Rheumatoid arthritis (RA) is a chronic disorder that involves inflammation of the lining of the joints. It typically starts in the small joints of the hands, and causes pain, redness, and swelling. RA is an autoimmune disease, which means the body’s own immune system attacks the joints as if they’re some type of virus or bacteria.
RA is a progressive disease, which means that symptoms will gradually worsen. As the condition progresses, it may spread to other joints, like the feet, ankles, wrists, elbows, and knees. It may also advance to the joints between the vertebrae in the spine, and even affect major organs like the skin, heart, and kidneys.
Even though there’s no cure for RA, it’s a manageable and treatable disease.
Managing the Progression
The goal of treatment is to slow the progression of RA and treat the symptoms. Healthcare providers typically use a combination approach of drug treatment, reducing stress on the joints, and physical therapy. In some cases, surgery may be necessary.
The first line of defense against RA is a class of drugs known as DMARDs, or disease-modifying anti-rheumatic drugs. DMARDs, which include newer biologic medications, are very effective, and doctors are now turning to DMARDs as soon as a diagnosis is made. These drugs are a type of anti-inflammatory, so they actually work to change the course of RA, rather than just treating the symptoms.
For acute, “right now” pain and inflammation, over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) may be used. These include household staples like ibuprofen (Advil, Motrin) and naproxen (Aleve).
Drugs like prednisone and cortisone reduce both inflammation and temper the body’s immune response. Corticosteroids are often used as short-term fixes, or during the four to six week period before DMARDs begin to take effect. There are a number of side effects and risks associated with corticosteroids, so some doctors may avoid prescribing them to avoid side effects.
Reducing Joint Stress
The next step in managing the progression of RA is reducing stress on the joints. During a flare-up, when joints are at their most painful, rest is very important. Maintaining a healthy weight will prevent added strain, as carrying even a little bit of extra weight greatly increases stress on the joints. If walking is difficult, using a cane or walker can take some of the burden off of stressed joints.
Regular exercise is very important to joint health. It strengthens muscles around the joints, reduces stress and inflammation, and improves mobility and flexibility. For people with RA, it’s important to stick with low-impact or nonimpact exercise. A physical or occupational therapist can help you come up with a personalized exercise plan geared towards your needs.
Dealing with Side Effects
As RA progresses, complications and side effects can arise. You may experience:
- skin problems, like rashes, bumps, or ulcers
- eye problems, like inflammation and dry eyes
- inflammation of the blood vessels or the membrane around the heart
- increased risk of heart attack and stroke
- anemia, or low red blood cell count
- diseases of the lungs or kidneys
- fatigue, lack of sleep
It’s important to talk to your doctor if you experience these or any other unusual symptoms that could be related to your RA. Side effects like skin and eye problems, anemia, fatigue, and depression are treatable with either medications or lifestyle changes. Other problems involving the heart, lungs, and kidneys need to be caught early, so ask your doctor about regular monitoring of these major organs, especially if you are taking corticosteroids.
As with any disease, your overall health plays a key role in managing your RA, and dealing with side effects and complications. Try to maintain a healthy diet, get plenty of rest and exercise, and stay in open communication with your healthcare providers to manage your RA progression.