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Rheumatoid arthritis (RA) is a condition in which the body's own immune system attacks the joints. This causes swollen, stiff, and painful (inflamed) joints, especially in the hands and feet.
Over time, RA can damage and deform joints. It makes it hard to open jars, write, and do other daily tasks. Sometimes it can also cause bumps to form under the skin.
Rheumatoid arthritis is more common in women than in men. It often starts between the ages of 40 and 60.
The cause of RA isn't fully understood. But it's an autoimmune disease. This means that the body's natural defense system attacks the joints. Genes play a role, but experts don't know exactly what that role is.
Symptoms of RA often develop slowly over weeks or months. Fatigue and stiffness are usually early symptoms.
Joint symptoms include:
Rheumatoid arthritis can also cause symptoms throughout the body (systemic). These include:
To diagnose RA, your doctor looks at a combination of your symptoms and test results. Your doctor will ask you questions about your symptoms and look at your joints for signs of tenderness or swelling.
RA is most often treated with medicine. Some medicines help to control the symptoms. Other medicines, especially when used early, can help to prevent the disease from getting worse.
Many of the medicines used to treat rheumatoid arthritis have side effects. Have regular checkups. And talk with your doctor about any problems. This will help your doctor find a treatment that works for you.
Physical therapy and finding the best balance between rest and activity can also help your symptoms.
If your treatment doesn't help, surgery may be an option. The type of surgery you can have depends on which joints are causing problems. Sometimes surgery to replace a joint (such as a hip or knee) is an option. Other types of surgery can remove debris or inflamed tissue from a joint, or relieve pressure on nerves.
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The cause of RA isn't fully understood. But it's an autoimmune disease. This means that the body's natural defense system attacks the joints.
Genes play a role, but experts don't know exactly what that role is. For most people with RA, the disease doesn't run in their families and they don't pass it along to their children. One or more genes may make it more likely that the body's immune system will attack the tissues of the joints. This immune response may also be triggered by bacteria, a virus, or some other foreign substance.
RA mostly affects the joints. But it can also cause problems in other parts of your body.
Joint pain can be an early symptom of many different diseases. In RA, symptoms often develop slowly over a period of weeks or months. Fatigue and stiffness are usually early symptoms. Weight loss and a low-grade fever can also occur.
When RA affects the joints of the neck, especially the joints at the top of the spine, the bones and joints may dislocate and press on the spinal cord or on the nerve roots. This pressure can cause:
Pressure on the spinal cord and nerve roots may obstruct blood flow through the blood vessels in the spinal cord. This compression of the spinal cord is fairly rare. But it can lead to being paralyzed if it's not treated.
Along with specific joint symptoms, RA can cause symptoms throughout the body (systemic). RA can cause problems in the:
People with RA may also have fatigue, loss of appetite, weight loss, and a mild fever.
The course of RA is hard to predict. It usually progresses slowly, over months or years. In some people it doesn't get worse, and symptoms stay about the same.
RA mostly affects the joints. The inflammation it causes affects the tissues that line the joints, and that can damage and deform the joints. But RA can also cause problems in other parts of the body. It can affect your eyes, lungs, heart, blood vessels, muscles, and nerves. Symptoms can come and go. You may have times in your life when symptoms go away on their own for a while. This is called remission.
If the disease progresses, joint pain can restrict simple movements, such as your ability to grip, and daily activities, such as climbing stairs. It is a common cause of lasting disability. But early treatment may control the disease and keep it from getting worse.
Call your doctor now if you have:
Call your doctor within the next few days if you have:
Watchful waiting is a wait-and-see approach. It's okay to try home treatment for mild joint pain and stiffness. If there is no improvement after 6 weeks, or if you have any other symptoms, call your doctor.
Early treatment can slow and sometimes prevent significant joint damage.
No single lab test can diagnose RA. The doctor will ask you questions about your health and look at your joints for signs of swelling or tenderness. The pattern and nature of joint symptoms are the most important clues to the diagnosis. Your doctor will then rule out other diseases that can cause similar symptoms.
