Rheumatoid arthritis is a chronic disease that causes joint pain, stiffness, swelling and decreased movement of the joints. RA happens when your body’s defenses thus your immune system targets your joint linings. Rheumatoid arthritis (RA) affects joints on either sides of the body, such as both hands, both wrists, or both knees. This is one way that doctors distinguish RA from other forms of arthritis, such as osteoarthritis.
However, in some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. The joint stiffness in active RA is often the worst in the morning. It may last one to two hours (or even the whole day). It generally improves with movement of the joints. There may be periods where symptoms become worse, known as flare-ups or flares.
RA is the most common form of autoimmune arthritis. It affects more than 1.3 million Americans. About 75% of RA patients are women. In fact, 1 – 3% of women may get rheumatoid arthritis in their lifetime. The disease most often begins between the ages of 30 and 50. However, RA can start at any age.
What causes rheumatoid arthritis?
RA is an autoimmune disease. Your immune system is supposed to attack foreigners in your body, like bacteria and viruses, by creating inflammation. In an autoimmune disease, the immune system mistakenly sends inflammation to your own healthy tissue.
This creates inflammation that causes the tissue that lines the inside of joints (the synovium) to thicken. This results in swelling and pain in and around your joints. The synovium makes a fluid that lubricates joints and helps them move smoothly.
If inflammation goes unchecked, it can damage cartilage thus the elastic tissue that covers the ends of bones in a joint, as well as the bones themselves. Over time, there is loss of cartilage, and the joint spacing between bones can become smaller. Joints can become loose, unstable, painful and lose their mobility. This damage typically cannot be reversed once it occurs. Sometimes, joint deformity can also even occur.
Rheumatoid arthritis symptoms
RA is a long-term or chronic disease marked by symptoms of inflammation and pain in the joints. In the early stages, people with RA may not initially see redness or swelling in the joints, but they may experience tenderness and pain.
These following joint symptoms are clues to RA:
- Joint pain, tenderness, swelling
- Morning stiffness or after sitting still for a long time.
Other symptoms can include:
- tiredness and lack of energy – this can be known as fatigue
- anemia, a lower than normal number of red blood cells
- a poor appetite (not feeling hungry)
- weight loss
- a high temperature, or a fever
- dry eyes – as a result of inflammation
- chest pain – as a result of inflammation.
Rheumatoid arthritis can affect any joint in the body. Although it is often felt in the small joints in the hands and feet first. Both sides of the body are usually affected at the same time, in the same way, but this does not happen always.
However, a few people develop fleshy lumps – rheumatoid nodules, which form under the skin around affected joints. They can be painful sometimes, but usually are not.
Rheumatoid arthritis can be difficult to diagnose in its early stages. This is because the early signs and symptoms mimic those of many other diseases. There is no one blood test or physical finding to confirm the diagnosis. It can either be through examining blood test results, examining the joints and organs, and reviewing x-ray or ultrasound images.
First your doctor will ask about your symptoms and medical history. They’ll also perform a physical exam of your joints. This will include looking for swelling and redness, and testing your reflexes and muscle strength. Your doctor will also touch the affected joints to check for warmth and tenderness. If they suspect RA, they’ll most likely refer you to a specialist called a rheumatologist.
Since no single test can confirm a diagnosis of RA, your doctor or rheumatologist may use several different types of tests. They may test your blood for certain substances like antibodies. Antibodies are small proteins in the bloodstream that help fight against foreign substances. These can be a sign of RA and help support the diagnosis.
They may also request certain imaging tests. Tests such as ultrasonography, x-ray exams, and magnetic resonance imaging (MRI) not only show if damage from RA has been done to your joints but also how severe the damage is.
Treating rheumatoid arthritis
There’s no cure for rheumatoid arthritis. However, early diagnosis and appropriate treatment enables many people with rheumatoid arthritis to have periods of months or even years between flares. This can help them to lead full lives and continue regular employment. Treatments may include:
- NSAIDs. Non-steroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). Stronger NSAIDs are available by prescription.
- Steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, weight gain and diabetes. Doctors often prescribe a corticosteroids to relieve acute symptoms, with the goal of gradually tapering off the medication.
- Disease-modifying antirheumatic drugs (DMARDs). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage.
- Biologic agents. Also known as biologic response modifiers. These drugs can target parts of the immune system that trigger inflammation that causes joint and tissue damage.
Certain home remedies and lifestyle adjustments may help to improve your quality of life when living with RA:
Exercise. Low-impact exercises can help to improve the range of motion in your joints and increase your mobility. Exercise can also strengthen muscles, which can help to relieve some of the pressure from your joints. You can also try gentle yoga, which will help you regain strength and flexibility.
Get enough rest. You may need more rest during flare-ups and less during remission. Getting enough sleep will help to reduce inflammation and pain as well as fatigue.
Apply heat or cold. Ice packs can help to reduce inflammation and pain. They may also be effective against muscle spasms. You can alternate cold with hot treatments such as warm showers and hot compresses. These treatments may help to reduce stiffness.
Try assistive devices. Certain devices such as splints and braces can hold your joints in a resting position. This may help to reduce inflammation. You can also install household devices, such as grab bars and handrails in bathrooms and along staircases.
While there is no specific “diet” for rheumatoid arthritis, researchers have identified certain foods. These includes diet that are rich in antioxidants. It can help control and reduce inflammation. These includes diets such as
- fishes that are high in omega-3 fatty acids such as salmon, tuna, herring, and mackerel
- vegetables such as broccoli, spinach
- fruits such as grapes, berries
- and olive oil, among other healthy foods.
It’s also important to eliminate or significantly reduce processed and fast foods that fuel inflammation.
If medications fail to prevent or slow joint damage, you and your doctor may consider surgery to repair damaged joints. Surgery may help restore your ability to use your joint. It can also reduce pain and correct deformities.