Rheumatoid arthritis is a chronic inflammatory autoimmune disorder. In individuals with rheumatoid arthritis, the immune system attacks the lining of the joints, called the synovium, causing “flares,” or periods of experiencing one or more of the following in affected areas:
- Inflammation and superficial warmth
- Loss of function
- Bumps beneath the skin called “rheumatoid nodules”
- General feelings of malaise such as sickness, fever, fatigue
It is very important to attain an early diagnosis, as it is possible for rheumatoid arthritis to progress very quickly and cause irreparable damage and destruction to the tendons, ligaments, cartilage, and bones in and around the joints, leading to the erosion and physical deformation of the joints. It may also affect the lungs, heart, eyes, and blood vessels, and can increase the risk of developing osteoporosis and carpal tunnel syndrome. A rheumatologist can make this diagnosis via blood tests for various factors, as well as X-rays to determine the progression of the disease’s impact on joints.
While each individual with rheumatoid arthritis experiences the disease differently, it typically affects joints in the extremes of the hands and feet first, then spreads towards more central joints like the ankles, knees, hips, elbows, and shoulders. Typically inflammation is symmetrical, meaning that both of an affected joint (for example, the left and right ankle) will experience the same symptoms at the same time. Progression of the disease can be slow or rapid, as the immune system initially attacks the synovium, damaging the bones and cartilage within the joint, and eventually causing damage to the ligaments and tendons that hold the joint together. The frequency of this process can vary, causing flares to occur often or with large periods of time in between them.
Currently, rheumatoid arthritis affects approximately 1.5 million Americans. The disease typically occurs at middle age, but it can also occur in children and the elderly. It affects two to three times as many women as men. The exact cause of the disease is unknown, though it is believed to be due to a combination of genetic, environmental, and hormonal factors that somehow trigger the immune system. Smoking also increases the risk of developing rheumatoid arthritis.
Unfortunately, there is no cure for rheumatoid arthritis. However, there are a wide variety of symptom management treatments that may work on their own or in combination, depending on the specific needs of the individual. These include:
- Laboratory medicines (ex: anti-inflammatories, pain relievers)
- Alternative medicines (ex: fish and plant oils)
- General and strategic rest and relaxation
- Use of assistive devices (especially during flares)
- New, less intensive methods for conducting daily tasks (to keep some stress off of joints)
- Surgical procedures (ex: total joint replacement, joint fusion)
- Heat application to ease pain and relax muscles
- Cold application to dull pain and decrease spasms
Finally, one of the most beneficial approaches to managing rheumatoid arthritis is engaging in regular physical activity. Some of the most beneficial exercises that can be performed by those with the disease include exercises and stretches that help maintain and improve flexibility and range of motion of joints, as well as those that strengthen muscles around joints. Additionally, to limit the impact of exercise on joints, low-impact activities such as walking and water aerobics may be recommended for individuals with rheumatoid arthritis.