Get to know rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that causes pain, swelling, and stiffness in the joints. While RA can attack joints throughout the body, it is most common in the hands, wrists, elbows, feet, ankles, and knees. Left untreated, it can damage cartilage and bones, causing joints to become damaged or misshapen. Since joint damage cannot be reversed, it’s important to get diagnosed and treated as soon as you notice the first signs and symptoms of the disease.

According to the Arthritis Foundation, 1.5 million Americans are currently living with rheumatoid arthritis. The disease is two to three times more common in women than in men. It often begins in women between ages 30 and 60, whereas men are more likely to be diagnosed later in life. Teenagers and young adults also can develop RA.

While scientists cannot pinpoint an exact cause of the disease, there are certain factors—in addition to age and sex—that may increase RA risk.

Family history: Genetics may predispose you to RA, but most people diagnosed have no family history of the disease.

Smoking: Lighting up can raise odds risk of RA and worsen symptoms if you’ve already been diagnosed.

Environment: Many experts believe that some infections or environmental factors may trigger the disease. Several factors have been studied—Epstein-Barr virus, stress, and insecticides are a few—but none have yet been confirmed.

Obesity: People who are obese, meaning they have a body mass index of at least 30, may be more likely to develop RA.

Symptoms include joint pain, tenderness, and stiffness. The stiffness may last 30 minutes or longer after you wake up or sit for a long time. The joints may be warm, red, and swollen. People may also have other symptoms, such as fatigue, a low-grade fever, and weight loss.

Rheumatoid arthritis usually affects the smaller joints first, and spreads to larger ones as it progresses. For example, the disease may start in the fingers and wrists, then spread to the elbows and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.

RA symptoms vary in intensity and may come and go, but flare-ups can last for days or even months. 

Some people with RA experience complications in places other than their joints, such as:

Osteoporosis. RA and steroids can up the risk of osteoporosis, a condition where bones are more fragile and prone to breaks.

Anemia. RA inflammation, as well as some RA meds, may cause anemia, a decrease in red blood cell count.

Heart disease. Those with RA have a 50 to 70 percent increased risk of heart disease compared to the general population, according to the Arthritis Foundation. 

Lung issues. Outside of joint problems, lung conditions are the most common health troubles tied to RA. Complications include small lung growths called pulmonary nodules, as well as interstitial lung disease, which scars lung tissue and can make it tough to breathe.

Other complications include neck pain, dry eyes and mouth, and inflammation of the blood vessels or the sac around the heart. Your best defense against RA complications is to get early treatment. 

Researchers believe that RA causes bone damage as early as the first or second year of the disease, which is why early diagnosis is important. If you’re experiencing signs and symptoms of RA, your healthcare provider may refer you to a rheumatologist. A doctor who specializes in musculoskeletal and autoimmune diseases, your rheumatologist will take your medical history and examine your joints, looking out for tenderness, redness, swelling, and painful or limited movement. 

Blood tests alone cannot diagnose RA, but they can measure inflammation levels and look for certain markers linked to the disease. Your rheumatologist may also order imaging tests such as an X-ray, ultrasound, or magnetic resonance imaging scan to check for joint damage and track the progress of the disease.

There is no cure for RA, so the goal of treatment is to relieve symptoms, decrease inflammation, and prevent further joint damage. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may ease pain and inflammation. Doctors sometimes prescribe short-term use of low-dose corticosteroids to reduce inflammation quickly. Disease-modifying antirheumatic drugs (DMARDS), which include biologics and janus kinase (JAK) inhibitors, are an important part of treatment, because they slow the course of the disease. However, if RA has caused permanent damage, your doctor may suggest joint replacement surgery.

Rheumatoid arthritis isn’t just about chronic pain. People with RA know that it can affect every aspect of their lives. The disease may cause depression, anxiety, feelings of helplessness, and low self-esteem, among other emotional and mental health difficulties. Take care of your RA—and yourself—through:

Exercise: A little movement can soothe sore joints and boost energy levels. Experts often recommend low-impact exercises like walking or swimming. 

Complementary therapies: Some people find that practices such as acupuncture and massage help to relieve their pain and stiffness. Ask your provider if these therapies are right for you, and make sure any practitioner has experience dealing with RA.

Thermotherapy: Rheumatologists may recommend cold packs to treat acute RA flare-ups and heat to ease stiffness.

Healthy eating: While no specific diet has been found to improve RA symptoms, eating lots of wholesome, nutritious foods may reduce inflammation and help you feel better. In general, try to emphasize produce, lean proteins, and heathy fats, and cut back on added sugar and saturated fat. 

Friends: Surround yourself with loved ones to help keep your mind off the pain and help you with daily activities.