Bergen Medical Associates’ Rheumatologist, Deana Nes, MD – talks about early rheumatoid arthritis diagnosis as key to prevent long-term damage to joints

 

There is good news for people who suffer from rheumatoid arthritis. Over the past 20 or so years, treatments have improved significantly, relieving pain and restoring functioning to countless patients, according to Dr. Deana Nes, a board-certified rheumatologist with Bergen Medical Associates.

The key is to get diagnosed early.

“If patients suspect they may have rheumatoid arthritis, they should be evaluated by a qualified rheumatologist to prevent long-term damage to joints and other parts of the body,’’ Dr. Nes explained. “The outlook for rheumatoid arthritis patients is so different than it was 20 or 30 years ago. Many do very well.’’

To help determine whether you may be at risk, Dr. Nes answers common questions about the disease.

What is rheumatoid arthritis?

It’s a chronic condition in which the immune system, which normally acts against foreign invaders like viruses, attacks the good guys – primarily the joints, but the eyes, lungs and skin can also be involved. There is, unfortunately, no cure, but the disease can be effectively managed.

Who gets rheumatoid arthritis?

Most of my patients have an auto immune disease and are affected at a young age, with 30 to 50 years being the general range when many patients are diagnosed. About three-quarter of patients are female.

What are common symptoms?

The most common symptoms are joint pain, stiffness and swelling, especially in the morning, and it can take hours for patients to move freely. Since rheumatoid arthritis can affect the whole body, patients may also experience shortness of breath, rashes or numbness and tingling in the hands or feet. Symptoms tend to develop over time.

When should people seek medical advice?

If they’re having persistent symptoms over a period of weeks — six weeks is the official criteria — they should consult their primary doctor or a rheumatologist. But if they are very uncomfortable or there is a lot of swelling, coming in sooner is warranted. Again, early diagnosis is critical to avoiding long-term complications.

What causes rheumatoid arthritis?

We still don’t know the exact cause, but genetic factors are believed to predispose some to the development of rheumatoid arthritis. That, along with environmental factors that we are exposed to throughout our lives — smoking, infections — can trigger rheumatoid arthritis.

Does diet impact rheumatoid arthritis?

Diet alone can’t cure rheumatoid arthritis, but eating right can help with symptoms and prevent complications. Eating healthy is key to maintaining a healthy weight. Excess weight adds pressure on already achy and stiff joints. We recommend the Mediterranean diet of fruits, vegetables, whole grains, fish and nuts.

What is a rheumatoid arthritis flare?

When patients are on medication, their RA symptoms are often controlled and we can induce remission where they are functioning normally. But, they can develop worsening of their RA symptoms even when in remission. Different factors trigger this — stress, infection, injuries.

Is it safe to exercise if you have rheumatoid arthritis?

Absolutely. Exercise helps to strengthen joints and the muscles around joints and improve range of motion. Since it’s important to avoid injury, we advise doing low-impact aerobics, like walking and swimming. Also, if patients experience a flare up, they may need to let the body rest and then return to their usual exercise regimen when they feel better.

How is the disease diagnosed?

This is where the job of a rheumatologist comes in. There is not just one test. Instead, we look at the whole patient. We examine the joints. We check for blood markers that indicate rheumatoid arthritis and other markers that show high levels of inflammation. We can perform X-rays or MRI studies. Then we put everything together to make a diagnosis.

How is it treated?

Medications known as disease modifying anti-rheumatic drugs  (DMARDs) change the course of the disease and prevent permanent joint damage. There are two categories: conventional DMARDs and biologics. We usually try conventional DMARDs first because they are more affordable and infection risk is generally lower or absent with these medications as compared with biologic DMARDs.

For more severe cases, we prescribe biologics — medication produced from living organisms or that contain components of living organisms. This tends to be a more immune suppressing and expensive treatment

Are there side effects?

Most patients tolerate these medications well, especially the conventional DMARDs. But, we often require blood testing every three to four months to monitor liver function and other potential issues. We also watch for infection. These medications help to calm the immune system, but they can also affect the immune system’s response to infection.

Any final words?

We encourage patients to consult with us should they be experiencing symptoms. Bergen Medical Associates provides high-quality, compassionate care.

With offices in Emerson, Paramus, Ridgewood, Northvale and Montvale, Bergen Medical Associates offers primary care and 12 areas of specialized care.  Patients enjoy the “one-stop shopping” approach where so many medical services are provided under one umbrella. The multi-specialty group fosters an environment of collaboration among the physicians, which results in a seamless continuum of care for the patients.

For more information, visit bergenmed.com or call 201-967-8221.