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Rheumatoid Arthritis And Peripheral Neuropathy: How Are They Different?
Peripheral neuropathy can develop as a complication of rheumatoid arthritis (RA). You may find similar treatments for both, but your doctor is best equipped to determine what medications may work for you.
RA is a chronic autoimmune disease that causes inflammation in your joints, and about 40% of people with RA develop a loss of sensation and motor function in their hands, feet, and other parts of the body.
Known as peripheral neuropathy, this condition — whether it's a complication of RA or not — can be quite painful and affect your life.
This article explores the relationship between RA and peripheral neuropathy, how they are related, and what you can do to relieve symptoms.
RA is a chronic form of inflammation caused by a dysfunction of your immune system. Your body attacks the bones and tissues in your joints, resulting in pain, stiffness, and swelling in joints throughout your body.
Over time, this condition can lead to joint damage and dysfunction, as well as other complications.
On the other hand, neuropathy is damage to the nerves that can happen for various reasons.
Peripheral neuropathy is a common form that develops in people with RA. Any form of nerve damage that occurs outside of the central nervous system and spinal cord is a form of peripheral neuropathy.
It's still a peripheral form of nerve damage, but people with neuropathy and RA might receive a diagnosis of rheumatoid neuropathy — one of the most common complications of RA.
Both of these conditions can cause discomfort or pain, but the exact nature and location of these pains can be a little different between RA and the neuropathy it can cause.
Symptoms of RA usually include:
Symptoms of peripheral or rheumatoid neuropathy usually include things such as:
Does rheumatoid arthritis cause numbness and tingling?RA usually causes swelling, inflammation, pain, and/or stiffness in your joints. Swelling can lead to a loss of sensation, but this is why RA and neuropathic disorders are so closely related.
Numbness and tingling aren't usually included in the list of direct symptoms of RA, but it's among the common complications of this disease.
Peripheral neuropathy is a common complication of RA.
Researchers estimate that up to 85% of people with RA experience some type of neuropathy, and about half of people with RA will develop some sort of nerve damage or pain.
Besides RA, other diseases can lead to the development of peripheral neuropathy.
Some chronic conditions that can lead to peripheral neuropathy include:
Autoimmune diseases are also a trigger for peripheral neuropathy, especially conditions such as:
RA isn't the only form of arthritis that can cause nerve damage.
Other forms of arthritis show an association with neuropathy, mainly because of the pressure swelling and inflammation put on your nerves. Over time, this pressure can lead to chronic nerve damage and neuropathic pain.
Treatment for peripheral neuropathy with RA should start with managing your underlying condition.
This usually means taking medications such as disease modifying anti-rheumatic drugs (DMARDs) and anti-inflammatories to reduce the effect and progression of RA.
Healthcare professionals may add other medications to treat symptoms you have that are specific to peripheral neuropathy. These include medications also taken to treat conditions such as depression or epilepsy.
Examples of medications prescribed specifically for peripheral neuropathy include:
You will likely want to consult your doctor and healthcare team about any of your symptoms, to determine whether medications are the best treatment options for you.
Healthcare professionals usually treat RA with a class of medications called DMARDs or biological response modifiers (biologicals).
The goal of these medications is usually to slow the progress of the disease and prevent permanent joint damage. Anti-inflammatory medications, pain medications, and steroids can be helpful, as well as physical therapy and other rehabilitative treatments.
Peripheral neuropathy is a common complication that develops alongside RA. Joint swelling and inflammation can damage nerve fibers, adding new layers to your joint pain.
Some treatments are the same for RA and peripheral neuropathy, but you might have additional treatments if you have RA and experience new nerve pain or damage.
What Are The Best Sleeping Positions If You Have Rheumatoid Arthritis?
Joints affected by rheumatoid arthritis may not only feel painful but also tender and stiff. Depending on which joints are affected, you may find it challenging to fall and stay asleep.
Rheumatoid arthritis (RA) is an autoimmune disease characterized by joint inflammation and pain, among other symptoms like weakness, fever, and fatigue. Experts estimate that 80% of people with arthritis have sleeping difficulties potentially caused by these symptoms of joint discomfort.
Unlike other types of arthritis, RA tends to affect the same joints on both sides of your body, such as both of your hands. While RA can affect any joint, it's most common in the joints of your knees, hands, and wrists.
If you have RA, you may already feel fatigue from this chronic inflammatory condition, making getting a good night's sleep even more important for your health. In fact, not getting enough sleep regularly can make RA-related pain worse.
Consider how you can position yourself for a better night's sleep, as well as other ways you may manage RA pain.
It may help to adjust your sleeping position according to the joints that RA affects. Here's how you can accomplish this if you experience symptoms in one of these commonly affected areas of the body.
Relief for hand and wrist painRA commonly develops within the small joints of the hands and wrists. If this type of joint pain is keeping you up at night, consider asking a doctor about compression gloves or splints you may wear to sleep.
Sleeping on your sideIf you're a side sleeper, it can place more pressure on your shoulder, hip, and knee joints. Even if you don't typically sleep on your side, it's difficult not to move around in your sleep, and you might still end up on your side.
So, it may help to use strategies to help support these joints to ease pain whenever you're on your side. For example, if you end up sleeping on a painful shoulder, you could try supporting it with a thick pillow so your shoulder joint doesn't roll forward.
To ease hip pain from RA, try placing a pillow between your legs for additional support of your hip joints. This same strategy can help relieve knee pain from RA — try placing a couple of pillows in between your knees for support.
How to reduce RA foot painIf foot pain from RA keeps you up at night, try placing a weighted blanket or towel on top of your feet. This works best while sleeping on your back.
For side sleepers, you may consider wearing compression stockings to support your foot joints.
