What is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune disorder which causes inflammation and eventual deterioration of your joints.
It is a degenerative condition and can cause severe loss of mobility and movement.
The disease is more common in women than men. In the US, approximately 1.5 million individuals have rheumatoid arthritis. (1)
Symptoms
Joints exist throughout your body. They are the points between two connecting bones, such as the knees, fingers and many more.
The main functions of the joints are to enable movement and stop your bones from rubbing against one another.
Healthy joints are essential for normal movement. Without them, you would not be able to perform most basic of movements. Examples include walking, sitting and writing. (2)
Rheumatoid arthritis develops when your immune system starts to attack the tissue lining the inside your joints. The underlying cause as to why this happens is yet to be determined.
As with the majority of autoimmune diseases, rheumatoid arthritis is chronic and incurable. Symptoms may periodically intensify (flare up) and then improve. (3)
Individuals with an existing autoimmune disorder are also more likely to develop another. If you already suffer from one such disease, you may have a greater risk of rheumatoid arthritis. (4)
Rheumatoid arthritis can target any joint in the body, although it usually starts in the smaller joints.
The disease also often manifests symmetrically – for example, both feet at the same time. Telltale warning signs of rheumatoid arthritis can include the following: (5)
Joint Pain
As rheumatoid arthritis causes inflammation in the joints, it can result in joint pain. You may notice joint pain is worse in the morning or after resting for prolonged periods.
The pain this disease causes is usually described as an aching, throbbing sensation.
Joint Stiffness
You may find certain joints are stiff and hard to move. If the condition targets the joints in your hand, you might have difficulty bending your fingers.
This stiffness can appear in any affected joints and hinder movement. As with joint pain, this symptom is more common after being inactive or first thing in the morning.
Swelling and Warmth
Rheumatoid arthritis causes the tissue lining in your joints to become inflamed. This can manifest as swollen, tender joints that can feel warm to the touch.
Redness
If your joints become severely inflamed, you might notice the affected areas turning pink or even red.
Redness usually accompanies flare-ups of joint pain, swelling and stiffness. (6)
Fatigue
Fatigue is frequently reported by individuals with rheumatoid arthritis. It is usually a result of persistent pain and inflammation caused by the disease.
However, fatigue can also be caused by disturbed sleep and lack of exercise. These are both potential side effects of the disabling nature of the condition. (7)
Sjogren’s Syndrome
Sjogren’s syndrome is an autoimmune disorder that commonly appears alongside rheumatoid arthritis.
The condition hinders the activity of mucus-producing glands which can result in dry, irritated eyes and mouth. (8)
Stages
Rheumatoid arthritis is a progressive disease and classified according to stages.
Symptoms become more debilitating as the condition worsens. Rheumatoid arthritis progresses as follows: (9)
Stage #0
Your immune system is not attacking your joint tissue. You are free from any symptoms of rheumatoid arthritis.
Stage #1
At this stage, initial inflammation of the joints begins to manifest. The tissue surrounding affected joints (joint capsule) becomes inflamed.
The synovial tissue, which lines the inside of your joint capsules, starts to swell. You will notice the telltale signs of an arthritic condition: pain, stiffness and swelling in the joints.
Stage #2
The synovial tissue is now swollen and inflamed enough to damage cartilage, a connective tissue.
Due to cartilage damage, you may witness an increased loss of mobility. Your range of motion might also become more limited.
Existing symptoms of pain, swelling and stiffness will get worse.
Stage #3
At stage 3, the disease is severe. Bones as well as joint cartilage are being damaged and destroyed.
You will likely experience more swelling and pain and visible deformity may appear on the affected areas.
Your ability to move might become even more restricted. Some individuals may start to lose muscle strength.
Stage #4
This stage is the final progression of rheumatoid arthritis. The inflammation process targeting your joints will halt. Yet, by now your joints will be severely damaged or destroyed.
However, as with stage 3, you will still continue to suffer from inflamed, swollen and stiff joints. Movement in the impacted areas will be difficult if not impossible.
Treatment
If you present any typical indicators of rheumatoid arthritis, your doctor will first perform a physical exam.
This is to check for swelling, warmth and tenderness in the joints as well as other physical symptoms.
A blood test will reveal the presence of antibodies which indicate rheumatoid arthritis. You may also receive an x-ray to check for joint damage.
