What is rheumatoid arthritis?

Rheumatoid arthritis is an autoimmune disease and a chronic inflammatory disorder that causes the immune system to attack the joints. The immune system normally serves to protect our bodies from attacking invaders (like bacteria and viruses) by attacking them. When the immune system attacks the joints it causes inflammation to develop around joints which leads to pain and swelling.

Rheumatoid arthritis usually affects the smaller joints in the hands and feet, but can also affect the knees, wrists, elbows, and ankles. The joints that are affected are usually symmetrical. This means that if one hand is affected, the other one is too. Unlike osteoarthritis, it affects the lining of the joints, also known as the synovium. The synovium is a thin layer of tissue that lines the joints and produces a fluid that lubricates the joints which helps them move smoothly.

The pain and swelling that results can gradually get worse and cause serious damage such as joint deformity and bone erosion. The disease can also affect other organs in the body such as the blood vessels, skin, lungs, or eyes. It can also affect be a systemic disease as it can affect the cardiovascular or respiratory system.

If the inflammation is not treated, it can result in cartilage and bone damage. The cartilage eventually deteriorates and the synovium gets smaller. This can cause the joints to become painful, loose, unstable, and eventually lose their mobility. Unfortunately, joint damage is irreversible. It’s important to diagnose and treat rheumatoid arthritis early because joint damage can occur early on. With early diagnosis and treatment, the disease can be managed.

Rheumatoid arthritis can happen at any age. However, the most common age a person is affected by the disease is about 40 years old. Women tend to get rheumatoid arthritis much more than men.

Symptoms (may come and go):

• Joint pain, tenderness, swelling or stiffness for six weeks or longer
• Morning stiffness for 30 minutes or longer
• More than one joint is affected
• Small joints (wrists, certain joints of the hands and feet) are affected
• The same joints on both sides of the body are affected
• Fatigue
• Loss of appetite
• Low-grade fever

Specific organ symptoms that may occur if inflammation persists:

• Blood. Anemia, a lower than normal number of red blood cells
• Mouth. Dryness and gum irritation or infection
• Lungs. Inflammation and scarring that can lead to shortness of breath
• Skin. Rheumatoid nodules – small lumps under the skin over bony areas
• Eyes. Dryness, pain, redness, sensitivity to light and impaired vision
• Blood Vessels. Inflammation of blood vessels that can lead to damage in the nerves, skin and other organs
  

Who gets rheumatoid arthritis?

There are about 1.5 million people in the United States that have rheumatoid arthritis. There are three main risk factors that raise a person’s risk for developing the disease: sex, age, and family history.

• Sex. Women are most affected by rheumatoid arthritis. In fact, three times as many women have rheumatoid arthritis than men.
• Age. Women most often develop the disease between ages 30 and 60. Men usually develop later on
• Family history. If you have a family history of rheumatoid arthritis, you have a higher chance of developing the disease. However, most people with the disease do not have a family history of it.

Treating rheumatoid arthritis

While there is no cure for rheumatoid arthritis, it can be controlled. A treatment plan includes stopping inflammation, relieving symptoms, preventing organ and joint damage, improving physical mobility, and reducing any long-term complications. This can be done using medications, therapy, or surgery.

1. Medications: NSAIDs (i.e. Ibuprofen, Advil, Motrin, Aleve), steroids, disease-modifying antirheumatic drugs, and biologic agents.
2. Therapy: to learn exercises to keep your joints flexible
3. Surgery: Total joint replacement, tendon repair, joint fusion

Prevention

Rheumatoid arthritis cannot be prevent because there is no known cause for the disease. However, there are things you can do to reduce the risk for the associated complications such as severe joint damage. This includes:

• See a doctor as soon as you notice symptoms. Early treatment can delay side effects and reduce the risk of eventually developing severe joint damage.
• Exercise. Talk to your doctor about exercises you can do such as gentle stretching and muscle strengthening exercises. These can minimize the associated pain and reduce bone loss. Be care though – exercise should be avoided while experiencing symptoms because it can make them worse.
• Do not smoke. Smoking increases your risk for developing rheumatoid arthritis.