Rheumatoid arthritis is an autoimmune disorder that affects 1.5 million people in the United States, according to the Arthritis Foundation. This chronic disease occurs when your body’s immune system attacks its own healthy cells, causing inflammation, swelling, pain and stiffness that can be severe. Most commonly affected is the lining of the joints in the hands, wrists and knees, although rheumatoid arthritis can cause damage to other tissues and parts of the body as well.
What Causes Rheumatoid Arthritis?
Our immune system usually works to protect us against foreign substances in the body, but in the case of rheumatoid arthritis, an abnormal response causes the immune system to target the body’s own tissues. The resulting inflammation leads to a thickening and painful swelling of the tissue inside the joints, called the synovium. If untreated, the inflammation of rheumatoid arthritis can permanently damage the tissue and joint.
It’s not known specifically what causes this condition to occur, but there are several factors that may increase the risk of developing rheumatoid arthritis or making it worse:
- Gender (the Arthritis Foundation reports that 70 percent of people with rheumatoid arthritis are women)
- Advancing age
- Exposure to environmental toxins and pollutants
- Physical or emotional stress
What Are the Symptoms of Rheumatoid Arthritis?
Symptoms often begin slowly and affect patients differently, but joint pain is a primary complaint of rheumatoid arthritis. The inflammation of the synovium makes joint movement difficult and uncomfortable. Common symptoms of rheumatoid arthritis include:
- Stiffness in the joints, especially in the morning or after periods of rest, that can last for hours
- Joint swelling, tenderness and redness
- Loss of joint function
- Bumps called rheumatoid nodules that appear under the skin over inflamed joints
- Excessive fatigue
- Low-grade fever
- Loss of appetite
Symptoms usually are most noticeable in the smaller joints of the fingers, hands and feet in the early stages, but can spread to the wrists, elbows, knees, ankles, shoulders and hips. In fact, symptoms often are present in multiple joints at the same time. This disease is considered symmetrical, meaning if a joint on one side of the body is affected, the other side tends to be affected as well.
Rheumatoid arthritis can also affect other parts of the body that do not involve the joints, including the skin, eyes, lungs, heart, blood vessels, nerves and kidneys. Another autoimmune disease that often accompanies rheumatoid arthritis is called Sjögren’s Syndrome. It attacks the glands that make tears and saliva, causing dry eyes and dry mouth.
The severity of rheumatoid arthritis symptoms often fluctuates. Periods of worsening inflammation and pain, called flares, are common and may last for months. At other times, rheumatoid arthritis patients may experience remissions and have no symptoms at all.
How is Rheumatoid Arthritis Diagnosed?
Rheumatoid arthritis can be tricky to diagnose in the early stages because its initial signs can suggest many possible conditions. That said, early diagnosis is key to limiting the damaging effects of rheumatoid arthritis. When you visit your doctor or rheumatologist, be sure to discuss your symptoms in detail, and provide your personal and family medical history as fully and accurately as you can.
How is Rheumatoid Arthritis Treated and Managed?
Unfortunately, rheumatoid arthritis does not yet have a cure. The primary goals for treatment are to decrease pain and inflammation, minimize or prevent joint damage, and continue with normal daily activities as much as possible. Treatment typically includes medications and managed self-care that includes rest, exercise and a healthy diet.
Common medications to treat rheumatoid arthritis include:
- DMARDs: Disease-modifying antirheumatic drugs block your body’s immune system response, helping to slow the progression of rheumatoid arthritis and the resulting joint damage. They also can help relieve your symptoms.
- Biologics: Biologic response modifiers target specific parts of the immune system that cause inflammation. Biologics are often effective for patients who don’t respond as well to DMARDs, or both medications may be used as a combination.
- NSAIDs: Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen, can relieve pain and reduce inflammation.
- Corticosteroids: Typically used short term to avoid side effects, medications such as prednisone can be fast and effective at reducing inflammation.
Other therapies that can help manage the effects of rheumatoid arthritis include:
- Physical activity: Your doctor will advise gentle, low-impact exercises for range of motion, strengthening and flexibility, not to mention better overall health and a more positive outlook. A physical therapist can help customize a routine for you.
- Rest: Although it’s important to stay active regularly, you need a balance. Listening to your body and taking it easy during a flare will help you battle inflammation and fatigue.
- Hot and cold therapy: Heat is recommended to treat stiff, aching joints; cold is effective for swelling and acute pain.
- Weight management: Keeping extra weight off inflamed joints will help with mobility and pain.
- Diet: Foods that are high in antioxidants and omega-3 fatty acids have been shown to fight inflammation, which is fueled by unhealthy processed and fast foods.
- Surgery: If medication is not effective or if bone damage is advanced, surgery such as joint replacement may be an option to restore function to the affected joints.
What Happens If Rheumatoid Arthritis Is Left Untreated?
If left untreated, the cartilage covering both ends of the joint, which acts as a shock absorber, begins to wear away as a response to the inflammation. This can lead to joint deformities, shifting and possible erosion. Over time, the muscles, ligaments and tendons supporting the joint begin to weaken. The combination of these factors results in pain that can sometimes be severe and debilitating.
Getting the Right Care and Support
Learning you have a chronic disease like rheumatoid arthritis can be a shock. But with recent advancements in treatments and a greater understanding of the disease – as well as a strong support system and regular communication with the doctor – many patients are able to maintain a positive quality of life.
If you are suffering from joint pain and would like to consult with us, please call 913-319-7600. New patients and established patients with new conditions can make appointments anytime using our online scheduling tool.
About the Author
Charles E. Rhoades, M.D., is a board-certified orthopedic surgeon specializing in conditions of the hand and upper extremities. His other areas of expertise involve the shoulder and sports injuries of the knee.
The medical information contained in the Dickson-Diveley Orthopaedics website is provided to increase your knowledge and understanding of orthopedic conditions. This information should not be interpreted as a recommendation for a specific medical or surgical treatment plan. As each patient may have specific symptoms or associated problems, the treatment regimen for a specific patient may not be the proper treatment for another.
Gaining knowledge and understanding of a particular problem or condition is the first step in any medical treatment plan. I believe the information presented on our website will be helpful for those individuals experiencing ankle pain, or other related problems. However, this information is not intended to replace the advice of your family physician. You are encouraged to consult with your physician to discuss any course of treatment presented or suggested.