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OVERVIEW

What is rheumatoid arthritis?

Rheumatoid (say: “roo-mah-toyd”) 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

What are the symptoms of RA?

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

How can I tell if I have RA?

The hands, wrists, feet and knees are usually the first joints affected. RA usually affects several joints at the same time, on both sides of your body. For example, both of your wrists may be painful and stiff. Over time, it may also affect larger joints, such as your jaw, shoulders and hips.

DIAGNOSIS & TESTS

How can my healthcare provider tell if I have RA?

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.

TREATMENT

How is RA treated?

Medicines you can buy without a prescription that reduce inflammation, such as aspirin, ibuprofen (one brand name: Motrin) or naproxen (brand name: Aleve), or relieve pain, such as acetaminophen (one brand name: Tylenol), can help you feel better. Your healthcare provider can also prescribe medicine for you, such as prescription pain relievers or prescription nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines reduce pain and swelling, but they do not slow the damage to your joints. These medicines should be used wisely. You only need the amount that makes you feel well enough to keep moving. Using too much medicine may increase the risk of side effects.

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.

If you have only a few sore joints, your healthcare provider may prescribe steroids (such as prednisone). Steroids reduce pain and swelling and slow the damage to your joints, but they can only be used for a little while. The longer steroids are used (many 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 (say: “anti-roo-mat-ick”) medicines can help fight RA. If these medicines are started early enough, they can slow the damage to your joints. These medicines work slowly, and it can 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 are pregnant. Your healthcare provider may talk to you about birth control before you use any anti-rheumatic medicines.

Surgery may be an option for cases of RA that are not effectively treated with medicine. Surgery can help you regain joint movement, ease pain and correct deformities caused by RA. Ask your healthcare provider about the benefits and risks of surgery.

Contact your healthcare provider about all the treatment options for RA.

Can RA be cured?

RA is a lifelong disease. Sometimes, if it’s treated, it will 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.

What can I do to care for myself if I have RA?

Regular, gentle exercise 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. Losing weight if you are overweight and eating a healthy diet can also help RA.

In order to lessen the stress on affected joints, you can use devices to help you do everyday activities. Grabbing tools can help you pick items up. Canes can make walking easier. Ask your healthcare provider about the tools that are available to make your daily life easier.

To ease pain, you can also apply heat or cold to your painful joints. Heat relaxes tense muscle and cold can numb pain.

An easy way to apply heat is to take a 15-minute hot shower or bath. Cold packs or soaking joints in cold water are effective ways to apply cold treatment. However, you should not use these methods if you have poor circulation.

What can I do?

• Exercise regularly.
• Lose weight if you are overweight.
• Eat a healthy diet.
• Use heat to reduce pain and stiffness (such as a hot shower or a heating pad).

COMPLICATIONS

What other problems can RA cause?

RA can cause other health problems. Your hands may become bent or twisted (deformed). Lung and heart problems may also occur. Contact your healthcare provider if you notice any new symptoms or problems.

QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER

• How is rheumatoid arthritis treated?
• What can I do to relieve swelling and pain in my joints?
• What causes rheumatoid arthritis?
• What medicines might treat this condition?
• What if my symptoms come back?

FOR MORE INFORMATION

The Arthritis Society:  
https://www.arthritis.ca/

Sources

Diagnosis and Management of Rheumatoid Arthritis by JA Rindfleisch, D Muller (09/15/05, http://www.aafp.org/afp/20050915/1037.html)