several options for relief from arthritis in ankles

From dailyherald.com

By Dr. Eve Glazier and Dr. Elizabeth Ko

Q: My 75-year-old husband has had arthritis in his ankles for many years. It's gotten to the point that the pain makes it unbearable for him to be on his feet for more than a few hours. What about surgery? Can you offer some insight as to what can be done?

A: Ankle arthritis is a painful and sometimes debilitating condition. It's marked by the steady deterioration of the connective, protective and supportive tissues in one or more of the three bones that meet to form the ankle joint. Symptoms include tenderness or pain within the joint, redness, a sensation of heat, swelling and reduced range of motion.

Treatment typically begins with nonsurgical approaches, such as changes in activities, losing weight in order to reduce stress on the ankle joints, physical therapy and the use of a variety of medications to address pain and inflammation. If none of these help, then surgery can become an option.

For some people, a minimally invasive procedure known as arthroscopic debridement can be helpful. A tiny camera is introduced via a small incision into the joint, and surgical tools are used to clear the ankle joint of the loose cartilage and other debris the camera has made visible. It's often done in an outpatient setting, and the individual returns home that same day.

A more intensive surgery, known as arthrodesis, involves the fusion of the bones of the ankle joint. This is achieved by first removing the damaged cartilage and then fixing the joint into permanent position with surgical plates, rods, pins or screws. Over time, the bones of the joint fuse together. This affects range of motion and the individual's gait, but offers relief from pain.

A third option is a total ankle joint replacement. Known as arthroplasty, it's a major surgical procedure. The surgeon removes the damaged bone and cartilage of the ankle joint and replaces it with an artificial joint. This eliminates the source of friction and pain while preserving range of motion.

Chronic ankle pain caused by arthritis can be treated in surgical and nonsurgical ways. Stock Photo

Not that long ago, total ankle joint replacement was considered an experimental surgery. However, advances in the design and materials used in artificial ankle joints, as well as in surgical instruments and techniques, have moved the procedure into the mainstream. It's still not as common as hip or knee replacement, and patients must meet a somewhat narrow set of criteria to be eligible. These include being in good health, not being overweight, and with ankle joints free of deformity or misalignment.

Although patients return home soon after surgery, the recovery period is significant. Patients are in a splint or cast for the first month, and they must not put weight on the foot. Complete recovery, which includes extensive physical therapy, takes at least a year. As with all surgeries, short- and long-term complications can occur. The risks and benefits of the surgery vary depending on the age and general health of the patient. It's important to find an experienced surgeon you are comfortable working with, and to be prepared to commit to what is a long and gradual recovery process.

https://www.dailyherald.com/entlife/20210815/several-options-for-relief-from-arthritis-in-ankles

Finger psoriatic arthritis: Symptoms and treatment

From medicalnewstoday.com

Psoriatic arthritis (PsA) is a chronic condition that occurs in people with psoriasis. Psoriasis is an inflammatory disease that affects the skin and nails and can also affect the joints. Finger PsA may cause pain and swelling in one or more finger joints.

In most cases, psoriasis occurs in early adulthood, with one-third of people going on to develop PsA after the age of 30. A milder form of psoriasis can also develop later in life, but typically, this form does not cause arthritis. 

Once PsA develops, it can start to damage the bones after a few months, so it is important to seek medical advice and treatment for the condition.

In this article, we will look at PsA in the fingers, including the symptoms, treatment, and management.

How does PsA affect the fingers?

It is common for PsA to affect smaller joints, such as those in the fingers. Often, the condition affects the joint closest to the nails.

People who develop PsA in the fingers may experience:

• pain and swelling
• difficulty bending the finger
• reduced range of motion
• misshapen finger joints
• white or silvery patches on the skin that may itch
• pitted or indented nails

PsA typically affects joints asymmetrically, which means it may develop in one hand and not the other. The symptoms can range from mild to severe and may progress, decrease, or remain the same for long periods of time.

The condition often affects the area of the hands closest to the nails, causing swelling that resembles gout. 

In the later stages of PsA, the spaces between joints may narrow or completely disappear due to a loss of cartilage.

Can PsA affect just one finger?

Yes, people can have PsA symptoms in just one finger, or just in one hand, according to the Arthritis Foundation. 

