Rheumatoid arthritis is an autoimmune disease. The immune system attacks the membrane lining the joints, causing pain, stiffness, swelling, and loss of function in the joints. There is no known cure. However, remission can occur for long periods of time.
Symptoms of RA
Rheumatoid arthritis symptoms can vary in degree and severity. Common symptoms include joint pain, joints that are tender to touch, joint swelling, fatigue, red and puffy hands, fever, weight loss, morning stiffness that lasts for hours, and firm bumps of tissue under the skin of the arms.
Rheumatoid arthritis generally starts out affecting your smaller joints first. Wrists, hands, feet, and ankles are common areas affected. When the disease starts to progress, knees, hips, shoulders, elbows, jaw, and your neck can be prone to RA.
Symptoms of rheumatoid arthritis vary in severity. The symptoms may come and go. Remission can occur for long period of times with flare-ups of the disease occurring at any time.
Causes and Testing
The cause of rheumatoid arthritis is unknown. Physicians do not know what starts the process of the immune system attacking the lining of the membranes surrounding your joints. According to the Mayo Clinic, a genetic component appears likely. Genes in general are not the cause, but certain genes can make you more susceptible to different environmental factors that could trigger this disease.
Testing for RA is not available by one certain test or physical exam. Patients with RA typically have an elevated erythrocyte sedimentation rate. Certain blood tests can look for a rheumatoid factor and anti-cyclic citrullinated peptide antibodies.
The American College of Rheumatology has a set criteria for diagnosing RA. There are seven criteria that include, morning stiffness, arthritis of hand joints, symmetric arthritis, arthritis of three or more joints, serum rheumatoid factor, rheumatoid nodules, and radiographic changes. A patient must have four of the seven criteria and the first four mentioned criteria must be ongoing for at least a six week time period to be given the diagnosis of rheumatoid arthritis.
Treatment of Rheumatoid Arthritis with Medications
Treatment for rheumatoid arthritis will depend on the severity of the disease and the symptoms. The first line of treatment is non-steroidal anti-inflammation drugs (NSAIDs). These medications can start off being over-the-counter with ibuprofen and naproxen sodium. However, the majority of patients, due to the severity of their symptoms, will eventually require a stronger prescription NSAIDs. This medicine works by helping with pain and reducing inflammation. Steroids such as prednisone and Medrol can help reduce inflammation, ease pain, and slow joint damage. Disease-modifying anti-rheumatic drugs (DMARDs) help to slow the progression of RA and help save joints and other tissues from permanent damage. Immunosuppressant medications tame your immune system, which has become out of control due to the RA. TNF-alpha inhibitors work to reduce morning stiffness, help with pain, and helps reduce tender or swollen joints.
The physician, generally a rheumatologist, will be able to determine which medications will work best for the treatment of rheumatoid arthritis.
Surgical Options for Treatment of RA
Rheumatoid arthritis can cause joint damage and deformities. Medication alone may not work to prevent or slow joint damage. If this occurs, a physician may indicate that surgery is necessary to restore the ability to use the affected joints.
Surgery can consist of several options including a total joint replacement, tendon repair, removal of the joint lining, or joint fusion. Surgical options will depend on the degree of damage to joints.
Rheumatoid Arthritis Facts
Rheumatoid arthritis commonly begins between the ages of 40 to 60 years old. However, it can occur at any age. If there is a family history of RA, there is an increased risk of the disease. Smoking increases the risk of developing RA.
Women are more likely than men to develop rheumatoid arthritis.
References:
Mayoclinic.com, "Rheumatoid Arthritis" (accessed February 23, 2010)
National Institute of Arthritis, "Rheumatoid Arthritis" (accessed February 23, 2010)
Sandra Blake - Sandra resides in Ohio. She attended the Academy of Health Sciences and Columbus State. She has years of experience in health information ...
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