Tips for sleeping on your back with RAWhile not as common as other joint pain, it's still possible for RA to affect your neck and spine.
If you sleep on your back, supporting these joints with the correct pillow is key to preventing worsening pain. You can also add pillows underneath your knees and the small of your back. A small U-shaped pillow can also help support your neck while sleeping on your back.
Can you sleep on your stomach with RA pain?Sleeping on your stomach can place more stress on your back and neck. If RA has affected these joints, it's best you try to avoid this sleeping position if you can.
Aside from adjusting your sleeping position, you may consider other tips to manage nighttime RA pain, such as:
Read more about managing RA pain at night.
It's common to experience worsening RA symptoms at night, including joint pain. Here are some of the most commonly asked questions about nighttime RA pain.
Why is rheumatoid arthritis worse at night?There are a few reasons why RA pain may be worse at night. When you're trying to sleep and don't have any other distractions, you may notice joint pain more than at other times of the day.
Your central nervous system may also play a role. For example, not getting enough sleep in the long term may affect how your body regulates pain. Another possible explanation may be increased inflammation at night.
What aggravates rheumatoid arthritis pain?Worsening RA pain may be a sign of a flare-up. A number of different factors may cause a flare. These include stress, too much exercise, or weather changes.
Not getting enough sleep can also make RA pain worse the next day. One possible reason for this is an increase in inflammation from lack of sleep, and inflammation can worsen RA symptoms.
If you find that your RA symptoms are causing difficulties with falling or staying asleep at night or waking you up too early on a regular basis, it may be time to see a doctor for help. This is especially the case if you've tried adjusting your sleeping position or are currently receiving treatment for RA.
You should also consider getting medical help if you're experiencing worsening pain and other RA symptoms. These could be signs of a flare-up that needs additional treatment.
Sleep deprivation is a complication seen in all types of arthritis, including RA. Pain and lack of sleep often occur together.
Not only can this be disruptive in the short term, but a chronic lack of sleep can make your condition worse. In turn, you may experience increased inflammation and worsening joint pain.
Adjusting your sleeping positions is one strategy that may help you get the sleep you need to help you manage RA symptoms and your overall health. Speak with a doctor about other RA treatment strategies that may help.
COVID Might Raise Odds For Immune Disorders Like Crohn's, Alopecia
In rare cases, some patients may develop an autoimmune disease following a bout of COVID, Korean researchers report.
Conditions such as alopecia (hair loss), psoriasis, vitiligo (white skin patches), vasculitis (inflammation of blood vessels), Crohn's disease, ulcerative colitis, rheumatoid arthritis, adult-onset Still's disease (painful skin rash), Sjogren's syndrome (autoimmune disease), ankylosing spondylitis (spinal arthritis) and sarcoidosis (enlarged lymph nodes) can all be triggered by COVID-19 infection, according to the new report.
COVID-19 patients faced 12% to 74% higher odds for various types of alopecia, a tripled risk for vasculitis, 68% higher odds for Crohn's and 59% higher odds for sarcoidosis, the study found.
"Our findings highlight a significant association between SARS-CoV-2 infection and the development of autoimmune and auto-inflammatory disorders. This emphasizes the need for a comprehensive medical approach that encompasses both the acute manifestations and potential long-term complications of COVID-19," said lead researcher Dr. Sung Ha Lim, from the department of dermatology at Yonsei University's Wonju College of Medicine in South Korea.
"Given the significant global population of COVID-19 survivors, vigilant monitoring for emergent autoimmune diseases is paramount for timely intervention," she added.
This study underlines previous findings, said Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City.
"It is likely because when you defend yourself against COVID, interferons are produced which trigger inflammation, which can then trigger auto-antibodies against the body's organs, muscles or nerves, especially when you have a tendency towards that disease in the first place," Siegel noted.
For the study, Lim and her colleagues collected data on nearly 355,000 men and women who had COVID-19. These patients were compared with more than 6 million people who didn't have COVID-19.
Lim added that the severity of the COVID infection, as well as being unvaccinated, upped the odds of developing these conditions.
"Unvaccinated individuals exhibited a greater risk for certain autoimmune diseases, including alopecia areata, alopecia totalis and Crohn's disease," she said.
The report was published online Oct. 6 in JAMA Network Open.
Another expert isn't surprised that COVID-19 can trigger autoimmune diseases.
"As all of us know, COVID impacts so many aspects of the human body," said Dr. Bruce Hirsch, an infectious disease specialist at Northwell Health in Manhasset, N.Y. "It's not surprising that COVID hit us the way it did without us having any pre-existing immune experience or immune protection, and it had a profound impact on the immune system."
Hirsch noted this reaction is not unique to COVID-19. "We do see post-infectious autoimmune conditions. We do see this with other types of infections," he said. "This is not limited to COVID."
The good news is that the population is becoming more experienced in terms of immune system recognition with COVID-19 because of cases and vaccinations, Hirsch said.
Not only that, "I think the risk to any specific individual of an autoimmune condition like the ones that were described is very, very low. We're talking a couple out of 100,000, much below 1%," Hirsch said.
The best overall protection for COVID-19 is getting vaccinated, he advised.
"It's our evolving immune experience that's going to reduce all these different risks and reduce the impact on us," Hirsch said. "I think one way of getting more immunologic experience without getting COVID is the COVID vaccines. I do think that taking additional COVID vaccines as they become available, including the current booster, is something that will be helpful."
More information: Sung Ha Lim et al, Autoimmune and Autoinflammatory Connective Tissue Disorders Following COVID-19, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.36120
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Citation: COVID might raise odds for immune disorders like Crohn's, alopecia (2023, October 10) retrieved 19 October 2023 from https://medicalxpress.Com/news/2023-10-covid-odds-immune-disorders-crohn.Html
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