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Frequently Asked Questions

What is rheumatoid arthritis?

Short Answer

It is a chronic autoimmune disorder that causes inflammation of the joints.

Long Answer

The word arthritis comes from the Greek words arthro (joint) and itis (inflammation). There are more than 100 types of arthritis, all of which cause inflammation and pain in one or more joints. The most common forms are osteoarthritis and rheumatoid arthritis.

In rheumatoid arthritis (RA), the body's immune system attacks the tissue lining the joint, causing it to become inflamed. If left untreated for a long period of time, tendons, ligaments, cartilage, and bone can be affected and joints may become severely damaged. Early diagnosis and aggressive treatment are key to slowing or stopping the progression of the disease and help prevent joint damage.

The cause of RA is unknown. Risk factors include:

  • Genetics
  • Gender: Women are two to three times more likely to develop RA.
  • Smoking
  • Age: Although RA can occur at any age, it's more likely in those over age 30 for women and later for men.

Symptoms

Joints potentially affected by rheumatoid arthritis The onset and progression of the disease varies from person to person. Most of the time RA develops slowly, affecting more joints over time, but sometimes it can appear suddenly and painfully. Symptoms can lessen or even disappear for periods of time, followed by flare-ups (called "flares").

Normally, RA sets into smaller joints first such as fingers, knuckles, wrists, or toes. Later on, it can spread to knees, ankles, elbows, shoulders, neck, and hips. When a joint on one side of the body is affected, the same joint on the other side will be also be affected.

Affected joints can be stiff, painful, swollen, and warm and the skin over the joint can turn pink or red. A classic sign is joint stiffness that lasts at least an hour after waking up or after periods of inactivity.

Other symptoms can include:

  • Mild to severe fatigue
  • Anemia
  • Weight loss or loss of appetite
  • Low-grade fever
  • Depression
  • Weakness

It's important to begin treatment early if you have RA. See your doctor if:

  • Unusual joint pain persists or worsens.
  • Affected joints are stiff for an hour or more in the morning.
  • Joints are swollen.
  • Several joints are affected.

Diagnosis

Your doctor will ask you about the history, frequency, duration, and nature of your symptoms and examine your joints. Tests may be ordered to help confirm or rule out RA such as:

  • An erythrocyte sedimentation rate (ESR) blood test that detects inflammation.
  • A C-reactive protein (CRP) blood test that checks for inflammation.
  • A rheumatoid factor (RF) blood test to detect the presence of an antibody that is present in the majority of people with RA.
  • Imaging tests such as an x-ray, ultrasound, or MRI.

Treatment

There is no cure for RA but early diagnosis and aggressive treatment helps reduce pain, prevent joint damage, and slow the progression of the disease.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are used to reduce pain and inflammation but have no effect on the arthritis itself. Some are available over the counter and others by prescription. Celecoxib is a COX-2 inhibitor that has fewer gastrointestinal side effects but has cardiovascular risks for those with hypertension, high cholesterol, or who smoke.
Corticosteroids
Corticosteroids may be prescribed when NSAIDs are ineffective or when it's important to reduce inflammation quickly.
Disease-Modifying Antirheumatic Drugs (DMARDs)
DMARDs slow down the progression of the disease and helps prevent damage to the joints and surrounding tissues. It can take months before they fully take effect; in the meantime, NSAIDs or corticosteroids can be used to reduce pain and swelling.
Immunosuppressants
Because RA is an autoimmune disease, immunosuppressants may help calm down the immune system and lessen the impact of the disease.
Biologic Response Modifiers
Also called biologics or BRMs, these genetically-engineered drugs can be used along with DMARDs to target the immune system. Biologics are administered by injection or infusion. Some examples are:
  • Adalimumab (Humira)
  • Anakinra (Kineret)
  • Infliximab (Remicade)
  • Rituximab (Rituxan)

In addition to medication, physical therapy or specific exercises can help improve joint function and strength. Strategies for protecting affected joints are helpful and application of heat or cold has a variety of benefits. Once joint damage has occurred, surgery may be an option to relieve pain and restore some function.

Additional Information

Arthritic Foundation (Arthritis.org)

Rheumatoid Arthritis (Arthritis.ca)

Rheumatoid Arthritis Health Center (WebMD.com)

Rheumatoid arthritis (MayoClinic.com)

All About Rheumatoid Arthritis (MedicalNewsToday.com)

Rheumatoid arthritis (HealthCommunities.com)

Rheumatoid Arthritis (https://www.rheumatoidarthritis.org)

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