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OVERVIEW

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is an autoimmune disease that causes inflammation and pain in your joints. It can also affect other parts of your body, such as the lining of your heart and lungs.

SYMPTOMS

Rheumatoid arthritis often occurs in your hands, wrists, feet and knees are usually the first. It can affect several joints at the same time, on both sides of your body. For example, both of your wrists may be painful and stiff. The joints of the fingers and toes can be some of the first places that have pain and stiffness.  Over time, it may also affect larger joints, such as your jaw, shoulders and hips.

Symptoms of RA may include one or more of the following:

• Painful and swollen joints, especially in your hands, feet and knees
• Difficulty moving joints
• Stiffness and pain in affected joints (especially after sleeping)
• Fever
• Red, puffy hands
• Fatigue
• Hard bumps (called rheumatoid nodules) just under the skin near the joints
• Loss of appetite

CAUSES

What causes RA?

Rheumatoid arthritis is a form of arthritis and a type of autoimmune disease. It occurs when the body’s immune system attacks its own joint tissue. The exact cause of this is unknown.

DIAGNOSIS & TESTS

How is RA diagnosed?

Your healthcare provider will ask you about your symptoms and may give you a physical exam. They may also order blood tests, a joint fluid analysis (which tests the fluid in your joints for other possible causes of your pain) and X-rays to help make a diagnosis.

PREVENTION

Can rheumatoid arthritis be prevented or avoided?

You can’t prevent or avoid rheumatoid arthritis since its cause is unknown. However, you may increase your chances of developing RA if you:

• Are older
• Are a woman
• Are a smoker
• Are overweight
• Have a family history of RA

TREATMENT

Treatment of rheumatoid arthritis aims to relieve symptoms, reduce pain, prevent future damage, and improve quality of life. Talk to your healthcare provider about treatment options. They can help you decide which is best for you. Options include medicine, surgery, and lifestyle changes.

Medicine

 For mild cases of RA, your doctor may suggest taking over-the-counter (OTC) medicines to reduce inflammation. These include aspirin, ibuprofen (one brand name: Motrin) or naproxen (brand name: Aleve)., Medicines such as acetaminophen (one brand name: Tylenol), can help relieve pain and make you feel better. Your healthcare provider can also prescribe medicine to help treat RA. Prescription pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs)are used to reduce pain and swelling. These medicines do have some side effects and should be taken wisely.

Medicines that manage your immune system (called immune-suppressants) can also be used to fight RA. When you have RA, your immune system is out of control. These drugs bring it back to normal. However, these medicines can lower your immune system’s response to infections.

Your healthcare provider may also prescribe a steroid such as prednisone. Steroids can reduce pain and swelling while slowing damage to your joints. However, they can only be used for a brief time. The longer steroids you use steroids (several months or years), the less effective they become. They can also cause side effects, such as easy bruising, bone thinning, cataracts and diabetes.

Anti-rheumatic medicines can help treat RA. If you start taking these drugs early enough, they can slow the damage to your joints. These medicines work slowly, and it may take a few weeks to start feeling better. Your healthcare provider may do a blood test to make sure these medicines are safe for you. Some of these medicines should not be taken if you’re pregnant.

Surgery

For severe cases of RA or cases not effectively treated with medicine surgery may be an option. Procedures may include correcting a deformity or replacing a joint. Knee and hip replacements are most common. The effects of surgery can help to ease pain and regain joint movement. Ask your healthcare provider about the benefits and risks of surgery.

Lifestyle Changes

There are lifestyle changes you can make to help manage RA.

• Lose weight if you are overweight.
• Eat a healthy diet.
• Stop Smoking
• Do regular, gentle exercise. This can strengthen the muscles around your joints and relieve fatigue. Mild water aerobics or walking are good exercises to start with. Stop if you feel pain in a new joint while exercising. If the pain does not get better, you should contact your healthcare provider.
• Use heat and cold. Heat relaxes tense muscle and cold can numb pain.  One way to apply heat is to take a 15-minute hot shower or bath. Cold treatments include ice packs or soaking your joints in cold water. Don’t use these methods if you have poor circulation.
• Reduce the stress on your affected joints. For instance, canes can help you walk. Consider using grabbing tools to help you pick up items. Ask your doctor about other ways to make your daily life easier.

Living with rheumatoid arthritis

RA is a lifelong disease. When it’s treated, it may go away for a little while, but it usually comes back. It is important to contact your healthcare provider as soon as you begin to experience symptoms.  The earlier you start treatment, the better your outcome. Some of the damage from RA is irreversible, so finding the disease and treating it early is important.

If left intreated, RA can cause other health problems. Your hands may become bent or twisted.  Other joints can become deformed. Inflammation will affect your cartilage and bones.  Lung and heart problems may also occur. Contact your healthcare provider if you notice any new symptoms or problems.

FOR MORE INFORMATION

The Arthritis Society 

https://www.arthritis.ca/