There are many different types of conditions that can cause chronic pain. Rheumatoid arthritis (RA) is certainly a challenging one. As one of the many types of arthritis, it can cause joint pain, swelling and stiffness. But what is rheumatoid arthritis exactly? How do you manage it if you’re diagnosed? Understanding the symptoms, causes and management techniques of RA can help you to live a more fulfilling life with this disease.
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is an autoimmune disease that causes the body’s immune system to mistakenly attack your joints. Typically, your body attacks foreign bacteria and viruses. But when you have RA, your body causes inflammation in your joints, resulting in both swelling and pain.
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. The pain you experience is a result of inflammation rather than joint wear and tear.
What are the symptoms of rheumatoid arthritis?
People with rheumatoid arthritis may not initially see swelling in their joints, but rather notice both tenderness and pain. Common RA symptoms include:
- joint tenderness and pain that lasts for 6 weeks or more
- stiffness during the mornings that lasts 30 minutes or longer
- pain and tenderness in more than one joint and often in the same joints on both sides of the body
Typically, early stages of rheumatoid arthritis affect smaller joints. This includes the joints in your hands and feet. As RA progresses, it may also affect larger joints such as elbows, wrists, knees, hips and shoulders.
In addition to the symptoms above, you may experience a loss of appetite and fatigue. You may even develop a low fever.
Rheumatoid arthritis symptoms can come and go. When you experience a period of increased inflammation and other symptoms, you are said to be experiencing a “flare.” Flares can last for days or even months at a time.
Keep in mind that RA is a systemic autoimmune disease. This means 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:
- Skin: you may develop small lumps under your skin that appear over bony areas of your body
- Eyes: you may experience light sensitivity, dryness, redness, and vision impairment
- Lungs: shortness of breath may be caused by inflammation
- Mouth: you may have dry mouth and gum irritation
- Blood vessels: your blood vessels can become inflamed, causing nerve and skin damage
- Blood: reduced red blood cells can cause anemia
As with any condition, RA affects people differently and at varying levels of severity.
What are the long-term effects of rheumatoid arthritis?
It’s important to treat RA promptly, as inflammation can cause damage if left untreated. Chronic inflammation from RA can damage the cartilage that covers the ends of the bones in your joints. This inflammation can cause a loss of cartilage, and gradually the space between your bones in your joints can become smaller. As your joints are altered, they can become loose, painful, and unstable. You may experience reduced joint mobility and joint deformity.
This damage to your joints is permanent, so it’s important to find a doctor who will aggressively treat rheumatoid arthritis.
Common complications of rheumatoid arthritis
So what is rheumatoid arthritis going to mean for your overall health? The disease can cause several complications. If you have RA, you’ll be at an increased risk of developing chronic diseases such as heart disease and diabetes. If you smoke or are overweight, your doctor will tell you to stop smoking and lose weight in order to lower your risk of developing heart disease.
Rheumatoid arthritis can also affect your quality of life and your ability to hold a job. As RA progresses, you may find that you cannot work as much or as well as you once did. This is especially true if your job is physically demanding. You may need to explore options such as a reduced workload or a career change.
Working with a doctor who can help you create a management plan for your RA can help to reduce the risks of these complications.
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 the cause. 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, though men are more likely to develop RA later on in their lives. People with a family history of RA have a higher risk of developing the disease, but you can still develop RA even if no one in your family has it.
There are also a number of RA risk factors to be aware of. You may be at an increased chance of developing rheumatoid arthritis if:
- You smoke: multiple studies have identified that smoking increases the chances of developing RA, and also makes RA worse.
- You’re a woman who has never given live birth: women who haven’t given live birth may be at a greater risk of developing the disease than women who have given live birth.
- You’re overweight or obese: studies have shown that the more overweight a person is, the greater the chances of their developing RA.
- You were exposed to particular early life situations: studies have shown that children whose mothers smoked faced an increased risk of developing RA later on in life.
You shouldn’t live in fear of RA. But it’s important to understand what rheumatoid arthritis is and know if you’re particularly at risk for the disease. This knowledge can help you to spot RA earlier on if it occurs.
How is rheumatoid arthritis diagnosed?
Because RA symptoms are similar to the symptoms of many other conditions, it can be difficult to get an accurate diagnosis, especially in the early stages of the disease. 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.
Treating rheumatoid arthritis
Your doctor can prescribe medications that slow the progression of RA and help to prevent joint damage. NSAIDs can also help to reduce the pain and inflammation caused by RA. You may find relief from patches or creams that you can apply directly to a painful, swollen joint.
In some cases, surgery may help to restore function and alleviate pain in damaged joints. If you do have joint replacement surgery, the surgeon will replace damaged parts of your joints with metal or plastic fabricated pieces. This surgery is most often performed on the hips, but can also be performed on the:
- and more
You may never need surgery, but it is an option for damaged joints.
Self-management strategies such as maintaining your physical activity, watching your weight and avoiding repetitive motions also play a role in treating RA. By staying active and implementing some practices that help to reduce the effects of RA, you can reduce your pain so that you can live a more fulfilling life with RA.
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This post has been updated as of March 2019 with new information and resources.