Rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that causes pain, swelling and loss of joint function. RA impacts your smaller joints first, like the ones in your fingers and toes. Eventually, RA symptoms appear in all the major joints, including ankles, elbows, hips, knees, shoulders, and wrists.

How do you get rheumatoid arthritis?

Doctors don’t know the exact cause of RA, but genetics play a role. Your genes and family history might make you more susceptible to developing rheumatoid arthritis.

Women are more likely than men to develop RA.

Rheumatoid arthritis is treatable

Although there is no cure for rheumatoid arthritis, the earlier you can start disease-modifying antirheumatic drugs (DMARDs), the better.

Symptoms of rheumatoid arthritis

Asian woman in painting class

Signs and symptoms of rheumatoid arthritis may include:

  • Fatigue, fever and loss of appetite.
  • Joint stiffness.
  • Tender, warm, swollen joints.

As rheumatoid arthritis sets in, it starts to impact your smaller joints first, like the ones in your fingers and toes. Eventually, RA symptoms will appear in all the major joints, including ankles, elbows, hips, knees, shoulders, and wrists.

It’s also possible to have symptoms that don’t involve the joints. About 40% of people who have RA exhibit symptoms in their:

  • Blood vessels
  • Bone marrow
  • Eyes
  • Heart
  • Kidneys
  • Lungs
  • Nerve tissue
  • Salivary glands
  • Skin

Risk factors for rheumatoid arthritis

There are certain factors that may increase the chances of you developing rheumatoid arthritis,  including:

  • Age. Although RA can occur at any age, most people see the onset during their 30s and 40s.
  • Excess weight. Carrying extra weight can play a factor in increasing the risk of developing RA.
  • Family history. There appears to be a genetic factor to RA, so if someone in your extended family has RA, you may also have an increased risk of developing the condition.
  • Smoking. Smoking cigarettes has been shown to increase the risk of developing RA, especially if your family has shown a predisposition for developing the disease in the past. Smoking can also increase the severity of the disease.
  • Your sex. It’s unknown why, but women are more likely than men to develop RA.

Two women strolling outside

Treatments for rheumatoid arthritis

Currently there is no cure for rheumatoid arthritis. However, the earlier you can start disease-modifying antirheumatic drugs (DMARDs), the better the results. Studies have shown that the probability of RA remission goes up with DMARD usage.

Medications

There are several types of medications your doctor can prescribe for your RA symptoms. Their recommendations will be heavily influenced by how severe your symptoms are an how long you’ve had RA.

  • Conventional DMARDs. Not only do DMARDs help slow the progression of RA, but they can also play an important role in preventing permanent damage to joints and other tissues.
    Biologic agents. This newer class of DMARDs, also called biologic response modifiers, usually work best when administered in conjunction with a conventional DMARD. This type of drug also increases the risk of infections.
  • Targeted synthetic DMARDs. If conventional DMARDs and biologics haven’t proven successful as treatment, targeted synthetic DMARDs may be prescribed instead.
  • NSAIDs. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil, Motrin, and Aleve can relieve pain and reduce inflammation. Your doctor can also prescribe stronger NSAIDs if needed.
  • Steroids. Corticosteroid medications, such as prednisone, help keep inflammation and pain down and inhibit joint damage. Corticosteroids are an effective way to bring immediate relief.

Therapy

As the RA progresses and your joints continue to weaken, finding practical ways to carry out everyday tasks becomes more and more important. Knowing this, your doctor may suggest you work with a physical or occupational therapist. They can teach you exercises to help your joints stay flexible and can offer insights on ways to perform daily tasks that will be easier on your joints.

Surgery

If medications don’t prove satisfactory in preventing or slowing joint damage, your doctor may suggest surgery as the next treatment option. Like every other medical procedure, there’s no guarantee that surgery will be 100% successful. However, surgery has been able to reduce pain and improve function to damaged joints in the past.

Depending on how your case of RA has impacted your joints, surgery may involve one or more of the following procedures:

  • Joint fusion. When joint replacement isn’t an option, your doctor may opt to surgically fuse the joint in order to stabilize or realign it and provide pain relief.
  • Synovectomy. By removing the inflamed lining of the joint (synovium), this surgery is able to decrease pain and increase joint flexibility.
  • Tendon repair. Over time, the tendons around your joint can become loose or even rupture. This procedure repairs the tendons around your joint.
  • Total joint replacement. This procedure removes the damaged parts of your joint and replaces it with a prosthesis made of metal and plastic.

