Seasonal Variation in Rheumatoid Arthritis: Difference between revisions

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== Introduction ==
== Introduction ==
The prevalance rate of Rheumatoid arthris in India is 0.28- 0.7%  of adult population ,which accounts to a large number of peple considering the population of the country.Globally the prevalance rate is 1% increasing with age and peking with 35 to 50 years of age.many researhers have reported seasonal based flare up of RA in all kinds of population.certain population experiences an acute flare up in winters some in summers and certai poupltaion have a worsening RA which aggrevates with time.If we as physiotherpist are able to find out specific duration of flareups so can we curtail the disease or can making changes in location prevent ra.
Rheumatoid arthris (RA) is a chronic,immuno_inflammatory,systemic diesase that mainly affects the synovial joints and extra articular structures of the body.This causes pain,swelling and stifness mainly in the periheral joints.The possible causes are genetic,smoking and post natal women.Apart from these RA during specific seasons have also been documented in many people.people may experience pain either during summers,winters or rainy season.What triggers these is not known yet but there have been many cases where changes in seasonal parameters have known to cause or trigger RA.


researhrs have mainly documented atomspheric pressure ,humidy and temperature as the main seasonal markers that leads to flare upsor that triggers the ra pain.
The seasonal parameters-Barometric pressure,temperature and humidy have known to cause a flare in RA or trigger the disease.
 
Weather conditions may worsen symptoms in rheumatoid arthritis patients: The possible effect of temperature
 
pathophysiplogy
 
it has been recorded that seasona variotion triggers certain immunological activites in our bodies.“Our results indicate that, in the modern environment, the increase in the pro- inflammatory status of the immune system in winter helps explain the peak of incidences of diseases that are caused by inflammation, by making people more susceptible to inflammations effects.”(as sited in NRAS:Activity of genes and immune system "affected" by seasonal changes)
 
According toa study by kyoto university ,japan IgG anitbodies does show seasonal variation in its lvels in blood
 
general and physical fatigue being significantly greater during the winter. As fatigue is a substantial symptom in many persons with RA, this information is important for rheumatology professionals when dealing with persons with RA in routine care.


== Influence of seasonal parameters on joints ==
== Influence of seasonal parameters on joints ==
Atmospheric Pressure:it is said to be the main culprit for the joint pai. Changes in barometric pressure may make your tendons, muscles, and any scar tissue expand and contract, and that can create pain in joints affected by arthritis. Low temperatures can also make the fluid inside joints thicker, so they feel stiffer.
Atmospheric Pressure:Its is te force exerted by the atmosphere at a given point.It varies at different altitules from sea level.The atmospheroc pressure changes with change in seasons.This increase or decrese causes the tendons, muscles, and any scar tissue expand and contract, and that can create pain in joints affected by arthritis.The Arthritis Foundation published a study from Tufts University in 2007 that found that every 10-degree drop in temperature corresponded with an incremental increase in arthritis pain.
 
The Arthritis Foundation published a study from Tufts University in 2007 that found that every 10-degree drop in temperature corresponded with an incremental increase in arthritis pain


The barometer is falling and the atmospheric pressure and the body spaces have been at a stable place for several days or weeks. Now, weather is coming. The outside pressure has fallen and the body must now compensate, but this is not immediate. Initially the decreased pressure outside will allow the tissues internally to swell outward, until the body finds equilibrium. So, you have pain on the day the barometer moves (it may not be raining yet, but its coming!). The next day, when it is rainy - the barometer may have stabilized and there is little if any pain. And if the rain lasts for several days and the barometer stays put, the pain goes away. As the barometer rises, the relative pressure inside the body decreases (because it is being compressed, decreasing the size of the joint capsule) and the pain goes away completely leaving the patient feeling as if they were younger again. Less pain, less stiffness.
Humidity: High humidity levels can cause sweating and dehydration which can make the blood thicker, which increases blood pressure in the blood vessels and makes the body work more to pump blood through the body which can decrease the concentration of fluid around the joints and create more joint pain. The classic opinion, "Cold and wet is bad, warm and dry is good for RA patients," seems to be true only as far as humidity is concerned.


humidy:Some studies also show that high humidity levels can cause sweating and dehydration which can make the blood thicker, which increases blood pressure in the blood vessels and makes the body work more to pump blood through the body.5,6 Humid days can also cause the body to become dehydrated, which can decrease the concentration of fluid around the joints and create more joint pain. The classic opinion, "Cold and wet is bad, warm and dry is good for RA patients," seems to be true only as far as humidity is concerned.
Temperature:It has been speculated that changes in temperature changes the thickness of joint fluids i.e. Low temperatures may also increase the thickness of joint fluids, making them stiffer and perhaps more sensitive to pain during movement.


Temperature: Low temperatures may also increase the thickness of joint fluids, making them stiffer and perhaps more sensitive to pain during movement.
All the above factors togethere  inititate various immunoligcal responses in RA.A change in season causes a raise in level of IgG antibodies (Rheumatoid factor),therby triggerin the RA inflamatory mechanims in the body.
 
