A to Z Disease

What Is Rheumatoid Arthritis?

Rheumatoid Arthritis, or RA, is an auto-immune disease. It develops when your own immune system attacks healthy parts of the body, like your joints, causing pain and swelling. It differs from osteoarthritis, which is the natural degeneration of joints and surrounding tissue when we age.

What Happens With Rheumatoid Arthritis?

When rheumatoid arthritis strikes, cells from your immune system attack the lining of the joint, which is called the synovium. This attack causes the lining to become inflamed, and swollen. Over time, the lining and other parts of the joint will thicken and lose their natural shape and alignment. If the joint loses its shape, it can become painful and difficult to move. For some people, the pain may come and go. These periods of pain are called flare ups. But, rheumatoid arthritis doesn't just affect the joints. The immune system may also attack muscles, ligaments and organs like the eyes and heart.

Risk Factors for Rheumatoid Arthritis

RA affects one out of a hundred people. It is not known what triggers the immune system to attack the joints, leading to RA, but there are factors that increase the risk of developing it. These include:

• Gender. Women are 75 percent more likely than men to develop it. And, the risk is higher for women who have never been pregnant, or who have just recently delivered a baby.
• Age. It typically develops in people 40 to 60 years old, but can occur at any age.
• Family History. Although RA is not inherited, if someone in your family has RA, you are at higher risk for developing the condition.
• Lifestyle Choices. Smokers are at higher risk.

Signs & Symptoms of Rheumatoid Arthritis

Rheumatoid Arthritis can develop slowly, and the symptoms can be subtle at first. Here are some common symptoms you should discuss with your doctor.

• Joint Stiffness or Pain. Especially for more than an hour or two in the morning, or after sitting down for an extended time. Most normal pain and stiffness will go away after a while.
• Tender Joints. If you feel tenderness when you touch your joints, you should see your doctor.
• Redness and Swelling. Red, swollen hands, wrists, feet and ankles can all be a concern. Typically, rheumatoid arthritis will affect smaller joints farthest from the center of the body first. That's why you may feel early symptoms in these parts.
• Rheumatoid Nodules. These are firm bumps under the skin on your arms.

Other symptoms may include fatigue, loss of energy, low-grade fever, loss of appetite, or weight loss.

While any of these can be a symptom of this disease, you don't need to have all of them to have the condition.

Screening for Rheumatoid Arthritis

A physical examination and some simple tests will help determine if you have Rheumatoid Arthritis. These tests can include:

• Blood Tests. These check for immune system cells and cells that cause inflammation.
• MRIs and X-Rays. These are used to look for joint deformity. In most early forms of Rheumatoid Arthritis, X-rays will not show any difference between diseased joins and healthy joints. But they're good for measuring the progression of the disease as you move forward.
• Joint Fluid Analysis. Your doctor will use a syringe to remove some of the fluid around your joints. It will be checked for inflammatory cells or chemicals that your body is producing.

Coping With Rheumatoid Arthritis

Unfortunately, there is no known way to prevent or cure Rheumatoid Arthritis. It's important to note that an early diagnosis is key to successful treatment of the pain and RA.

Here are some things that might help you cope with a diagnosis of Rheumatoid Arthritis:

• Think Positively. While this is a chronic condition, many people do very well with existing treatment options. A positive mindset will help you be one of those success stories.
• Know Your Limits. You may feel tired or pain quicker than you are used to. Listen to your body and know when to take a rest.
• Use Assistive Tools or Devices. There's nothing wrong with using a cane or special jar opener or asking for help. It'll make your life easier.
• Get Support. Don't be afraid to lean on a few different people in your life.

The best treatment results usually include a number of different therapies used in combination. But that combination will be different for everyone.

Treatment of Rheumatoid Arthritis

Treatment options can be broken down into two categories: medication therapies and surgical options

Medication Therapies

Medication therapies are used to treat the inflammation that causes the swelling and pain from rheumatoid arthritis. The primary role of most of these drugs is to slow down the inflammatory process.

• NSAIDs, or Nonsteroidal Anti-Inflammatory Drugs. Over-the-counter pain relievers like aspirin, ibuprofen and naproxen fall into this group of medicines. These target the enzymes that cause joint inflammation and relieve pain.
• COX-2 Inhibitors. These are the next generation of, or newer, NSAIDs and you need a prescription from your doctor to take them. These drugs are easier on your stomach, but there have been questions about their safety in relation to the heart. It's important to talk to your doctor about whether they're right for you.
• DMARDs, or Disease-Modifying Antirheumatic Drugs. If they are taken before major joint damage happens, they can limit the long-term effects of Rheumatoid Arthritis. DMARDs include immunosuppressants, TNF blockers and corticosteroids.
  • Immunosuppressants. These act to slow the immune response, which drives the inflammatory process. It's important to note that by slowing the immune system, these drugs can actually leave you more susceptible to infection.
  • Corticosteroids are powerful medications used to treat painful flare-ups. These can become less effective and cause problems with long-term use, including ulcers. In addition, the body becomes dependent on them over time—so you need to be slowly taper off of them.
• Antibiologics. These are a class of drugs that are given by injection. They target the proteins that cause inflammation.

Surgery Options

More severe cases of RA may require surgeries such as synovectomy, in which the joint lining is removed. Some people may benefit from replacing an entire joint like a knee or hip. And, there are surgeries to repair tendons that have become damaged from the arthritis.

Many people also find relief from complimentary therapies and relaxation techniques, like hypnosis, deep breathing, and muscle relaxation. Acupuncture, gentle forms of yoga and tai chi can also help. The bottom line is, if it helps and doesn't hurt, give it a try.