Rheumatoid arthritis is a systemic autoimmune disease. It is not caused by old age, years of hard work, or injury. In fact, the true cause remains unknown. In this disease, a person’s immune system attacks the synovial membranes that cover the joints, causing pain, swelling, heat, and eventual deterioration of the joints.
This disease can onset at any age. When it occurs in children, it is called juvenile rheumatoid arthritis. This form is rarer than adult onset rheumatoid arthritis. When the disease occurs in adults, it occurs more often in women than in men. Rheumatoid arthritis is a chronic disease that progresses over a person’s lifetime. Currently there is no cure. Although the cause is unknown, the disease is known to have a strong hereditary component. Prior infections are also suspected to play a roll in the development of this disease.
Symptoms of this disease include pain, swelling, and stiffness in multiple joints. Usually the smaller joints of the body are affected, including the finger and wrist joints, the foot and ankle joints, and the joints in the cervical spine (the neck). Larger joints can also be affected, especially as the disease progresses. Joints on both sides of the body are usually affected, and multiple joints are affected, not just one or two.
When joint swelling occurs, the joints become enlarged and warm to the touch. They may appear red in color. Stiffness is present in the affected joints, especially in the morning. A person may feel stiffness in the joints for an hour or more after getting out of bed in the morning. This makes movement difficult until the stiffness wears off. Other common symptoms a person may experience include fatigue, dry eyes, and skin lesions.
As rheumatoid arthritis progresses, joint deformities may occur. The knuckles of the fingers may deteriorate, causing the tendons of the finger muscles to pull the fingers toward the little finger side of the hands. This deformity is called ulnar drift. Another deformity that can occur is Boutonniere deformity, in which the small joints of the finger deform in a way to appear that the finger is permanently pushing down on a flat surface. The middle joint is flexed and the far joint is extended. A third deformity that can occur is swan neck deformity, where the joints deform in a way that causes the finger to take the shape of a swan’s neck. The middle joint is extended and the far joint is flexed.
This disease is diagnosed through physical examination and blood tests. A positive indicator for rheumatoid arthritis is the presence of the rheumatoid factor in the blood. However, the absence of this factor does not mean that a person does not have rheumatoid arthritis. Other substances in the blood and physical symptoms are also used to diagnose this disease. It can take several months and several rounds of tests before the diagnosis of rheumatoid arthritis is determined, as the early symptoms are similar to several other conditions.
Treatment for rheumatoid arthritis includes medications, regular exercise and weight loss, rest, adaptations to protect deteriorating joints, and other interventions such as physical and occupational therapies. Numerous diets and supplements exist to treat this condition as well.
When treating rheumatoid arthritis, a person should work with a rheumatologist, a doctor who specializes in the treatment of arthritis. If a rheumatologist is not available in a person’s area or insurance plan, a person should seek a doctor who has experience in arthritis treatment. A person should always discuss new medications and nutritional supplements with this doctor before trying them, as medication reactions are quite common and treatment setbacks might occur if medications and supplements interact. One example involves nutritional supplements that are designed to remove excess fluid from a person’s system. These supplements work well in reducing swelling, but may also remove medications that are designed to build up in a person’s system over time. The therapeutic effects of the medication may be reduced or eliminated entirely by the supplement. Therefore, while supplements may be effective and valuable in the treatment of rheumatoid arthritis, a person should always check with his or her doctor before trying a new one.
The progressive joint changes that occur in rheumatoid arthritis may force a person to make lifestyle changes to compensate for activities they can no longer do the same way. Energy conservation, joint protection, and work simplification techniques can help a person adapt activities so that he or she can still do what needs to be done in a day. Please refer to additional articles in this series for descriptions of these techniques.