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Rheumatoid Arthritis

Overview and Facts

Rheumatoid arthritis is a chronic inflammation of the joints of the body. Each person is affected differently. There may be long bouts of inactivity with no pain at all, or there may be flare-ups, with constant pain and symptoms, for weeks or months at a time. RA, one of the most common forms of arthritis, causes eventual destruction to the joint’s bone and cartilage. Puffiness at the joint is caused by an accumulation of fluid or pus in the joints’ cavities. Deformities often occur with the gradual breakdown of the bone cartilage and tissue.

Signs and Symptoms

Symptoms vary for people affected with RA, but may include feelings of fatigue, stiffness, swelling, joint pain, and warmth or redness to the affected joint. Flu-like symptoms are often present and are characterized by general body aches, muscle pain and lack of appetite. Occasionally, painful nodules are noticed just under the skin, especially in the elbow area. There is often so much stiffness, especially in the morning, that the joints cannot function properly. This stiffness may last for a short period or continue throughout the day. The knees, wrists, hands, spinal column and jaw are the joints most often affected. Typically RA occurs simultaneously to the same joints on either side of the body. Daily tasks become difficult to perform as range of motion becomes noticeably decreased. Walking can be painful or impossible, often requiring a walker or wheelchair.

Causes and Diagnosis

Some possible causes of RA are rheumatic fever, pneumonia, influenza, and infections of the tonsils and teeth. Trauma induced arthritis may occur when there has been a severe injury to a joint. The aging process may also produce arthritic-like symptoms with noticeable swelling, pain and deformity in the joints. Diagnosis can be difficult since symptoms vary greatly from person to person. There are seven general factors that physicians take into consideration when diagnosing rheumatoid arthritis. If four or more of the following have been present for several weeks, RA is suspected.

• Joint stiffness for one hour or more in the morning
• Swelling affecting three or more joints at the same time
• Presence of a swollen joint
• Symmetrical arthritis (same joints affected on either side of the body)
• Rheumatoid nodules
• Blood test showing an unusual rheumatoid factor
• Changes from original baseline x-rays of affected joints showing a progression of the disease

Tests and Treatments

RA responds best to early diagnosis and treatment in order to successfully prevent the continued destruction of the bones and joints. While a complete reversal is not possible, the progression of the disease can be halted, or, at least, slowed down. A physician will take into consideration the patient’s history and perform a physical exam. Lab work can determine whether there is inflammation in the fluid of the blood or joints. X-rays will pinpoint any deformities and successive x-rays will show the progression of the disease.

Helpful Tips and Home Remedies

The pain associated with RA may be relieved by the use of an analgesic medication such as acetaminophen or tramadol. These medications do not reduce the inflammation, however. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen tend to be more successful at reducing both the pain and the inflammation. Disease-modifying antirheumatic drugs (DMARDs) help to suppress the overactive immune system which adversely affects the joints in RA. These drugs can slow or halt the progression of RA, but also tend to hinder the body’s ability to ward off other types of infections. Genetically engineered proteins (biologics) are among the newer and more successful treatments for RA. Surgery may be recommended to repair deformed joints. As an alternative or addition to medication or surgery, it has been shown that simple, repetitive exercises can strengthen the joint muscles and increase the range of motion. Swimming is an exercise that is easy on the body, but is very effective at strengthening the joints and muscles. Heat applied to the affected areas may relieve the stiffness and help minimize the pain. Cold packs tend to reduce the swelling. The use of a sturdy cane or a walker will reduce pressure on the joints and allow for more stable walking and less chance for falls to occur. Weight loss for the overweight person will reduce the pressure on the weight-bearing limbs and joints and further reduce the risk of increased injury.
Rheumatoid arthritis has numerous causes, many of which are not easily determined. While there is no cure, there are steps that can be taken to minimize the pain and inflammation. Early detection is key to successful treatment. A proper diagnosis and follow-up by a medical professional is important to continued care and relief.