RA occurs when a person’s immune system attacks the synovium — the lining of the membranes that surround joints. The resulting inflammation thickens the synovium, which can eventually destroy the cartilage and bone within the joint. The tendons and ligaments that hold the joint together weaken and stretch. Gradually, the joint loses its shape and alignment.
Rheumatoid arthritis (RA) is an autoimmune disorder. It is an inflammatory disease that affects the lining of joints, causing a painful swelling that can eventually result in joint deformity and bone erosion.
Signs and symptoms of rheumatoid arthritis may include:
- Tender, warm, swollen joints
- Joint stiffness
- Fatigue, fever, and loss of appetite
Early RA tends to affect smaller joints first — particularly the joints that attach fingers to hands and toes to feet. As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of the body.
About 40 percent of people with RA experience additional signs and symptoms. RA can affect many non-joint structures, including:
-Skin -Heart -Nerve -Tissue
-Eye -Kidneys -Bone Marrow
-Lungs -Salivary -Blood Vessels -Glands
RA signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission.
Factors that may increase your risk of rheumatoid arthritis include:
- Sex — Women are more likely than men to develop RA.
- Age — RA can occur at any age, but it most commonly begins in middle age.
- Family History — If a family member has RA, a person may have an increased risk.
- Smoking — Cigarette smoking increases risk, particularly if there is a genetic predisposition for developing the disease.
- Environmental Exposure — Although poorly understood, some exposures such as asbestos or silica may increase the risk.
- Obesity — People who are overweight appear to be at a higher risk.
There is no cure for rheumatoid arthritis. The severity of the RA symptoms helps determine the right course of treatment.
For moderate RA:
- NSAIDs — Nonsteroidal anti-inflammatory drugs can relieve pain and reduce inflammation. Over-the-counter NSAIDs include: ibuprofen and naproxen sodium.
- Steroids — Corticosteroid medications reduce inflammation and pain and slow joint damage. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication.
For severe RA:
- DMARDs — Disease-modifying antirheumatic drugs are generally distributed by specialty pharmacies due to stringent requirements. These drugs can slow the progression of RA and save the joints and other tissues from permanent damage. Common DMARDs include: Trexall, Otrexup, Arava, Plaquenil, and Azulfidine.
- Biologic Agents — Like DMARDs, these drugs are also dispensed by specialty pharmacies. These drugs can target parts of the immune system that trigger inflammation that causes joint and tissue damage. This newer class of DMARDs includes: Orencia, Humira, Kineret, Olumiant, Cimzia, Enbrel, Simponi, Remicade, Rinvoq, Rituxan, Kevzara, Actemra, and Xeljanz.
GETTING THE MOST OUT OF TREATMENT
Combined with medication, these 3 lifestyle changes may help ease symptoms of RA:
- Regular Exercise – Exercise is one of the key treatments to help reduce the disability often associated with RA. Gentle exercise can help strengthen the muscles around joints and help fight fatigue.
- Apply Heat and Cold – Heat can help ease pain and relax tense, painful muscles. Cold may dull the sensation of pain. Cold also has a numbing effect and can reduce swelling.
- Quit Smoking – Cigarette smoking not only increases risk of developing RA, it also appears to be associated with greater disease severity.
Studies have found that tai chi may improve mood and quality of life in people with RA. This movement therapy involves gentle exercises and stretches combined with deep breathing. Many people use tai chi to relieve stress. When led by a knowledgeable instructor, tai chi is safe.
* Always check with a doctor before starting an exercise routine. Avoid exercising tender, injured, or severely inflamed joints. Always refrain from doing any moves that cause pain