What is RA?
RA, the most common type of autoimmune arthritis, triggers a faulty reaction in the body’s immune system, where it mistakes the body’s own tissues for foreign bodies, like bacteria and viruses, and attacks them. Unlike osteoarthritis, this disease attacks the linings of the joints, causing swelling, which, over time, can lead to joint erosion and deformity.
While arthritis is a disease typically associated with joint pain, this systemic disease can attack major organs, including the heart, lungs, eyes, vascular system, skin and other tissues, causing permanent disability. Infections related to RA are responsible for up to 25 percent of deaths in people with RA.
What are the signs?
Symptom onset for RA typically starts between the ages of 30 and 60, although even young children can begin experiencing symptoms. Surprisingly, more than 300,000 children have juvenile RA.
Early symptoms of the disease are similar to other forms of arthritis: small joints, typically in the fingers or toes, may begin to feel stiff, swollen or warm. The symptoms may come and go in flare-ups, lasting for a few days or weeks before easing.
Over time, however, RA will begin to affect larger joints, including the hips, shoulders or knees, and symptoms will become more severe, with remission periods shortening.
RA also may present with other symptoms, which can include:
· Chronic fatigue
· Fevers
· Numbness in the hands or tingling sensation, caused by carpal tunnel syndrome as a result of RA
· Pain in the front of the foot
· Locked joints, especially in the knees and elbows
· Anemia
· Morning stiffness
· Loss of appetite/weight loss
· Dry eyes and mouth
· The appearance of hard lumps, called rheumatoid nodules, beneath the skin around the elbows or hands
· Injuries that are slow to heal, especially in younger patients
Because some symptoms can mimic other forms of arthritis, misdiagnosis is possible in early stages. Because of the damage that this condition can cause, it’s important to seek an accurate diagnosis and implement treatment as early as possible. According to Healthline, 60 percent of RA patients who haven’t received proper treatment are unable to work 10 years after symptom onset.
Am I at risk?
No one knows what causes RA, although new research has given scientists a better understanding of how the immune system attacks the body and causes inflammation. Research indicates that people with RA have a specific genetic marker that can increase a person’s chances of developing the disease fivefold, although not all people with the marker develop the disease.
Gender seems to be one of the greatest risk factors for RA, but other factors contribute to a person’s risk of developing the disease, including:
· Age -- typical symptom onset seen around the age of 40
· Environmental factors -- air pollution, insecticides and occupational exposures can increase the risk of developing RA
· Infectious agents -- bacteria or viruses can trigger the development of the disease in someone who is at risk for getting it
· Weight -- obese people being at a higher risk of developing RA than their fit counterparts
· Lifestyle choices, such as smoking
What are my treatment options?
If you suspect that you have RA, make an appointment with your doctor to get an exam and diagnosis. You’ll be asked about your family and personal medical history, as well as receive an exam that will focus on your joints. Blood tests may be ordered to measure inflammation levels and check for antibodies associated with the disease.
As part of testing, your doctor may order X-rays, ultrasounds or MRIs to check for bone damage and narrowing of the joint space. This isn’t a marker of RA because patients in early stages of the disease may not have any joint damage, but it will give your doctor a measure of the disease's progression.
While there is no cure for RA, new treatments have shown success in managing pain, decreasing inflammation, minimizing joint damage and slowing the progression of the disease. You should make an appointment with your doctor to discuss a treatment regimen that will address your specific symptoms. There are a number of medications that can be used to treat symptoms, including:
· Non-steroidal anti-inflammatory drugs (NSAIDs) and low-dose corticosteroids are given to decrease swelling, pain, and fevers associated with the disease.
· Disease-modifying anti-rheumatic drugs (DMARDs) are prescribed not only to ease symptoms, but also to slow the progression of the disease. These drugs have been shown to ease symptoms and improve the quality of life for patients with RA.
· Biologic DMARDs are biologic response modifiers that are prescribed in patients with more severe or advanced forms of RA. These drugs target parts of the immune system that lead to tissue and joint damage.
Low-impact aerobic exercises, including walking and swimming, and muscle-strengthening exercises can help ease pressure on your joints and improve overall health. These exercises are essential for minimizing joint damage and reducing the risk of a joint replacement.
RA, especially uncontrolled RA, can increase a person’s risk of heart disease and stroke, according to the American College of Rheumatology. Because of this, it’s important to maintain an active lifestyle, but scale back activities during flare-ups, focusing on range of motion exercises and stretches that keep joints flexible. A physical therapist (PT) can work with you to develop a series of exercises and stretches that will be best suited to your individual needs.
Chronic diseases are also linked to increased incidences of depression. If you find yourself feeling isolated or depressed, it’s important to discuss these feelings with your physician or meet with support groups or a counselor who can talk to you about steps to reduce these symptoms.