There are many different types of conditions that can cause chronic pain. For people living with rheumatoid arthritis, pain, swelling and stiffness are common problems. Rheumatoid arthritis (RA) is an autoimmune disease that causes the body’s immune system to mistakenly attack normal tissues. Rheumatoid arthritis occurs in your joints, but it can also occur throughout the body.
Rheumatoid arthritis is different than osteoarthritis. Generally, osteoarthritis occurs because of wear and tear damage to joints. Rheumatoid arthritis on the other hand, affects the lining (tissue) of your joints and creates chronic inflammation.
What are the Symptoms of Rheumatoid Arthritis?
Typically, early stages of rheumatoid arthritis affect smaller joints, such as the joints in your hands and feet. As RA progresses, it may also affect larger joints, such as elbows, wrists, knees, hips and shoulders. RA usually affects the same joints on both sides of the body as well.
Common RA Symptoms include:
- Tender, warm or swollen joints
- Stiffness in the joints (especially in the morning or after inactivity)
- Weight loss
Keep in mind that RA is a systemic autoimmune disease, meaning that it often affects the entire body. For many people, RA affects more than just their joints.
Other Non-Joint Areas that May be Affected by RA include:
- Salivary glands
- Nerve tissues
- Bone marrow
- Blood vessels
As with any condition, RA affects people differently and at varying levels of severity. People with RA often go through times where their symptoms are worse than usual, which is called a flare-up.
What Causes Rheumatoid Arthritis?
Doctors aren’t exactly sure what starts the RA process. However, many believe that a genetic component may be part of it. Even though your genes don’t cause RA, they may make you more susceptible to environmental factors, such as viruses, infections or trauma, that may trigger the disease to develop.
RA can develop at any age, but it most commonly begins between 40 and 60 years old. Women are more likely to develop RA than men. However, RA can occur in both men and women. People with a family history of RA have a higher risk of developing the disease.
How Is RA Diagnosed?
In the early stages of RA, it can be difficult to get an accurate diagnosis. This is because the symptoms of RA are similar to the symptoms of other conditions. In addition, there isn’t one blood test or physical finding to confirm an RA diagnosis.
In order to diagnose RA, your doctor may take a detailed family history, perform a physical exam and order various lab tests, such as blood work. These blood tests might include sedimentation rate (ESR or sed rate), C-reactive protein (CRP), rheumatoid factor and others. These tests help doctors see how much inflammation or inflammatory markers are present in the blood.
Your doctor may also order imaging tests, such as X-rays, MRI scans, CT scans or ultrasounds. These tests help your doctor see if any joints are affected or how severely they are affected. Your doctor will monitor your imaging tests and blood tests over time as well.
How Is RA Treated?
While your primary care doctor may help in the discovery or diagnosis of RA, a rheumatologist is a doctor who specializes in autoimmune conditions. Often, your primary care doctor will send you to a rheumatologist for confirmation of the diagnosis and the best course of treatment.
Because RA affects everyone differently and at different levels of severity, you and your doctor will work together to develop an individualized treatment plan. Your treatment plan may include special types of medications, lifestyle modifications and alternative therapies. While there isn’t a cure for RA, the goal of your treatment plan is often to reduce the severity and frequency of your symptoms and to help you manage your RA.
- NSAIDS—Nonsteroidal anti-inflammatory drugs are often prescribed for people with RA. These medications help to reduce inflammation and relieve pain.
- Steroids—Sometimes, your doctor may prescribe steroids to help reduce inflammation and pain as well as slow joint damage. These may come in pill form, or your doctor may give you an injection into an affected joint.
- DMARDs—Disease-modifying anti-rheumatic drugs can help slow the progression of RA as well as slow or stop further joint damage. Common types of DMARDs include methotrexate, hydroxychloroquine, leflunomide and sulfasalazine.
- Biologic agents—Biologics are also known as biologic response modifiers, and these medications have the ability to target certain parts of the immune system that cause inflammation. Common biologic agents include adalimumab, abatacept, anakinra, etanercept, golimumab, infliximab, tofacitinib and others.
Many people living with RA also have to modify their lifestyle. Staying active is important when you have RA, but it can be hard to stay active when you’re in pain. Your doctor may send you to a physical therapist to help you learn gentle exercises and stretches you can do at home.
Your doctor may also send you to an occupational therapist to help you learn new techniques to make living your life easier. These might include using assistive devices like electric jar openers, Velcro shoes instead of laces, hook and loop fasteners instead of buttons, a cane and more.
Sometimes alternative therapies, like acupuncture, yoga, Tai Chi, relaxation massage and seeing a chiropractic physician can also help relieve pain and promote relaxation. Whether you’ve had rheumatoid arthritis for a long time or you’re newly diagnosed, it’s important to learn all you can about your condition, ask your doctor questions, follow your treatment plan and see your doctor regularly.