All the above factors does lead to inflammatory response in joints and the blood reports does conclude a maked increase in creactive proteins,hence triggers ra.


== role of physiotherapy ==
== role of physiotherapy ==
We can marke the wethere conditions using various weter apps and alrt the patient before hand about the triggering of ra
As physioherapist have a long term follow up with RA patients,they can document the seasonal parametrs using various wether apps during whih the patient experiences pain.Depending on these records we can predict when will there will be next trigger of RA and preplan the treatmet.
 
alternatively the patient can be asked to cange the location whenever the wether conditons turn unfavourabble.
 
Swimming  and other exercises can also be started before hand so as to inimize the symptoms.
 
Pneumatic pressure pumps have been found usefull in reducing pain and swelling in subjects who demonstrate sensiticvity to seasonal changes.


these can be applied twice a day for a duration of   10min to 30 min depending upon the pain and symptoms.
As per the protocl patient can be recommended various exercises before the onset of RA reducing the ai and stifness tehrfterFor examle the pain might experence ai whenver the pressure is 1002 mbar,humidy at 17% and temperature t 41degrees, so we can alert the patient whenver hese conditions are reached and take preventative measures.


Conclusion
Pneumatic pressure pumps have been found usefull in reducing pain and swelling duringa seasonal flare up.


Whtever
Alternatively the patient can be asked to change the location whenevr the wether conditions turn unfavourable.


== Resources ==
Resources
*bulleted list
*bulleted list
*x
*x

Revision as of 12:19, 17 February 2019

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Introduction[edit | edit source]

Rheumatoid arthris (RA) is a chronic,immuno_inflammatory,systemic diesase that mainly affects the synovial joints and extra articular structures of the body.This causes pain,swelling and stifness mainly in the periheral joints.The possible causes are genetic,smoking and post natal women.Apart from these RA during specific seasons have also been documented in many people.people may experience pain either during summers,winters or rainy season.What triggers these is not known yet but there have been many cases where changes in seasonal parameters have known to cause or trigger RA.

The seasonal parameters-Barometric pressure,temperature and humidy have known to cause a flare in RA or trigger the disease.

Influence of seasonal parameters on joints[edit | edit source]

Atmospheric Pressure:Its is te force exerted by the atmosphere at a given point.It varies at different altitules from sea level.The atmospheroc pressure changes with change in seasons.This increase or decrese causes the tendons, muscles, and any scar tissue expand and contract, and that can create pain in joints affected by arthritis.The Arthritis Foundation published a study from Tufts University in 2007 that found that every 10-degree drop in temperature corresponded with an incremental increase in arthritis pain.

Humidity: High humidity levels can cause sweating and dehydration which can make the blood thicker, which increases blood pressure in the blood vessels and makes the body work more to pump blood through the body which can decrease the concentration of fluid around the joints and create more joint pain. The classic opinion, "Cold and wet is bad, warm and dry is good for RA patients," seems to be true only as far as humidity is concerned.

Temperature:It has been speculated that changes in temperature changes the thickness of joint fluids i.e. Low temperatures may also increase the thickness of joint fluids, making them stiffer and perhaps more sensitive to pain during movement.

All the above factors togethere inititate various immunoligcal responses in RA.A change in season causes a raise in level of IgG antibodies (Rheumatoid factor),therby triggerin the RA inflamatory mechanims in the body.

role of physiotherapy[edit | edit source]

As physioherapist have a long term follow up with RA patients,they can document the seasonal parametrs using various wether apps during whih the patient experiences pain.Depending on these records we can predict when will there will be next trigger of RA and preplan the treatmet.

As per the protocl patient can be recommended various exercises before the onset of RA reducing the ai and stifness tehrfterFor examle the pain might experence ai whenver the pressure is 1002 mbar,humidy at 17% and temperature t 41degrees, so we can alert the patient whenver hese conditions are reached and take preventative measures.

Pneumatic pressure pumps have been found usefull in reducing pain and swelling duringa seasonal flare up.

Alternatively the patient can be asked to change the location whenevr the wether conditions turn unfavourable.

Resources

  • bulleted list
  • x

or

  1. numbered list
  2. x

References[edit | edit source]

https://www.bmj.com/content/359/bmj.j5326/rapid-responses

https://www.ncbi.nlm.nih.gov/pubmed/17466654

https://www.health.harvard.edu/blog/can-the-weather-really-worsen-arthritis-pain-201511208661

http://blog.arthritis.org/living-with-arthritis/weather-arthritis-pain/

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0085376

https://repository.kulib.kyoto-u.ac.jp/dspace/bitstream/2433/160127/3/s10165-011-0535-3.pdf

https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-0911-4

https://www.sciencedirect.com/science/article/pii/S2173574313000282

http://www.jrheum.org/content/31/7/1327.short


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