PsA affects everyone differently. Doctors are not sure what causes it or why some people with psoriasis develop joint problems where others do not.

However, it is likely that a combination of genetic and environmental factors plays a role.

Can PsA cause trigger finger?

Trigger finger, also known as tenosynovitis, occurs when a pulley in the hand becomes inflamed. Each finger has a sheath, or “tunnel,” of tissue that acts like a pulley, holding tendons in place as they move. If this part of the finger thickens, the finger will become stuck in a bent position.

Tenosynovitis can occur in many places around the body, but it most frequently occurs in the hands, wrists, and feet.

A 2018 study suggests that in people with PsA, these pulleys are thickened, which could result in PsA-related trigger finger.

However, trigger finger does have other causes, including infections. Sometimes, infections that cause the condition are serious and spread quickly.

That is why it is important to seek guidance from a doctor if a person develops trigger finger, especially if redness and swelling are present.

Diagnosis and treatment of finger PsA

When diagnosing PsA in the fingers, doctors will begin by taking a medical history.

If an individual already has psoriasis or if their family has a history of the condition, this may help determine the cause of finger pain and swelling.

Next, doctors may examine the hand. They will look for:

• inflammation and swelling in the joints
• inflammation in places where tendons attach to bones
• difficulty moving the fingers, including trigger finger
• nail changes
• skin changes
• skeletal disorders in other parts of the body

Doctors may also order imaging tests, such as radiography, ultrasonography, and MRI scans.

Treatment for PsA may entail:

• corticosteroid medication or injections
• nonsteroidal anti-inflammatory drugs (NSAIDS)
• disease-modifying anti-rheumatic drugs
• anti-tumour necrosis factor agents

Doctors choose treatments based on the severity of a person’s symptoms. Some people may only need NSAIDs or to take medications during flare-ups, while those with more advanced PsA may need more intensive treatment.

In some cases, surgery may be necessary to address damage.

Not all of these drugs are suitable for everyone. That is why doctors will take into account any other medical conditions a person has, any medications they are taking, their individual response to different treatments, and risk of side effects.

Tips for living with PsA in the fingers

Living with PsA can be challenging, particularly if it inhibits movement in the hands.

People can look after the health of their joints and manage the symptoms of PsA by trying:

• hot and cold therapies, which can ease pain and swelling
• stretching and flexibility exercises to improve the health of the joint
• an anti-inflammatory diet that contains plenty of fruits and vegetables
• avoiding things that worsen inflammation, such as tobacco, alcohol, saturated fat, and sugar
• reducing sources of stress, which can aggravate PsA flare-ups
• learning relaxation techniques to relax the muscles, slow breathing down, and boost mental well-being

It is important to look after the health of other joints in the body, even if they have not become affected by pain and swelling. Regular low-impact exercise, such as walking or swimming, can improve health without placing strain on the joints.

It is also advisable to protect the skin if a person has psoriasis on the affected joint. People can do this by:

• taking warm, but not hot, baths or showers
• using colloidal oatmeal, Epsom salts, or Dead Sea salts in the bath
• applying moisturizers after getting the skin wet, particularly ones that contain aloe vera, zinc, or jojoba
• wearing rubber gloves to protect the hands while washing the dishes or cleaning
• using unscented products to avoid skin reactions

If a person struggles to move their finger much or if PsA affects multiple joints, they may benefit from consulting an occupational therapist. These are medical professionals who can help a person adapt their home and learn how to use assistive devices so that everyday tasks become easier.

Other potential causes

There are other conditions that can cause symptoms similar to those of PsA. If a person does not have psoriasis, the cause of finger swelling may be something else.

Some examples of conditions that could result in finger joint inflammation include:

• osteoarthritis
• gout
• rheumatoid arthritis
• reactive arthritis, which occurs as a response to infection in another part of the body
• ankylosing spondylitis, which causes inflammation and fusion of bones in the spine
• trigger finger

When to contact a doctor

If a person suspects they have psoriasis or PsA, they should contact a doctor for diagnosis and treatment as soon as they can.

Without treatment, the symptoms may continue or get worse over time. PsA can also cause damage to bones, which is irreversible.