Diagnosis is based on a set of classification criteria. The criteria include the results of these blood tests:
RA is most often treated with medicine. Physical therapy and finding the right balance between rest and activity can also help. There's no cure for RA, but treatment may help relieve symptoms and control the disease. Treatment usually continues throughout your life. But it will vary depending on:
The goal of treatment is to help you maintain your lifestyle, reduce joint pain, slow joint damage, and prevent disability. Treatment should start with learning about the disease. Learn what might happen with joint damage and disability. Find out the risks and benefits of possible treatments. You and your team of doctors can make a long-term treatment plan.
If you try medicine, exercise, and lifestyle changes for at least a few years but pain and disability get much worse, surgery may be an option.
Early and ongoing treatment of RA with medicines called disease-modifying antirheumatic drugs (DMARDs) can reduce how severe the disease is. And it can slow or sometimes prevent joints being destroyed. Other medicines may be combined with DMARDs to relieve symptoms. These medicines include:
Types of treatment that may help you control some of the symptoms of RA include:
Surgical treatment for RA is used to relieve severe pain and improve function of severely deformed joints that don't respond to medicine and physical therapy. There are several types of surgery that are used. The type of surgery you have depends on which joints are affected. Sometimes surgery to replace a joint (such as a hip or knee) is an option. Other types of surgery can remove debris or inflamed tissue from a joint or can relieve pressure on nerves.
Surgery options include:
Living with RA often means making changes to your lifestyle. You can do things at home, such as staying active and taking medicines, to help relieve your symptoms and prevent the disease from getting worse. Here are some ways that you can care for yourself.
RA causes fatigue. And the strain of dealing with pain and limited activities also can make you tired. The amount of rest you need depends on how bad your symptoms are.
You may need to change the way you do certain activities so that you are not overusing your joints. Try to find different ways to relieve your joint pain.
Keep moving to keep your muscle strength, flexibility, and overall health.
People with RA have an increased risk of plaque in the arteries (atherosclerosis). Smoking increases this risk even more. Smoking may also lower your response to treatment.footnote 1 So, if you smoke, quit.
Try to eat a variety of healthy foods. Dietary needs are not the same for all people who have RA. To be sure you get the nutrients you need, you can ask a registered dietitian to help you make a plan.
People who have RA tend to get gum disease. You can help prevent gum disease through good basic dental care.
Exercise can reduce pain and improve function in people who have RA. It may also help prevent the buildup of scar tissue. This can lead to weakness and stiffness. Exercise for arthritis takes three forms:
Stretching involves moving joint and muscle groups through and slightly beyond their normal range of motion and holding them in position for at least 15 to 30 seconds.
Strengthening involves moving muscles against some resistance. Strengthening exercise helps people who have RA stay more active and able to do their daily activities. It even seems to help their outlook.footnote 1
Conditioning exercise improves aerobic fitness. It may help reduce pain and help you stay more active.footnote 2 Even moderate activity, such as walking, can improve your health and may prevent disability from RA.
Be sure to follow your doctor's advice about your exercise program.
Medicines are the main treatment for RA. The types of medicines used, the amount you take, and the length of time you take them depends on how severe your RA is, how fast it's progressing, and how it affects your daily life.
Medicines are used to:
Medicines called disease-modifying antirheumatic drugs (DMARDs) can slow or sometimes prevent joints from being destroyed. An early start to treatment with DMARDs can reduce how severe RA is. These medicines are most often taken over a long period to help control the disease.
Other medicines may be combined with DMARDs to relieve symptoms. They include:
Surgical treatment for RA is used to relieve severe pain and improve function of severely deformed joints that don't respond to medicine and physical therapy.
CitationsO'Dell JR (2013). Treatment of rheumatoid arthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 9th ed., vol. 2, pp. 1137–1160. Philadelphia: Saunders.Baillet A, et al. (2010). Efficacy of cardiorespiratory aerobic exercise in rheumatoid arthritis: Meta-analysis of randomized controlled trials. Arthritis Care and Research, 62(7): 984–992.
Current as of: July 11, 2023
Author: Healthwise StaffClinical Review Board: All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Current as of: July 11, 2023
Author: Healthwise Staff
Clinical Review Board: All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
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