What Is It?
Rheumatoid arthritis is a chronic (long-lasting) inflammatory disease that causes pain, stiffness, warmth, redness and swelling in joints. Over time, the affected joints may become misshapen, misaligned and damaged. Tissue lining the joint can become thick, and may wear away surrounding ligaments, cartilage and bone as it spreads. Rheumatoid arthritis usually occurs in a symmetrical pattern, meaning that if one knee or hand has it, the other usually does, too.
The cause of rheumatoid arthritis is unknown, although it appears to be an autoimmune disease. When the body's immune system does not operate as it should, white blood cells that normally attack bacteria or viruses attack healthy tissue instead â€” in this case, the synovium, or joint tissue. As the synovial membrane (the thin layer of cells lining the joint) becomes inflamed, enzymes are released. Over time, these enzymes and certain immune cells damage the cartilage, bone, tendons and ligaments near the joint.
Some research suggests that a virus triggers this faulty immune response. However, there is not yet convincing evidence that a single virus is the cause in all patients. At the same time, it appears that some people are more likely to get the disease because of their genetics.
Rheumatoid arthritis, the most disabling form of arthritis, generally affects more than one joint at a time. Commonly affected joints include those in the hands, wrists, feet, ankles, elbows, shoulders, hips, knees and neck. Rheumatoid arthritis can result in loose, deformed joints, loss of mobility and diminished strength. It also can cause painless lumps the size of a pea or acorn, called rheumatoid nodules. These develop under the skin, especially around the elbow or beneath the toes.Symptoms
Pain, swelling, limited motion, warmth and tightness around affected joints, which most commonly include the hands and wrists, feet and ankles, elbows, shoulders, neck, knees and hips, usually in a symmetrical pattern. Over time, joints may develop deformities.
Fatigue, soreness, stiffness and aching, particularly in the morning and afternoon (described as morning stiffness and afternoon fatigue)
Lumps or rheumatoid nodules below the skin
Low-grade fever and sweats
Weakness and loss of mobility
There is no way to prevent rheumatoid arthritis. Treatment
The treatment of rheumatoid arthritis has improved dramatically in the past 50 years. A comprehensive approach that combines medications, rest balanced with exercise, lifestyle modifications, and sometimes surgery, can help many people to lead normal lives. The most important goals in treating rheumatoid arthritis are maintaining your ability to move and function, reducing pain, and preventing future joint damage. If these are achieved, quality of life and length of life may be normal. The treatments themselves may cause problems. You and your doctor will have to weigh the risks and benefits of any medication or other treatment that is available for this disease.
Certain medications relieve the symptoms of rheumatoid arthritis (such as pain and swelling), while other medications slow the progress of the disease.
Nonsteroidal anti-inflammatory drugs (NSAIDs), including prescription aspirin, ibuprofen (Motrin and other brand names) and naproxen (Aleve, Naprosyn), can help relieve symptoms. Side effects occur in a minority of patients. These include upset stomach, ulcers, reduced kidney function or allergic reactions.
Newer medications include:
Diet, Exercise and Rehabilitation Services
Finding a balance between rest and exercise is crucial to managing rheumatoid arthritis. When your symptoms flare up â€” when your joints are sore, warm and swollen â€” take it easy and rest. You can continue to do range-of-motion exercises to keep your joints mobile, but be careful not to tire yourself or aggravate your joints. Avoid unnecessary walking, housework or other activities. When your joints feel better and when other symptoms, including fatigue and morning stiffness, are less noticeable, increase your activity. Weight-bearing exercises such as walking and lifting weights can strengthen weakened muscles without risking additional joint damage. If exercise produces more pain or joint swelling, cut back a bit.
Despite many claims, there are no dietary changes, supplements, herbs or other alternative therapies known to improve the symptoms of rheumatoid arthritis over a long period of time.
Having rheumatoid arthritis often means that you have to pay special attention to the way you move. An occupational therapist or physical therapist can offer suggestions and guidance as you manage ordinary tasks around your home and work. In addition, a therapist can provide special devices that can help you conserve energy and protect your joints during your daily activities. A splint, brace, sling or Ace bandage worn when your joints are especially tender can take the pressure off the joints and protect them from injury. A podiatrist may provide shoe inserts (orthotics) or even suggest surgery to improve pain and function in arthritic feet.