Treatment aims to reduce symptoms and potential joint damage. The treatment for rheumatoid arthritis can include one or more of the following:
Diet and Exercise
Avoiding foods which provoke inflammation can reduce flare-ups of rheumatoid arthritis. These include heavily processed foods such as sugary snacks and fast food.
Exercise is a key aspect of self-care for rheumatoid arthritis patients. A physical therapist can work with you to improve your mobility and flexibility. (10)
Non-Steroidal Anti Inflammatory Drugs (NSAIDs)
Non-steroidal anti inflammatory drugs (NSAIDs) are used to alleviate symptoms. They can help to reduce pain and inflammation in your joints.
These medications include tablets and topical ointments and gels. They range from mild and non-prescription to stronger, prescription only drugs for more serious cases. (11)
Corticosteroids
Corticosteroids provide fast relief for inflammation. They can also regulate immune system activity. This helps to control autoimmune disorders like rheumatoid arthritis.
These encompass a wide range of drugs that can be administered in different ways. You may receive injections, tablets or ointments and gels.
However, corticosteroids can cause unpleasant side effects such as a weakened immune system. (12)
Disease Modifying Anti Rheumatic Drugs (DMARDs)
Disease modifying anti rheumatic drugs (DMARDs) restrict your immune system’s activity. They lessen the attacks that wear out your joints, lessening inflammation.
These drugs can take up to several months to begin working. In the meantime, your doctor may prescribe NSAIDs or corticosteroids to help you manage symptoms.
As certain DMARDs can have side effects, you will be subjected to blood tests before a treatment plan is determined.
For example, some DMARDs cannot be taken by pregnant women or those trying to conceive. (13)
Surgery
There are various types of surgeries to help patients with rheumatoid arthritis. The different procedures are depicted according to mild, moderate and severe damage.
Some surgeries, such as a synovectomy, are for individuals who have mild cartilage damage.
Other surgeries like arthroscopy are ideal for active patients under the age of 40. An arthroscopy repairs torn connective tissue and can restore mobility.
Certain surgeries are a last resort for people who are not responding to other treatment plans.
An example of one such procedure is a total joint replacement. Destroyed joints are replaced with artificial implants. (14)
FAQ
What is rheumatoid arthritis? Rheumatoid arthritis is a condition that results in inflammation of the joints. Over time, it can cause permanent joint damage.
What are the signs of rheumatoid arthritis? The signs of rheumatoid arthritis typically manifest as tender, swollen or stiff joints. You may also experience fatigue and fever.
How do you develop rheumatoid arthritis? Rheumatoid arthritis develops when your immune system begins to attack your joint tissue. The reason behind this self-attack is not completely understood by medical science.
What is the best treatment for rheumatoid arthritis? The best treatment for rheumatoid arthritis depends on what stage of the disease you are at. Treatments can include: modified diet, exercise, and anti inflammatory drugs. You may also receive corticosteroids, disease modifying drugs, or surgery.
What are the long term complications of rheumatoid arthritis? As the disease progresses, it can result in loss of movement and persistent pain due to joint inflammation. One in three individuals with a chronic arthritic condition are affected by depression.
Is rheumatoid arthritis considered a disability? If your rheumatoid arthritis is severe, you may qualify for disability. This includes suffering from deformed, inflamed joints and being unable to move normally. (15)
Is there any cure for rheumatoid arthritis? There is no cure for rheumatoid arthritis. However, there are numerous treatments to help manage the symptoms of the condition.
Is rheumatoid arthritis life threatening? Although rheumatoid arthritis can cause debilitating pain and loss of movement, it is not usually considered life threatening. However, amyloidosis is a rare complication of rheumatoid arthritis that can be fatal if untreated. It causes a dangerous buildup of protein in the body. (16)
Summary
Although rheumatoid arthritis is not fatal, it can be debilitating. The condition can limit your ability to perform daily tasks over time.
However, the earlier rheumatoid arthritis is caught the more aggressively it can be treated.
As a progressive disease, it will not get better or disappear with time. The longer you ignore potential symptoms, the greater the risk of irreversible joint damage.
If you suspect you have rheumatoid arthritis, schedule an appointment with your doctor as soon as possible. (17)