All forms of arthritis exhibit joint pain, inflammation and stiffness, but rheumatoid arthritis sets itself apart in many ways. Unlike the most common form of arthritis—osteoarthritis—rheumatoid arthritis is an auto-immune disorder in which your own immune system attacks joint tissue.  This can cause loss of cartilage over time resulting in joint instability and loss of mobility.

In the United States, almost 1.5 million people have rheumatoid arthritis, with this disease afflicting three times as many women as men.  The cause of rheumatoid arthritis remains unknown, but it is suspected that genetics and environment play key roles in its onset and progression. If you or someone you know suspects that they may have rheumatoid arthritis, you should visit a physician as soon as possible so that you can learn about rheumatoid arthritis symptoms and treatments.

What Is Rheumatoid Arthritis?

Rheumatoid arthritis or RA is an auto-immune disease that attacks your joints as well as other organs.  Auto-immune disorders cause your immune system to mistake your own bodily tissue for foreign pathogens.  While normally, your immune system should attack and destroy invading viruses and bacteria, it may send antibodies to destroy healthy tissue if there is an auto-immune disorder.

RA may mistakenly attack and erode your muscles, ligaments and cartilage as well as organs like the heart or lungs.  While the danger to key bodily systems is high, perhaps the greatest threat to patients is loss of joint function. As the disease progresses, there will be swelling, pain and possibly permanent disability.

Initially, patients may experience mild swelling, stiffness or warmth in smaller joints found in hands or feet. For many RA sufferers, these symptoms may disappear for periods of time, but they will eventually flare up again. Without proper medical treatment, rheumatoid arthritis will attack major joints including knees, hips, and shoulders. Among patients who do not seek treatment, almost 60 percent are unable to work within ten years.

Rheumatoid Arthritis Diagnosis

It can be difficult for most people to distinguish between rheumatoid arthritis and other kinds of arthritis, but there are several ways that doctors can correctly diagnose RA.

  • Bilateral symmetry—one of the key indicators of RA is that it usually attacks the same joint on both sides of the body.  Joint pain is most commonly found in the fingers and wrists but may also occur in the feet, knees, ankles or shoulders.
  • Common symptoms—your doctor will also check for the classic symptoms of rheumatoid arthritis which include
    • Joint tenderness
    • Joint inflammation
    • Redness at joints
    • Weight loss
    • Joint stiffness, especially in the morning
    • Fatigue
    • Slight fever
  • Family and medical history—your doctor will also ask if anyone in your family has a history of rheumatoid arthritis. If so, this elevates the risk that your health condition is rheumatoid arthritis. You will also be asked if you smoke cigarettes, since that also is a risk factor.
  • Blood tests—although there is no definitive blood test for rheumatoid arthritis, your physician may conduct several tests to determine if certain immunological factors associated with rheumatoid arthritis or auto-immune disorders are present. Tests should also analyze how much white blood cells are present.
  • Imaging—it is important to know if there is actual joint damage, and the best way to determine this is by administering CT or MRI scans.

Treatment Options for Rheumatoid Arthritis

There is no cure for rheumatoid arthritis, but there are many treatment options that can help you maintain joint function and limit pain.  Your doctor should discuss with you all of your available options and design a treatment plan.  It is critical that you adhere to your treatment plan, or you could lose joint functionality and quality of life.

  • Medications—one of the first methods that your doctor will recommend for treating rheumatoid arthritis is drugs. Depending on the severity of symptoms and disease progression, your doctor may prescribe one or more of the following
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)—these include over-the-counter drugs like ibuprofen or naproxen but may come in prescription strength if necessary.  They offer pain relief and reduce swelling.
    • Steroids—for patients with serious swelling, pain and joint damage, corticosteroids like prednisone may be used.  However, there are some risks associated with steroids including thinning bones, diabetes and weight gain which is why steroids are only used for limited periods.
    • Disease-modifying antirheumatic drugs (DMARDs)—DMARDs help slow the progress of RA but may come with serious side effects like lung infections, liver damage and bone marrow suppression.
  • Physical therapy—your doctor should almost immediately prescribe physical therapy to help with arthritis symptoms and treatments. During these sessions, you may participate in strength-building exercises, ultrasound or electrotherapy.  Physical therapy is intended to help strengthen and stretch muscles around joints so that joint function is optimized and pain symptoms are minimized.
  • Healthy diet—there are many foods that can assist you in your fight against rheumatoid arthritis. One of the most commonly recommended is the Mediterranean diet which includes fruits, vegetables, whole grains, olive oil and fish.  All of these foods help lower inflammation or protect joints, as well as offer nutritious fare with modest calories. Lowering body weight should be a priority as it will reduce stress on many joints and help preserve mobility.
  • Regular exercise—although you should be getting some exercise through your physical therapy sessions, you should exercise as often as possible.  Not only will this help preserve joint health, but you should experience a boost in physical and emotional wellness due to increased endorphin production. Furthermore, you will find that regular exercise facilitates restful sleep, a critical component of your rheumatoid arthritis treatment plan.  While many people focus on strength training and stretching to help joint function, it is also important to include some cardiovascular routines to help burn off some calories.  Many people recommend low-impact exercises like cycling or swimming, but perhaps the most effective is yoga which also emphasizes a mental component that can help ward off pain.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information. 

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