Arthritis is the name for a set of conditions that cause inflammation of the joints. Rheumatoid arthritis is a chronic autoimmune type of joint inflammation in which the body's immune system attacks its own joints, causing swelling and stiffness. This can lead to joint damage, chronic pain, and eventually loss of joint function.
Rheumatoid arthritis usually affects the hands, feet, hips, knees, and elbows on both sides of the body but it can affect any joint and may even affect other body organs. Rheumatoid arthritis is an ongoing condition for which there is no cure but early treatment can limit joint damage and allow rheumatoid arthritis sufferers to live long, productive lives.
Rheumatoid arthritis affects 1.3 million Americans and is two to three times more common in women than in men. People of all ages may be affected by rheumatoid arthritis but the disease usually begins between the ages of 40 and 60. When RA occurs between the ages of 6 months and 16 years it is called juvenile rheumatoid arthritis. Rheumatoid arthritis is not a normal consequence of aging and is not caused by excessive wear-and-tear on joints.
One of the main features of RA that differentiates it from other types of arthritis is that the joint stiffness is worst in the morning after waking. When symptoms of RA first begin, they tend to affect your smaller joints first: those of the wrists, hands, ankles and feet. As the disease progresses, larger joints become involved such as the shoulders, elbows, knees, hips, jaw and neck.
Another feature of RA is that symptoms tend to come and go: periods of severe symptoms called flare-ups or flares may alternate with periods of remission.
Rheumatoid arthritis occurs when the immune system, the body's defense against invading viruses and bacteria, starts to attack the membranes that surround the joints called the synovium. Immune system cells attack these tissues causing inflammation, swelling, pain, and stiffness.
While it is clear that an autoimmune reaction causes rheumatoid arthritis, it is not clear what causes that reaction to occur in certain people and not others. It is likely that several factors interact to cause the disease including genetics, lifestyle, and environmental factors such as exposure to certain viruses.
One of the hallmarks of rheumatoid arthritis is that symptoms develop slowly over weeks or months. Early symptoms usually include fatigue and stiffness upon waking in the morning, especially in the small joints of the hands and feet. If you suspect you may have rheumatoid arthritis, see a doctor right away to be tested. Studies show that the earlier you start treatment for rheumatoid arthritis, the better your outcome will be.
When you visit the doctor: He or she will likely ask about your history of symptoms and about your family history of rheumatoid arthritis and other autoimmune diseases such as lupus and multiple sclerosis. The doctor will also do a physical examination of your joints. He or she may also recommend additional laboratory tests to determine if you have rheumatoid arthritis.
Several medications have been recently developed that can help manage the symptoms of rheumatoid arthritis allowing most patients to live productive and relatively pain-free lives.
For short-term relief of acute inflammation and stiffness, non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, and celecoxib can be used. Also, corticosteroids such as prednisone and methylprednisolone can be used to reduce acute inflammation and pain, but cannot be used for long periods due to serious side effects and decreased efficacy.
In addition to the medications mentioned above for treating acute symptoms, most people with rheumatoid arthritis also take some type of disease-modifying antirheumatic drugs (DMARDs). When used in the early stages of the disease, these drugs can help slow disease progression and help prevent new joints from becoming involved.
Physical and occupational therapy may also help improve symptoms while assistive devices can help take the stress off of some joints. In some cases when joint damage is severe, surgery may be an option to help correct deformities and restore some motion to the joint.
There is no known way to prevent rheumatoid arthritis from occurring and the only risk factor for rheumatoid arthritis that you can control is smoking. However, if you do start having symptoms of rheumatoid arthritis, you can prevent permanent damage to your joints by seeing a doctor right away and starting treatment.
When to seek medical care: If you experience persistent discomfort and swelling in multiple joints on both sides of your body that does not go away or seems to get worse over time, contact your doctor to be tested for rheumatoid arthritis. The earlier you start treatment, the less likely you are to have permanent joint damage. If you have been diagnosed with RA already and you have a flare-up of your symptoms or experience side effects of your medication, talk to your doctor right away.