Additionally, people should seek guidance from a doctor if they have any other unexplained symptoms, such as:

• pain or swelling elsewhere in the body
• morning joint stiffness
• fatigue
• fever or hot flashes
• general malaise, or feeling of being unwell

These could be signs of other conditions that resemble PsA.

Summary

Finger PsA causes pain and swelling in the finger joints. It can affect just one finger or one hand. While PsA occurs in people with psoriasis, doctors do not know the exact cause of the condition.

Doctors can diagnose PsA with the help of physical examination and diagnostic and medical imaging tests.

Treatment can depend on how severe the symptoms are but may include a combination of medications and diet or lifestyle changes.

https://www.medicalnewstoday.com/articles/finger-psoriatic-arthritis

Arthritis diet: The 'ultimate' diet swaps and best foods to avoid arthritis symptoms

From express.co.uk

ARTHRITIS is a debilitating condition people can develop at almost any age, most predominantly in later life. One way to help alleviate the symptoms is by making diet alterations, according to the Arthritis Foundation.

Arthritis proves debilitating for sufferers and can drastically reduce people's quality of life as they approach their twilight years. Most efforts to relieve the pain include medicines or surgical interventions. But people often benefit from a few lifestyle changes as well, such as a new diet.

Arthritis symptoms manifest at the joints, where inflammation makes movement painful.

They include:

• Tender, stiff and painful joints
• Inflammation inside and surrounding the joints
• Impeded movement at the joints
• Warm and red skin on the surface of each affected joint
• Muscle wastage and weakness

Making slight changes to people's diet can help manage the disease's activity, and the Arthritis Foundation recommends sufferers try the "Mediterranean diet".

The long-touted diet includes meals rich in fruit, vegetables, beans and fish, with as little processed content as possible.

Over time, research suggests adopting it will help lower people's blood pressure, protect against chronic illness, curb inflammation, aid weight loss and benefit the joints and heart.

The foundation has suggested six types of food people with arthritis should eat more.

The 'ultimate' diet swaps and best foods to avoid arthritis symptoms (Image: GETTY)

Fish and olive oil

Fish, specifically salmon, tuna, sardines, and cold water varieties, serves as one of the best sources of omega-3 fatty acids.

These help to reduce inflammatory proteins, according to research that found people with fish-rich diets have fewer in their bodies. And olive oil provides a source of healthy fat and oleocanthal.

The latter acts similarly to non-steroidal anti-inflammatory drugs (NSAIDs) by dampening the body's inflammation capabilities and stemming pain sensitivity.

Fruits and vegetables

Both fruit and vegetables contain generous helpings of antioxidants. These, especially anthocyanins found in cherries, raspberries, strawberries, blueberries and others of the same colour, help fight potentially damaging free radicals.

Vitamin C rich fruits such as oranges can reduce inflammatory markers, while vitamin K rich vegetables such as broccoli and spinach reduce inflammatory markers.

Beans

Beans contain fibre and phytonutrients known to help lower inflammation indicators. These indicators, known as CRP, indicate infections and rheumatoid arthritis when at a high enough level.

Readily available varieties such as red, kidney and pinto beans contain antioxidant and anti-inflammatory compounds which reduce CRP.

Nightshade vegetables

Although they share a name with deadly nightshade, nightshade vegetables will help improve people's lives. These include red peppers, eggplant, tomatoes and potatoes, each nutrient-rich.

They can help people lose weight, a well-known aggravator of arthritis, and research has suggested these vegetables could also inhibit pain.

Nuts and seeds

Nuts and seeds are fibre-rich foods that form a vital cornerstone of an anti-inflammatory diet.

Studies centred on people with a nut and seed rich diet found they had a 51 percent lower risk of dying from inflammatory diseases.

People who lack vitamin B6, which nuts have in droves, often have higher inflammatory markers.

https://www.express.co.uk/life-style/health/1476743/Arthritis-diet-ultimate-anti-inflammatory-diet-swap-arthritis-symptoms-evg

Is Rheumatoid Arthritis Genetic—And Does Family History Boost Your Risk?

From health.com

Genes can play a role, but they don't necessarily determine your individual likelihood of developing this autoimmune disease

A large number of health conditions list "genetics" or "family history" as risk factors—everything from obesity and asthma to cancer and diabetes make it clear that if the condition runs in your family, you are at a higher risk for developing it yourself.

