Rheumatoid Arthritis

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is a chronic (lasting) inflammatory disorder. It causes swelling and pain in the lining of your joints. It can affect other parts of your body, such as the lining of your heart and lungs.

What are the symptoms of RA?

RA often occurs in your hands, wrists, feet, and knees first. It can affect several joints at the same time, on both sides of your body. For example, both of your wrists may be painful and stiff. Over time, RA may affect other joints, such as your jaw, shoulders, and hips.

Symptoms of RA may include one or more of the following:

  • Painful and swollen joints, especially in your hands, feet, and knees.
  • Difficulty moving joints.
  • Stiffness and pain in joints, especially after sleeping.
  • Fever.
  • Fatigue.
  • Red, puffy hands.
  • Hard bumps (called rheumatoid nodules) just under the skin near the joints.
  • Loss of appetite.

What causes RA?

RA is a form of arthritis and a type of autoimmune disease. It occurs when the body’s immune system attacks its own joint tissue. The exact cause of this is unknown.

Diagnosis

How is RA diagnosed?

Your doctor will review your symptoms and do a physical exam. They also may order blood tests, X-rays, or a joint fluid analysis, which tests the fluid in your joints for other possible causes of pain.

Can RA be prevented or avoided?

You cannot prevent or avoid RA since the cause is unknown. RA is more common in older people. Women get RA more often than men.

Treatment

The purpose of treatment is to relieve symptoms, reduce pain, prevent future damage, and improve quality of life. Talk to your doctor about all the treatment options for RA.

Medicine

For mild cases of RA, your doctor may suggest taking over-the-counter (OTC) medicines to reduce inflammation. These include aspirin, ibuprofen, ketoprofen, or naproxen. Medicines such as acetaminophen can help relieve pain and make you feel better. Your doctor will also prescribe medicines to help treat RA. Prescription pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) are used to reduce pain and swelling. These medicines do have some side effects and should be taken wisely.

Medicines that manage your immune system (called immunosuppresants) also can be used to fight RA. When you have RA, your immune system is out of control. These drugs bring it back to normal. However, they can affect your immune system’s ability to respond to infections.

ctor also may prescribe a steroid, such as prednisone. Steroids can reduce pain and swelling, while slowing the damage to your joints. However, they can only be used for a brief time. The longer you use steroids (several months or years), the less effective they become. Steroids do have side effects, such as easy bruising, bone thinning, cataracts, and diabetes.

Anti-rheumatic medicines can help treat RA. If you start taking these drugs early enough, they can slow the damage to your joints. These medicines work slowly, and it may take a few weeks to start feeling better. Your doctor may do a blood test to make sure these medicines are safe for you. Some of these medicines should not be taken if you are pregnant.

Surgery

Surgery may be an option for cases of RA that are severe or are not effectively treated with medicine. These may include correcting a deformity or replacing a joint. Knee and hip replacements are most common. The effects of surgery can help to ease pain and regain joint movement. Talk to your doctor about the benefits and risks of surgery.

Lifestyle

There are lifestyle changes you can make to help manage RA.

  • Do regular, gentle exercise. This can strengthen the muscles around your joints and lessen fatigue. Mild water aerobics and walking are good exercises to try. If you feel pain in a new joint while exercising, stop and rest. Talk to your doctor if the pain persists.
  • Lose weight if you are overweight and eat a healthy
  • Use heat and cold. Heat relaxes tensemuscles and cold numbs pain. One way to apply heat is to take a 15-minute hot shower or bath. Cold treatments include ice packs or soaking your joints in cold water. Do not use these methods if you have poor circulation.
  • Reduce thestress on your affected joints. For instance, canes can help you walk. Grabbing tools can help you pick up items. Ask your doctor about other ways to make your daily life easier.

Living with RA

RA is a lifelong disease. When it’s treated, it may go away for a little while, but it usually comes back. It is important to see your doctor as soon as symptoms begin. The earlier you start treatment, the better your outcome.

If left untreated, RA can cause other health problems. Your hands may become bent or twisted. Other joints can become deformed. Inflammation will affect your cartilage and bones. Lung and heart problems also can occur. Talk to your doctor if you notice any new symptoms or problems.

Questions to ask your doctor

  • How do I know if my joint pain is caused by rheumatoid arthritis?
  • Is RA a genetic condition?
  • What medicines would work best for me, and what are the side effects?
  • Is there anything I can do to prevent flare-ups of RA?
  • What are the pros and cons of surgery to treat RA?
  • Does RA affect my life expectancy?

Resources

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