Knowledge Center: Rheumatoid Arthritis
Medically reviewed on Mar 18, 2018 by L. Anderson, PharmD.
What is Rheumatoid Arthritis?
If you watch prime time TV, you have probably seen the many commercials for rheumatoid arthritis treatments. But maybe you need more detailed information than what you get in the 30 sec ad?
Rheumatoid arthritis is a chronic (long-term) disease that causes inflammation of the joints and surrounding tissues. It can also affect other organs. Usually rheumatoid arthritis afflicts the joints on both sides of the body equally.
The wrists, fingers, knees, feet, and ankles are most commonly involved. Patients may experience low-grade fevers, fatigue, and weakness, as well.
What Causes Rheumatoid Arthritis?
The exact cause of rheumatoid arthritis (RA) is unknown.
It is considered an autoimmune disease; that is, a disease where the body's immune system, which normally fights off foreign substances such as a virus or bacteria, instead confuses healthy tissue for a foreign substance. This confusion leads the body to set up an attack on itself - at the joints where RA occurs. Joint and bone destruction can occur over time if the disease process is not well-controlled.
Genetics and family history may also play a part. Learn more about autoimmune diseases here.
Who Gets Rheumatoid Arthritis?
Maybe you've seen the pictures of the twisted joints in the hands of older people, and think rheumatoid arthritis is simply a disease of the elderly. But rheumatoid arthritis can occur at any age but it is usually seen in people between the ages of 25 and 55. Women are affected 2 to 3 times more often than men. Rheumatoid arthritis can even occur in juveniles.
The course and severity of the illness can vary considerably. Infection, genetics, and hormones may all contribute to the development of the disease. Roughly 1 out of 100 American adults (1%) have rheumatoid arthritis, and currently there is no cure.
What Are the Symptoms of Rheumatoid Arthritis?
We all have moments when our joints ache or our muscles feel tired. But rheumatoid arthritis usually begins gradually with symptoms such as:
- morning stiffness (lasting more than one hour)
- widespread muscle aches
- loss of appetite
Eventually, joint pain appears. When the joint is not used for a while, it can become warm, tender, and stiff. When the lining of the joint (synovium) becomes inflamed, it gives off more fluid and the joint becomes swollen. Joint pain is often felt on both sides of the body, and may affect the wrist, knees, elbows, fingers, toes, ankle or neck. Nonjoint structures can also be affected such as the eyes, skin, lungs, heart, or blood vessels.
How is Rheumatoid Arthritis Diagnosed?
Rheumatoid arthritis can mimick other diseases and is not always an obvious diagnosis. Rheumatoid arthritis (RA) is diagnosed based on the results of joint x-rays and a rheumatoid factor test (which is positive in about 75% of people with symptoms). There is no one test, exam, or x-ray that can confirm the diagnosis.
Your doctor will complete a physical exam checking your joints for warmth or redness, and also checking reflexes and strength in your joints.
Lab work may be completed, too. The erythrocyte sedimentation rate (sed rate), a test that measures inflammation, can be elevated and the complete blood count may show low hematocrit (a measure of red blood cells in your plasma), anemia (a deficiency of red blood cells), or abnormal platelet counts (which help with blood clotting), all tests that measure the health of the blood and may indicate that you have an underlying medical condition.
A C-reactive protein (CRC) test may also be positive, or a rheumatoid factor (RF). Most patients with rheumatoid arthritis have positive RF tests.A synovial fluid analysis may be used to diagnose the cause of pain and swelling in joints.
Imaging tests such as x-rays or MRI may be ordered at the outset and to monitor RA progression over time.
How is Rheumatoid Arthritis Treated?
Rheumatoid arthritis usually requires lifelong treatment with:
- physical therapy
- targeted home exercises
- health education
- possibly surgery.
Early, aggressive treatment of rheumatoid arthritis can delay joint destruction. Rheumatoid arthritis is a disease with a variable prognosis that can impair the quality of life. Getting an early diagnosis with a qualified healthcare provider is important.
Drug treatment options for rheumatoid arthritis have advanced significantly in recent years.
A summary of the many options available can be found in the slideshow:
Quality of Life With Rheumatoid Arthritis
Yes, being diagnosed with RA is life changing, but it needn't be a life sentence.
The stresses of completing simple tasks while juggling family life and work commitments can be a daunting prospect. Adjustment to a new routine is certainly not easy but rest assured, you're not alone.
Getting medical help and treatment is important, but so is helping yourself.
- Be sure to learn about range-of-motion exercises and stay active.
- Consider joining the Drugs.com Rheumatoid Arthritis Support group to stay up-to-date with the latest approvals, ask questions, and voice your concerns.
- Review the latest rheumatoid arthritis news to see recent developments.
- Educate yourself so you know the right questions to ask of your healthcare team.
Finished: Knowledge Center: Rheumatoid Arthritis
- Singh J, et al. 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care & Research. DOI 10.1002/acr.22783. Accessed March 18, 2018 at https://www.rheumatology.org/Portals/0/Files/ACR 2015 RA Guideline.pdf
- Up to Date. Patient education: Rheumatoid arthritis (Beyond the Basics). Updated Mar 23, 2017. Accessed March 18, 2018 at https://www.uptodate.com/contents/rheumatoid-arthritis-symptoms-and-diagnosis-beyond-the-basics
- Rheumatoid Arthritis Support Network. Facts and Statistics. Accessed March 18, 2018 at https://www.rheumatoidarthritis.org/ra/facts-and-statistics/