The same can be said for rheumatoid arthritis (RA), an autoimmune disease that causes your immune system to attack the healthy tissue of your joints. But while RA does include genetics as a risk factor, genetics aren't the only thing that can trigger the disease and, in some cases, genetics have very little to do with whether or not a person develops RA.

"There are there some genes transmitted from one family member to another that might predispose you to RA," says Jonathan Greer, MD, rheumatologist with Arthritis & Rheumatology Associates of Palm Beach and medical advisor to CreakyJoints. "But having the genes only makes it more likely [you'll develop RA], not guaranteed."

So is RA genetic or not? What about hereditary? And what are your chances of developing RA if someone else in your family has it? Here's what you need to know about the genetic component of RA, from what that actually means to how it affects your overall risk.

First Off: Do Genetic and Hereditary Mean the Same Thing?

The words "genetic" and "hereditary" are usually used interchangeably to describe health conditions passed on from one family member to the next (like a parent to their child). But technically, there is a difference between the terms.

• A genetic condition is one that occurs because of a gene mutation. Sometimes these mutations are passed on through family DNA, but other times, they happen totally randomly or because of an external or environmental factor.
• A hereditary condition, on the other hand, is always handed down from parent to child through genetic makeup. Hereditary conditions don't occur "naturally," i.e., as the result of external or environmental factors.

In other words: a hereditary condition is always genetic, but not all genetic conditions are hereditary.

Is Rheumatoid Arthritis Genetic or Hereditary?

OK, so here's where things get a little tricky: the answer is both...and also neither!

RA can be caused by an inherited gene or a random gene mutation, so to say RA is strictly hereditary isn't accurate. While the genes that cause RA can be passed down through family, many cases of RA happen independently of any family history. Likewise, most people with RA have some genetic markers for the disease, but that doesn't mean everyone with the genes will ultimately end up with RA.

According to Robert Koval, MD, an Austin-based rheumatologist at Texas Orthopaedics, the risk of RA in the general population is between 1% and 2%; with a family history, your risk may double or even triple, but that still only leaves you with less than a 10% chance at most.

"The odds are in your favour, but you should be aware of symptoms if you have a family history," Dr. Koval tells Health.

He notes that the incidence of RA in identical twins, who share 50% of their genes, is higher than it is in non-identical twins, but still quite low: if one identical twin has RA, there's still less than a 15% chance the other twin will have it as well.

Overall, about 60% of RA cases can be traced back to inheritability versus other factors, according to the UK's National Rheumatoid Arthritis Society. Still, that doesn't mean you, personally, have a 60% chance of developing RA with a family history; the individual risk is much, much lower.

What Genes Can Cause RA?

There are over 100 possible genes that could trigger the heightened immune response that causes RA, some of which may be inherited while others may occur naturally, as the result of random gene mutations.

However, researchers have identified four genetic markers they know to be linked to RA:

• HLA-DR4, the most prominent risk factor for RA, which makes you five times more likely to develop RA than someone without it.
• STAT4, a gene responsible for immune system regulation.
• TRAF1 and C5, genes known to cause chronic inflammation.
• PTPN22, which may trigger RA and affect its progression.

Dr. Greer says that because there is such a large number of genes that can cause RA, just having one gene doesn't mean you'll develop the disease; there are lots of changes that can take place in the body, from your gut to your mouth, that can trigger the onset of RA if you are already predisposed genetically.

If RA Isn't Always Genetic, Then What Causes It?

People who develop RA do seem to have some genes in common, indicating that genetics predisposes you to developing the disease. But since the individual chances of having RA with and without family history are still fairly low, what else causes RA to develop?

The answer is external factors, which play a huge part in turning the genetic possibility of RA into a reality. They include the following:

Gender

RA is far more common in women than it is in men, so simply being female (with the right combination of genes) can increase your chances of developing RA. Per Brigham and Women's Hospital in Boston, about 75% of RA patients are female.

Age

RA can develop at any age, says Dr. Koval, though there are still observable patterns. "For females, in your 50s—around the time of menopause—is common, and so is your 20s [because of hormonal changes]," he explains. "Childbirth, and the major hormone shift it causes in the first six months, is a common time for RA to present." Beyond that, Dr. Greer notes that the reduced efficiency of our immune system as we age leaves people in their 70s and 80s especially vulnerable to developing RA as well.

