Have inflamed joints? It might just be arthritis. After all, the condition commonly affects women between the ages of 20 and 45 years.
While there are more than 100 different types, the two most common ones are osteoarthritis (caused by mechanical wear and tear on joints) and rheumatoid arthritis (an autoimmune disease in which the body’s own immune system attacks the body’s joints). Interestingly, research has found that women are not only more likely to develop rheumatoid arthritis, but also experience greater pain than men with the condition.
The symptoms of rheumatoid arthritis
Someone suffering from rheumatoid arthritis typically experiences pain and stiffness in the joints of their fingers and toes.
“The pattern of joint inflammation is typically described as ‘symmetrical’ as both sides of the body are equally affected,” explains Dr Anindita Santosa, a consultant at the Department of Medicine (Rheumatology) at Changi General Hospital and the Chair of the medical committee at the National Arthritis Foundation. She adds that the inflammation can also occur in the wrists, elbows, knees and ankles, and on rare occasions, in organs like the eyes, lungs, blood vessels and nerves.
Other symptoms include fatigue, poor appetite and unintentional weight loss due to ongoing inflammation; dryness of the eye, eye redness and blurry vision as a result of inflammation in the eye; and a persistent cough and/or breathlessness when there is inflammation of the lungs. There may also be numbness or tingling in the hands or feet if there is inflammation of the nerves.
A more severe impact on women
Doctors don’t know what causes autoimmune conditions such as rheumatoid arthritis, but what they do know is that there are certain risk factors associated with an increased risk for the development of the disease. These factors include the female gender, obesity, cigarette smoking and early life exposure to cigarette smoke.
“Some studies suggest that it boils down to the genetic differences between men and women. For example, the sex hormone oestrogen has been shown to make the immune system more ‘aggressive’. Since women have much higher levels of oestrogen compared to men, they are at higher risk of developing autoimmune conditions,” explains Dr Santosa. She adds that women who have never given birth may be at greater risk of developing rheumatoid arthritis.
But just why do women who suffer from the condition usually report being in greater pain than men?
“There is no definite explanation. However, women are also more likely to experience anxiety and depression, which in combination with the functioning of the central nervous system and pain receptors, put them at risk for greater pain.”
“Also, some studies suggest that the hormone and nervous system differences between men and women are potential underlying factors. Thus far, animal studies suggest that testosterone may have a potential protective effect against pain, which can potentially explain the difference in pain perception,” she adds.
Living with rheumatoid arthritis
Blood tests and X-rays (or other imaging modalities such as ultrasound or MRI scans) are usually performed to support a clinical diagnosis but there is no cure for rheumatoid arthritis at the moment.
“However, rapid and intensive research has led to the development of medications that can be used, allowing patients to lead relatively normal lives,” says Dr Santosa. She adds that these medications include non-steroid, anti-inflammatory drugs and systemic glucocorticoids (otherwise known as ‘steroids’).
And if you’re wondering, there is no merit to old wives’ tales such as the cold and rain imposing greater pain.
‘Joint pain due to rheumatoid arthritis is not dependent on the weather–it is determined by the degree of inflammation of the joint.”
“Many people use the term ‘rheumatism’ loosely in the context of the weather, but rheumatism is not rheumatoid arthritis. And while some reports suggest that individuals with rheumatism have nerves in their ligaments that are sensitive enough to detect the fluctuations in the atmospheric air pressure, there is not much credence to these claims.”