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Stage 1

During stage 1, early RA, inflammation inside the joint causes swelling, stiffness, and joint pain.

Stage 2

During moderate-stage RA, the inflammation inside the joint increases and begins to adversely impact the joint cartilage. As the damage to the cartilage spreads, patients may experience a more limited range of motion in their joints which may lead to a loss of mobility.

Stage 3

During Stage 3, severe RA, the damage has spread beyond the cartilage and is now affecting the bones as well. As the protective cushion between bones wears down, the bones will start to rub together, causing more pain and swelling. In addition, there may also be muscle weakness and more mobility loss. As the damaged bone starts to erode, some deformity may occur.

Stage 4

At the end stage, the joints no longer work. Even though the joints may be completely destroyed, patients may still experience pain, swelling, stiffness, mobility loss, and reduced muscle strength. There’s even the possibility that the bones fuse together.

Frequently asked questions (FAQs) about rheumatoid arthritis

The chronic inflammation associated with rheumatoid arthritis can be quite debilitating over time. As the condition progresses, people can experience any number of complications, including:

  • Breathing difficulty.
  • Carpal tunnel syndrome.
  • Heart conditions like pericarditis and myocarditis.
  • Infections.
  • Lymphoma.
  • Osteoporosis.
  • Rheumatoid nodules.
  • Sjögren’s syndrome, a disorder that causes dryness in the eyes and mouth.
  • Weight gain.

Rheumatoid arthritis is the condition marked by varying degrees of inflammation of the synovial membrane that protects and lubricates joints. This results in pain and swelling and, as it progresses, it may cause the joint itself to erode.

Osteoarthritis, on the other hand, is the most common form of arthritis and involves the cartilage that caps the bones in your joints slowly wearing away over time.

Arthritis describes the chronic or acute inflammation of joints. The worse the arthritis, the greater the chances for pain and structural damage.

Rheumatism, on the other hand, is a generic term that encompasses an entire group of joint diseases or syndromes.

Rheumatoid arthritis has no cure, but it can go into remission for periods of several weeks to more than 12 months.

Although the inflammation from RA mainly impacts the joints, causing pain, stiffness, swelling, and loss of function, it can also affect other parts of the body, including internal organs like the lungs, heart, kidneys, and eyes.

Diet always plays an important role in the health of RA patients. The more anti-inflammatory foods such as fruits, herbs, vegetables, and legumes you incorporate into your diet, the better, as they can help reduce the inflammation associated with RA. Bananas can be considered “good” for RA because they are considered a low-purine food that contains vitamin C, which can help reduce inflammation.

Overall, you’re probably better off choosing fruits like cherries, strawberries, raspberries, blueberries, and blackberries that have a more proven anti-inflammatory effect. Oranges, grapefruits, and limes are also excellent sources of Vitamin C and should be included in your diet whenever possible.

When considering home remedies for RA, it’s important to remember that they should never be considered as a replacement for doctor-prescribed medication or treatments. Many natural remedies aren’t backed by science or the research is very limited or weak.

You can do a little self-experimentation to see what helps you the most. Many of these fall under the “can’t hurt to try” category and many do have clinical data to support them.

  • Cannabidiol (CBD) products.
  • Chili pepper loti.
  • Fermented foods.
  • Fish oil.
  • Gentle exercises.
  • Glucosamine/chondroitin supplement.
  • Gluten-free diet.
  • Hot paraffin soak.
  • Probiotic supplement.
  • Reduce sugar.
  • Self-massage.
  • Turmeric.
  • Wrist, hand, or finger splints.

According to the Arthritis Foundation, there isn’t a single vitamin identified as the “best” for RA. Rather, it’s been shown that a proper mix of vitamins and minerals can be an essential part of treatment for many patients with inflammatory arthritis. The list includes:

  • Calcium.
  • Chromium.
  • Copper.
  • Folate.
  • Iron.
  • Magnesium.
  • Selenium.
  • Sodium.
  • Vitamin A.
  • Vitamin B12.
  • Vitamin B1 (Thiamine).
  • Vitamin B2 (Riboflavin).
  • Vitamin B3 (Niacin).
  • Vitamin B6.
  • Vitamin C.
  • Vitamin D.
  • Vitamin E.
  • Vitamin K.
  • Zinc.