Rheumatoid Arthritis Overview
Rheumatoid arthritis (RA) is an inflammatory disease that affects the immune system that is designed to protect the body by attacking foreign substances like viruses or bacteria. The normal action of the immune system is affected when the autoimmune disease mistakenly attacks the joints. The body responds by creating information in the synovium (the tissue inside joints) causing them to thicken, swell and create pain. This reduces the synovium action of creating fluid to lubricate the joint system to allow to move smoothly.
Without treatment, the information can cause severe damage to bones and cartilage that covers the joint bone. Eventually, the loss of cartilage will minimize the spacing between the joint bones until they become unstable, loose and extremely painful. At this point, the joint loses much of its mobility and begins to deform. If the disease is left to progress to this point, the damage caused by rheumatoid arthritis cannot be reversed.
Many individuals who suffer from rheumatoid arthritis have affected knees, elbows, wrists, feet, hands, and ankles. Usually, the disease affects the body symmetrically meaning it affects both hands, both knees, both ankles, and so on. Rheumatoid arthritis is a systemic disease. This means it affects many body systems including the respiratory and cardiovascular system.
- Who Is at Risk for Rheumatoid Arthritis?
- Common Symptoms
- Diagnosing Rheumatoid Arthritis
- Rheumatoid Arthritis Treatments
Who Is at Risk for Rheumatoid Arthritis?
According to the CDC (Centers for Disease Control and Prevention), more than 1.5 million individuals in America suffer from rheumatoid arthritis, where women are three times more likely to develop the disease compared to men. Most commonly, room a tort arthritis begins to develop in women between 30 and 60 years of age. Men tend to develop RA much later in life. The major known risk factors associated with rheumatoid arthritis include:
- Age – While anyone can develop rheumatoid arthritis at any age, individuals tend to develop the disease after the age of 30.
- Smoking – The use of cigarettes and other tobacco products are known to increased potential risk of developing rheumatoid arthritis, especially if the individual is genetically predisposed to developing the condition. In addition, smoking tends to exacerbate the severity of the disease once it has been acquired.
- Gender – Men are less likely to develop rheumatoid arthritis compared to women.
- Family History – Having a family history of rheumatoid arthritis can increase the potential risk of the individual developing it too.
- Obesity – People who are obese or overweight have a somewhat higher risk of developing the condition, especially women who were often diagnosed with the disease when they were 55 years or younger.
- Exposure to Environmental Substances – Scientists have yet to determine exactly why, but exposure to harmful substances including silica and asbestos are known to increase the risk of developing the disease. First responders to fires or collapsing buildings are also at greater risk of developing an autoimmune disease including RA.
Rheumatoid arthritis is known to create certain complications either during its onset or later in life. Individuals with rheumatoid arthritis can develop:
- Osteoporosis – The disease and the medications used to treat the disease are known to increased potential risk of developing osteoporosis, where the bones become weakened and prone to fracture.
- Infections – Research indicates that rheumatoid arthritis in the drugs used to treat the disease likely impair the body’s immune system, which can cause infections.
- Rheumatoid Nodules – Bumps and lumps of tissue can form nodules around the body’s pressure points or deep within the organs, including in the lungs.
- Dry Mouth and Dry Eyes – Sjogren's symptom is a serious side effect of rheumatoid arthritis where the moisture in the mouth and eyes decrease significantly.
- Carpal Tunnel Syndrome – Rheumatoid arthritis can cause significant inflammation that compresses the wrist nerves that provide electrical energy to the fingers and hands.
- Abnormal Body Composition – Individuals with rheumatoid arthritis can develop an abnormal body composition where lean muscle mass is overwhelmed by stored fat, even in individuals with a normal BMI (body mass index).
- Lung Disease – Rheumatoid arthritis is known to cause scarring and inflammation of lung tissues which can progressively lead to shortness of breath.
- Heart Issues – Blocked and hardened arteries are serious side effects of rheumatoid arthritis as is inflammation of the pericardium (the sac enclosing the heart).
- Lymphoma – Individuals with rheumatoid arthritis are more at risk of developing lymphoma, which are blood cancers that begin in the lymph system.
The most common symptoms associated with rheumatoid arthritis include:
- Unexpected weight loss
- Swollen, warm, and/or tendered joints
- Joint stiffness especially when inactive
In its initial stage, rheumatoid arthritis primarily affects smaller joints including the toes and fingers. Over time, the symptoms will move outwards to the ankles, knees, wrists, elbows, shoulders, and hips. The symptoms nearly always occur symmetrically where the same joints on both sides of the body display the same symptoms.
Approximately four out of every ten individuals suffering from rheumatoid arthritis experience symptoms in an area other than the joints. These could include:
- Eyes and Skin
- Heart and Lungs
- Salivary glands
- Bone marrow
- Blood vessels
- Nerve tissue
Many of the symptoms can increase in severity or disappear altogether over time. Most individuals will experience flare-ups, where the activity of the disease runs rampant before alternating into remission. As the disease progresses, it can cause the joints to deform to the point where the joint moves out of place.
Diagnosing Rheumatoid Arthritis
No single test has yet been developed to accurately diagnose RA. This makes it challenging for doctors to identify the condition. This is because many of the symptoms associated with rheumatoid arthritis mimic other diseases. Instead, the doctor will perform a comprehensive physical examination and check the joints to detect warmth, redness, and swelling. The joints reflexes and muscle strength will be evaluated before imaging tests and blood tests are ordered.
- Imaging Tests – Ultrasound, X-rays, and MRIs (magnetic resonance imaging) scans can provide detailed visual images of the joints to determine the progression of RA and the severity of the condition in the body.
- Blood Tests – The doctor may order blood tests to look for C-reactive protein or an elevated erythrocyte sedimentation rate to verify that inflammation is occurring in the body. Results of an anti-cyclic citrullinated peptide antibiotic can validate the presence of a rheumatoid factor.
Rheumatoid Arthritis Treatments
Scientists have yet to find a cure for rheumatoid arthritis. However, in recent years, new advancements in medical technology have shown considerable progress in keeping it in remission. Doctors will often treat the condition using:
- Medications including nonsteroidal anti-inflammatory drugs (NSAIDs) steroids and disease-modifying antirheumatic drugs (DMARD) that often produce serious side effects including own marrow suppression, liver damage, and severe lung infections.
- Biological agents that target the immune system to stop triggering inflammation in the joints and cause significant damage to the surrounding tissue.
- Occupational or Physical Therapy to keep the joints flexible.
- Surgical procedures including joint fusion, tendon repair, total joint replacement, or synovectomy where the synovium (lining of the joint) is removed to eliminate inflammation.
There are also alternative procedures, medicines, and supplements including plant oils and fish can minimize many of the signs and symptoms associated with rheumatoid arthritis.