Lifestyle

This is a broad category, including everything from diet to illness to toxin exposure. The single biggest lifestyle risk factor, however, is smoking, especially if you are a heavy smoker or have smoked for more than 20 years, according to the Mayo Clinic. (Smoking can also increase your RA symptoms, BTW, as the Arthritis Foundation points out.)

The Bottom Line

Genes are undeniably a key piece of the RA puzzle; we know a large number of genes are associated with RA, and any one of them can increase your general risk for the disease. In some cases, those genes may be inherited, and in others, they might occur randomly. But genes remain only a piece of the puzzle, not the whole puzzle.

"It's a complicated issue," says Dr. Greer. "If you have a predisposed patient who comes into contact with an environmental stimulus, it can trigger the disease." 

As for whether or not RA is hereditary, within families, a history of RA slightly increases your risk of developing the disease but is by no means a guarantee. Much of the time, something else—like age, gender, or certain lifestyle factors—combines with your genetic makeup to create the hyper-inflammatory response that leads to RA (family history or not).

https://www.health.com/condition/rheumatoid-arthritis/rheumatoid-arthritis-genetic-hereditary

6 Powerful Natural Herbs for Fighting Arthritis Pain

From indiawest.com

Arthritis is a medical term that refers to more than 100 distinct rheumatic illnesses that cause pain, stiffness, and swelling in joints or connective tissue. Arthritis affects 50 million individuals in the United States, and it is the leading cause of disability among those aged 65 and over. 

Osteoarthritis (OA) is a disease that affects athletes and elderly persons who have worn out their joints due to excessive wear to the cartilage between joints. Rheumatoid arthritis (RA) is an autoimmune illness, which means that the immune system of the body fights itself, producing pain and inflammation. At any age, RA can affect any joint, no matter how much or how little it has been used. 

Herbalists use alternative herbs to promote the kidneys’ and large intestines’ natural cleaning activities, improve blood flow, and help lymph drainage. 

Here are a few of the greatest herbs for arthritic pain relief. 

1.   Kratom

Arthritis is a disorder that causes pain, stiffness in joints, and reduced mobility, all of which can worsen with time. Anxiety and sadness are two more symptoms of arthritis. Conventional medications may be effective in the short term, but the chemicals in them are ineffective in the long run. There are several drawbacks to using pharmacological drugs for an extended period. 

(image provided)

 Arthritis therapy is restricted even further for individuals with diabetes, high blood pressure, or heart problems. They can’t take large doses and can’t rely on high-potency medications, thus their treatment options are limited. For such patients, organic herbs like red hulu kapuas kratom is wonderful news because it relieves pain without the negative effects that come with pharmaceutical medications for this disease. Kratom is a natural chemical that helps to enhance the senses and relieve bodily aches and pains. It’s a fantastic vitamin for arthritis.

Kratom increases the blood flow in the body and improves blood circulation. Along with this, it also helps in cutting down fat from the body. This is because a side effect of Kratom is to lose appetite. Hence you do not consume much fat and thus the muscles are toned. Intake of this plant 30-40 minutes before working out will give your body a tremendous boost of energy and the lethargic feeling will be gone. This allows you to work out even more and achieve your dream goal.

2.   Turmeric (Curcuma longa) 

Turmeric is a powerful anti-inflammatory and pain reducer. It includes two compounds that help to reduce inflammation (curcumin and curcuminoids) (and are very much like the oft-prescribed non-steroidal anti-inflammatory drugs, or NSAIDs). Turmeric is frequently prescribed for the treatment of cancer, cataracts, and Alzheimer’s disease due to its anti-inflammatory properties.  

While you may easily incorporate turmeric into your regular diet, you’ll need to take it as a supplement to reap the full therapeutic advantages. To help activate turmeric, add black pepper or dried ginger to your dish. To alleviate discomfort, the herb can also be administered topically. 

3.   Boswellia 

Boswellia (Boswellia serrata), often known as frankincense, includes boswellic acids, which assist to reduce inflammation in the body through a variety of methods. Several herbal treatments, including Boswellia, were compared to the supplement glucosamine and the arthritis medication celecoxib in a 2013 research published in Rheumatology. The botanicals, like the medication and glucosamine, decreased knee discomfort and increased knee function. Take 500 mg of Boswellia extract standardized to 30% boswellic acid each day. 

