Overview
Rheumatoid arthritis (RA) is a chronic inflammatory disorder that primarily affects the joints but can have a wide range of impacts on other body systems as well. It is an autoimmune disease, which means the immune system mistakenly attacks healthy tissue in the joints, causing painful swelling, bone erosion, and joint deformity. Unlike osteoarthritis, which is caused by wear and tear, RA affects the lining of the joints. The inflammation associated with RA can also lead to damage in other parts of the body, such as the skin, eyes, lungs, heart, blood vessels, kidneys, salivary glands, nerve tissue, bone marrow, and blood vessels. While treatments have improved, severe RA can still result in physical disabilities.
Understanding the disease
Symptoms
Symptoms of rheumatoid arthritis may include tender, warm, swollen joints, joint stiffness, fatigue, fever, loss of appetite, and symptoms that don't involve the joints such as skin, eyes, lungs, heart, kidneys, salivary glands, nerve tissue, bone marrow, blood vessels, dry eyes and mouth, infections, abnormal body composition, and carpal tunnel syndrome.
Risk Factors
Risk factors for developing rheumatoid arthritis include:
- Sex: Women are more likely than men to develop rheumatoid arthritis.
- Age: Rheumatoid arthritis can occur at any age, but it most commonly begins in middle age.
- Family history: If a member of your family has rheumatoid arthritis, you may have an increased risk of the disease.
- Smoking: Cigarette smoking increases your risk of developing rheumatoid arthritis, particularly if you have a genetic predisposition for developing the disease. Smoking also appears to be associated with greater disease severity.
Development
Rheumatoid arthritis is an autoimmune disorder, which means the immune system mistakenly attacks the body's own tissues, specifically the synovial membrane that encloses the joints. This attack causes inflammation and swelling in the joints, leading to pain, stiffness, and eventually bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis can also damage other parts of the body, such as the skin, eyes, lungs, heart, and blood vessels. While the exact cause of rheumatoid arthritis is not known, genetic factors and environmental triggers, such as infection with certain viruses and bacteria, may contribute to its development.
Assessment and Diagnosis
Triage
You should see a doctor if rheumatoid arthritis is suspected, especially if you experience persistent symptoms such as tender, warm, and swollen joints, joint stiffness, fatigue, fever, and loss of appetite. Early rheumatoid arthritis typically affects the smaller joints, particularly those in the fingers and toes. If left untreated, rheumatoid arthritis can progress to affect larger joints such as the wrists, knees, ankles, elbows, hips, and shoulders, and may cause damage to other parts of the body, including the skin, eyes, lungs, heart, kidneys, salivary glands, nerve tissue, bone marrow, and blood vessels. Early diagnosis and treatment are important to manage symptoms, slow disease progression, and prevent complications.
Diagnosis
To diagnose rheumatoid arthritis, doctors typically follow a combination of physical examination, blood tests, and imaging tests. The physical exam involves checking joints for swelling, redness, and warmth. Blood tests may show elevated levels of erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP), and tests for rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies can be helpful in confirming the diagnosis. Imaging tests, such as X-rays, can provide additional information on joint damage and progression.
Management and Treatment
Complications
Potential complications of rheumatoid arthritis include osteoporosis, rheumatoid nodules, heart problems, and lung disease. Rheumatoid arthritis can also increase the risk of lymphoma and hardened and blocked arteries.
Home Remedies
on specific home remedies for rheumatoid arthritis. It is recommended to consult a healthcare professional for proper diagnosis and treatment options, as rheumatoid arthritis is a chronic condition that requires medical attention.
Treatment
The treatments for rheumatoid arthritis vary and depend on the severity and progression of the condition. The main goals of treatment are to manage symptoms, reduce inflammation, and slow down or prevent joint damage. Medications, physical therapy, lifestyle changes, and sometimes surgery may be involved in the management of rheumatoid arthritis. Some of the commonly used medications include nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), biologic agents, and corticosteroids. It is important to work closely with a healthcare professional to determine the most appropriate treatment plan for each individual case.
Preparing for medical consultation
To prepare for an appointment for rheumatoid arthritis, you should:
- Be aware of any pre-appointment restrictions: At the time of scheduling the appointment, inquire about any specific instructions or guidelines you need to follow in advance, such as refraining from taking certain medications or fasting before the appointment.
- Write down your symptoms: Make a list of all the symptoms you are experiencing, including any that may seem unrelated to rheumatoid arthritis. Note when they started and how they have changed or worsened over time.
- Write down key personal information: Include any major stresses or recent life changes that could potentially trigger or exacerbate rheumatoid arthritis symptoms.
- Make a list of all medications, vitamins, and supplements: Record all the prescription and non-prescription drugs, vitamins, and supplements you are currently taking, including their dosages.
- Note what seems to improve or worsen your signs and symptoms: Keep track of which factors, such as specific foods, medications, or activities, seem to impact your rheumatoid arthritis symptoms.
- Consider bringing a family member or friend: Having someone accompany you can be helpful in remembering important details discussed during the appointment and providing support.
- Prepare questions: Write down a list of questions to ask your doctor, including:
- What's the most likely cause of my rheumatoid arthritis?
- What test