Rheumatoid arthritis (RA) is an autoimmune condition that causes painful and debilitating inflammation of the joints. It mostly targets the synovium of the joint–a special tissue that keeps our joints healthy by providing nutrition and lubrication. When affected by RA, this synovial membrane becomes inflamed, leading to joint pain and swelling.
The way RA impacts people is pretty unique. It usually goes after the small joints in our hands and feet, and it does so in a symmetrical pattern. That means if your left hand is affected, your right hand is likely to be affected too. But don't be fooled – every synovial joint in the body is at risk, especially if the disease progresses unchecked.
According to estimates, RA affects over a million adults in the U.S. alone. Women are twice as likely to develop RA, for reasons unknown. Genetics and environment are suspected to be involved. Most people first experience telltale symptoms of RA between ages 40 and 60.
Because RA can quickly damage joints, early diagnosis and treatment are critical. While there's no cure yet, the good news is that proper management can reduce pain and inflammation, limiting its effects on your daily life.
What are The Symptoms of Rheumatoid Arthritis?
RA symptoms come and go in what are known as flares. Periods of remission, where symptoms disappear, can last for months or years. The pain and physical limitations of RA can significantly diminish your quality of life.
Common symptoms of rheumatoid arthritis include:
Swollen, painful joints
Joint stiffness (usually worse in the morning or after prolonged sitting or inactivity)
Loss of joint function
Fatigue
Weight loss
Low-grade fevers (rare)
What Are The Causes and Risk Factors of RA?
This painful condition occurs when your immune system mistakenly attacks the synovium. This triggers inflammation and an overactive immune response that floods your joints with chemicals that damage cartilage and bone.
Why the immune system malfunctions like this is unclear. It seems to be a mix of genetic risks and environmental triggers that lead to an abnormal immune reaction in susceptible people. Left unchecked, this persistent cycle of inflammation and immune assault may lead to irreversible joint damage and disability.
Here are the major risk factors for rheumatoid arthritis:
Gender - It occurs more commonly in women than in men. The female-to-male ratio is about 3 to 1.
Age - It often begins between the ages of 40 and 60.
Genetics - Having a family member with rheumatoid arthritis increases the risk of developing the disease. Certain genes have been linked to increased risk of rheumatoid arthritis.
Smoking - Quitting smoking can reduce the risk of RA.
Obesity - Excess weight or obesity increases the risk of rheumatoid arthritis and also makes the treatment more difficult.
Infections - Some bacterial and viral infections may trigger an immune response that leads to joint inflammation in susceptible individuals. The 'infection hypothesis' is still being studied.
How is Rheumatoid Arthritis Diagnosed?
To diagnose rheumatoid arthritis, a rheumatologist will typically:
Conduct a physical exam
The rheumatologist will examine the joints for signs of inflammation like swelling, redness, or tenderness. They will assess joint mobility and check for any deformities. The exam will also look for more generalized inflammation or symptoms in other parts of the body.
Take a patient history
The rheumatologist will ask the patient about their symptoms, when they started, how severe they are, and how they affect their day to day life. Particular attention is paid to whether symptoms are symmetrical (affecting both sides of the body) and if there has been any morning stiffness that lasts more than 30 minutes.
Run blood tests
Blood tests are done to check for inflammation in the body and signs of an overactive immune system. Common tests include erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor, and anti-CCP antibody. Elevated levels of these markers can indicate rheumatoid arthritis.
Conduct imaging tests
X-rays, MRI, or ultrasound of the joints may be done to check for joint damage or erosion of cartilage and bone. These imaging tests can also reveal inflammation in the joints.
What Are The Treatments for Rheumatoid Arthritis?
Treatment focuses on reducing inflammation and pain, preventing joint damage, and maintaining joint mobility and function. Options include medications, physical therapy, exercise, and sometimes surgery.
Medications
The most common medications for RA are:
Disease-modifying antirheumatic drugs (DMARDs) like methotrexate - these help reduce joint inflammation and damage.
Steroids like prednisone - these anti-inflammatory drugs help reduce inflammation but can have side effects with long term use.
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen - these reduce pain and inflammation but do not stop joint damage.
Biologic agents like etanercept - these target specific aspects of the immune system involved in RA and are often used for severe, persistent cases.
Physical therapy and exercise
Gentle exercise and PT can help maintain joint mobility and range of motion. Low-impact activities like swimming or water aerobics are good options. PT may also help with pain management and fatigue.
Lifestyle changes
Resting inflamed joints, eating an anti-inflammatory diet, reducing stress, and not smoking can all help manage RA symptoms and reduce flare-ups. Applying hot/cold packs to joints and using assistive devices can also help with daily activities.
What Are The Complications and Prognosis of RA?
While rheumatoid arthritis is a serious condition, with proper management and treatment, the prognosis is hopeful for most patients. The key is to get evaluated and start treatment early to control inflammation and prevent complications from developing or worsening.
If left untreated, rheumatoid arthritis can lead to some serious complications:
Joint damage - he ongoing inflammation can erode the cartilage and bones in the joints, leading to permanent joint damage and deformities. This can significantly impact mobility and daily activities.
Chronic pain - the joint pain and inflammation can become persistent, leading to chronic pain that is difficult to manage.
Increased cardiovascular risk - RA also increases the risk of cardiovascular disease like heart disease or strokes. The inflammation and immune system dysfunction seem to contribute to these higher risks.
Rheumatoid Arthritis Care at Orange County
There are so many treatment options for RA that it can be overwhelming for patients. Some spend too much time trying different treatments that they miss their chance to control the disease and prevent permanent damage. It's like a maze, and we don't want anyone to get lost in it.
At OC Rheumatology & Arthritis, we specialized in rheumatoid arthritis diagnosis and treatment for decades. We are one of the leading experts in Orange County for managing this complex autoimmune disease.
Our team of board-certified rheumatologists will work closely with you to determine the right treatment to stop inflammation, relieve pain, and prevent joint damage. We offer the latest medications and advanced therapies for RA. Call or visit us today for compassionate, customized care from experts you can trust.
OC Rheumatology & Arthritis 714-825-0891
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