It’s possible that combining Boswellia with other herbal anti-inflammatories will be even more effective. Researchers gave patients with OA either 100 mg of Boswellia, 450 mg of ashwagandha, 50 mg of turmeric, and 50 mg of a zinc complex each day, or a placebo, for three months, according to a study published in the Journal of Ethnopharmacology. The herbal mixture considerably decreased the intensity of OA-related pain and impairment. 

4.   CBD 

CBD oil derived from hemp (Cannabis sativa) is well-known for its anti-inflammatory properties. Anecdotal evidence supports its potential to reduce pain and inflammation. Cannabis plants contain a variety of cannabinoids, which are potent plant chemicals with a variety of therapeutic effects. 

(image provided)

Endocannabinoids are the ones we create (endo meaning coming from within). The well-known runner’s high is generated by an endocannabinoid that rises in the bloodstream during aerobic activity, then crosses the blood-brain barrier, and binds to cannabinoid receptors in the brain. Nowadays, CBD  products are available in various forms such as CBDfx gummies, tinctures, vape oil, topicals and other edibles. Certain herbs, such as ginger and Boswellia, can boost your body’s endocannabinoid system naturally, resulting in decreased pain and inflammation. 

5.   Ginger 

Ginger (Zingiber officinale) was evaluated in 261 patients with OA of the knee in a research published in Arthritis & Rheumatology. For six weeks, patients were given either ginger extract or a placebo twice daily. Overall, the ginger group reported less discomfort, as well as decreased knee pain when standing and walking. Take 250 milligrams each day in capsules.

A ginger compress applied topically aids in the circulation of blood to a region, speeding up the healing process. Researchers examined changes in moderate-to-severe osteoarthritis before and after therapy with a topical ginger compress or patch in one study published in the Journal of Holistic Nursing.  

Twenty people with persistent osteoarthritis were given topical ginger treatments for seven days by trained nurses, after which they self-administered the treatments for another 24 weeks. Subjects reported less pain and exhaustion after just one week, and this trend was maintained throughout the research. Topical ginger therapy has the potential to alleviate symptoms and enhance independence in patients with persistent osteoarthritis, according to the researchers. 

Make a strong pot of ginger tea or simmer the fresh herb (approximately 12 cups grated or sliced ginger). Soak a washcloth in the mixture and use it as required. 

6.   Nettles (Urtica dioica) 

Nettles are a multi-talented plant that may be used for almost any purpose. Nettles are loaded in protein, calcium, phosphorus, iron, magnesium, beta-carotene, and vitamins A, C, D, and B complex, all of which are easily absorbed by the body. 

For individuals suffering from arthritis or gout, stinging nettle is a powerful plant. Its anti-inflammatory properties, as well as its minerals (boron, calcium, magnesium, and silicon), assist to relieve pain while also promoting bone health. While NSAIDs are typically a necessary evil for most people with arthritis, nettle can help you take less of them. 

(Herbalists’ disclaimer: Please be with your doctor before using herbal supplements or reducing your prescription medication.) Nettle leaf tea (a cup or more per day) helps to alleviate and prevent water retention and inflammation while also nourishing the kidneys and adrenals. Note: Many arthritis sufferers have discovered that hitting an inflamed joint with a fresh nettle plant cutting relieves joint pain (the stinging part of the nettles draws blood to the joints, relieving pain and inflammation). 

Conclusion 

A diet rich in fresh fruits and vegetables, vital fatty acids, and fibre is the greatest treatment for arthritis, aside from herbal regimens (and reducing or eliminating foods that cause an inflammatory response such as fried foods, animal fats, dairy, and anything else which might cause an allergy sensitivity). By opening joints and promoting the dispersion of synovial fluid, which lubricates joints, yoga (particularly Yin Yoga) and moderate stretching go a long way toward arthritis prevention and pain alleviation.

https://www.indiawest.com/blogs/info4u/6-powerful-natural-herbs-for-fighting-arthritis-pain/article_abcb9fec-f8e3-11eb-8d91-cb08c2f8c352.html