Rheumatoid Arthritis

What is rheumatoid arthritis?

Rheumatoid arthritis (RA) is a disease that causes pain, stiffness, swelling, and loss of movement in your joints. It happens most often in the fingers, wrists, elbows, shoulders, jaw, hips, knees, and toes. It can also affect other parts of the body.

RA usually appears first in early adulthood or middle age. You may have just one attack, but more often the symptoms come and go. The disease cannot be cured, but medicine can help you have fewer and less severe attacks.

How does it occur?

The exact cause of RA is not known. Most experts think that RA is an autoimmune disease. This means that the body's defenses against infection attack the body's own tissue. In rheumatoid arthritis, the lining of joints becomes inflamed, causing swelling, stiffness, and misshapen joints.

Things that may cause or contribute to rheumatoid arthritis are:

• genes (passed from parent to child)
• infections
• hormones
• smoking
• long-term exposure to silica or asbestos.

What are the symptoms?

The symptoms may include:

• joint pain and stiffness, particularly morning stiffness
• red, warm, or swollen joints
• misshapen joints
• mild fever
• tiredness
• loss of appetite
• small lumps or nodules under the skin.

How is it diagnosed?

Your healthcare provider will review your medical history and examine you. You may have simple blood tests and X-rays.

How is it treated?

The goal of treatment is to keep the joints working properly by:

• reducing inflammation
• relieving pain and stiffness
• reducing swelling
• stopping or slowing down damage to the joints.

There are many ways to treat rheumatoid arthritis. Finding the treatments that will be most helpful for you depends on:

• how severe your symptoms are
• if your symptoms are getting worse
• the effect of the disease on your daily activities.

Many drugs are used to treat the symptoms of rheumatoid arthritis.

• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen can help relieve pain and swelling. NSAIDs may be bought with or without a prescription. NSAIDs can cause can cause stomach bleeding, kidney problems, and other problems. Take the medicine as directed. Read and follow all label directions. NSAIDs should not be taken for more than 10 days for pain or 3 days for fever. They should not be taken for other reasons unless recommended by your healthcare provider. COX-2 inhibitors such as celecoxib (Celebrex) are prescription NSAIDs. COX-2 inhibitors may cause fewer stomach problems than other NSAIDs, but they have been linked to a greater risk of heart attack and stroke. Talk with your healthcare provider to learn more about taking NSAIDs.
• Steroid medicines, such as prednisone or cortisone, are very effective, but they can have serious side effects.
• Disease-modifying antirheumatic drugs (DMARDs) slow down or stop some of the rheumatoid disease process. They can help lessen inflammation in the joints. A commonly used DMARD is methotrexate (Rheumatrex or Trexall). Medicines called biologics are another type of DMARDs. They are called biologics because they are like proteins that naturally occur in the body, such as antibodies. Biological response modifiers, such as Enbrel, Humira, or Remicade, are a type of biologic drug. Often, these drugs must be given as shots or as short-term IV treatments. Treatment with DMARDs has to be watched carefully by your provider to avoid serious side effects.

Talk to your healthcare provider about all treatment possibilities. Or ask to see a rheumatologist--that is, a doctor who specializes in treating inflammatory diseases such as rheumatoid arthritis.

If you have arthritis in your knee, hyaluronic acid can be injected into the knee to act as a lubricant. It helps the knee to move without pain.

Physical therapy helps you to have better use of affected joints and muscles. Occupational therapy teaches you how to overcome disability and manage everyday tasks.

You may wear splints to rest inflamed joints and to prevent them from becoming misshapen.

Very severe RA may be treated by filtering harmful antibodies out of the blood. Sometimes severely damaged hips and knees are surgically replaced.

How long will the effects last?

You may have just 1 attack of RA in your life or you may have repeated flare-ups. Repeated attacks can lead to permanent joint damage. Fortunately, early treatment with DMARD medicine can prevent this most of the time. If necessary, splinting and surgery may help damaged joints.

A woman's ability to get pregnant and have children is not affected much by RA. The disease may get less severe during pregnancy. This means that a woman may be able to stop taking high-potency arthritis drugs during pregnancy to avoid affecting the baby. Still, managing a major disease like RA and a pregnancy is complex. Women should seek expert healthcare for their pregnancy if they have RA.

How can I take care of myself?

You can relieve symptoms and help prevent permanently misshapen joints by following these guidelines:

• Take the medicine your healthcare provider recommends.
• Rest your joints when they are warm, swollen, or painful.
• Follow the advice given by your healthcare provider or a physical therapist for keeping the affected joints mobile.
• Ask an occupational therapist about ways to do everyday tasks. Be open to using tools or other equipment that make everyday tasks easier on your joints.
• Join a support group or take classes about managing arthritis symptoms and your health. Encourage your family to also learn about arthritis. Studies have shown that training like this can help you feel better.
• Keep your body healthy by eating a healthy diet.
• Follow any other recommendations from your healthcare provider.

How can I help prevent rheumatoid arthritis?

If you are a smoker, you can reduce the risk of RA by quitting.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File orre3228.htm Release 13/2010