Affecting approximately 1 percent of adults, rheumatoid arthritis (RA) is a serious and debilitating form of arthritis. Sufferers experience a wide variety of symptoms. Often starting in middle age, the disease affects more women than men. It can also occur in young children and elderly individuals. Symptoms may appear for a short period, wax and wane, or persist throughout a sufferer’s lifetime.
While it can affect any joint, RA is most commonly diagnosed in the wrists and fingers. Although RA is a serious medical condition, the treatment outcome for the disease has greatly improved in recent years. These treatment advances may be able to stop or slow the progression of the disease, which make living with rheumatoid arthritis somewhat easier.
What is Rheumatoid Arthritis?
While osteoarthritis is a condition typically triggered by degeneration of the joint, RA is an autoimmune disorder. It occurs when the immune system mistakenly attacks your body’s tissue. Unlike, the wear-and-tear damage associated with osteoarthritis, RA affects the synovium, the membrane lining that surrounds your joints. Typical zones that are affected by RA are the joints in your hands, wrists, knees, elbows, and ankles. The result is painful swelling that can eventually cause bone erosion as well as joint deformity. The inflammation can also damage other parts of your body.
Causes, Signs and Symptoms
The cause of RA is unknown. Various theories indicate that genetics, hormones or environmental factors may trigger the condition. Evidence also suggests that exposure to asbestos and silica may increase the risk for developing the disease.
Although women are twice as likely to experience RA, the symptoms are usually more pronounced in men. The disease most commonly begins to present symptoms between the ages of 40 and 60. Those with family members suffering from RA and are overweight also have an increased risk. Along with gender, age, family history, obesity and smoking are potential risk factors. Smoking is associated with a greater severity of the condition.
RA affects each person differently. For some, the symptoms may develop gradually over time while they may appear quickly in other individuals. Some people may have symptoms for a short period that go into remission and never occur again. Signs of RA include:
- Warmth and redness
- Tender, swollen joints
- Joint stiffness that is typically worse in the morning or after activity
- Fever, fatigue, muscle aches and weight loss
The symptoms tend to affect smaller joints first, such as those of the fingers and toes. As the condition progresses, it spreads to the wrists, ankles and elbows. In most cases, RA affects both sides of the body simultaneously. When RA occurs, white blood cells move to the affected joint. The resulting inflammation causes the synovium to thicken, which eventually destroys the cartilage and bone within the affected joint. As the cartilage wears away, the space between the bones gets smaller. Once the cushioning material is diminished, the bones begin to rub together. The inflammation of the joint lining causes a buildup of fluid and swelling, which may also damage your bones.
In addition to the joints, RA may affect the tissue lining other parts of the body. Signs and symptoms may also occur in the:
- Nerve tissue
While RA can be difficult to diagnose initially, you should see a doctor if your joints are sore and swollen for an extended period, especially if symptoms are worse in the morning. Your doctor will perform an examination, discuss your medical history and order diagnostic procedures, such as blood tests, an MRI and x-rays. The imaging tests will enable your doctor to track the progression of the disease and evaluate the severity of any symptoms. The sooner the disease is diagnosed, the better the treatment outcome.
Common Treatment Options
Common treatment options to stop or slow the damage caused by the disease as well as reduce the associated pain and swelling includes lifestyle changes, medicine and surgery. While there is no cure, research indicates that remission is more likely when treatment begins early with medication known as disease-modifying anti-rheumatic drugs (DMARDS). Depending upon the severity and duration of your symptoms, your doctor may prescribe a variety of medications, such as:
NSAIDS – Nonsteroidal anti-inflammatory drugs (NSAIDS) work to relieve pain and reduce inflammation. These include over-the-counter medications like ibuprofen and naproxen sodium products, including Advil, Motrin and Aleve. Prescription-strength NSAIDS are also available. Side effects include stomach upset and heart problems as well as liver and kidney damage.
Steroids – Corticosteroids like prednisone are designed to alleviate pain, reduce swelling and slow the rate of joint damage. After these medications improve acute systemic issues, the physician gradually tapers their use. Side effects include weight gain, thinning of the bones and the onset of Type 2 diabetes.
Biological agents – a newer class of disease-modifying antirheumatic drugs (DMARDS), biological agents are designed to target the immune system and prevent the occurrence of inflammation that cause pain and tissue damage. The primary goals are to slow the progression of RA and save your joints. Side effects include an increased risk of infection.
Therapy – Physical and occupational therapy can teach you exercises that help keep your joints flexible. The techniques will help you perform daily tasks in ways that are easier on your joints. The therapists can also make recommendations regarding tools and devices that support and protect your joints.
Surgery – If medications and therapy fail to slow or prevent joint damage, the doctor may recommend surgery to help restore function to the affected joints. The surgical procedure may entail removing the inflamed synovium, repairing damaged tendons or fusing the bones to stabilize and realign the joint. Severe RA may require joint replacement surgery.
You may also consider some alternative treatments to reduce the pain, swelling and stiffness associated with RA. Diets and lifestyle changes have shown promise. Consider adding fish that are high in omega-3 fatty acids, like salmon, to your diet. The popular Mediterranean diet can potentially reduce systemic inflammation. Research shows that dietary turmeric, an ingredient in curry, reduces some RA symptoms.
You may also consider dietary supplements that include vitamin D and folic acid or foods rich in these nutrients, such as oily fish and green leafy vegetables. Yoga and Tai Chi are low-impact exercises that help maintain strength and flexibility. Staying active helps shed extra weight that can place added pressure on inflamed back, hip and leg joints. Minimizing stress and working with support groups also help to improve your overall health.
With an early diagnosis and aggressive treatment, the outlook for individuals who have RA is very good. The ability to control the disease has improved significantly in recent years. Doctors strive to prevent flare-ups and eradicate signs of the disease.
New clinical studies have identified ways that RA is biochemically triggered in some patients. Identifying genetic markers showing predisposition to the disease may help researchers with the development of future treatments and methods to prevent RA. Along with biologic treatment, clinical studies are being conducted on inflammation inhibitors and B cell depletion therapy that reverses the immune system dysfunction.
Living with rheumatoid arthritis can be challenging because it can affect your quality of life. The disease can be managed with customized protocol of medication, diet, physical therapy and lifestyle changes. It is possible to live a full productive life.