Rheumatoid arthritis (RA) is both an inflammatory condition and an autoimmune disease. For unknown reasons, your immune system attacks the lining of the joints, causing pain and tenderness, swelling, and limited range of motion.
RA is a progressive disease in most people, meaning that the symptoms intensify over time. Early and aggressive treatment can manage symptoms and help you live a normal, independent life.
Types of RA
Rheumatoid arthritis is a form of joint disease known as polyarthritis, or one that affects at least five separate joints. The condition can be classified even further, depending on the severity and frequency of symptoms:
- monocylic: you may have an extended flare of symptoms lasting an average of two to five years, after which point symptoms abate and do not recur
- polycyclic: pain and inflammation fluctuates over the course of your life
- progressive: pain, swelling and limited function increases with time and does not recede
Early diagnosis and treatment—within six months of experiencing symptoms, according to the Centers for Disease Control and Prevention—can play a role in keeping your pain at bay or in a period of remission (CDC, 2011). However, even with treatment, some people with RA suffer from progressive symptoms that may lead to joint deformity and severely limited ability to perform everyday activities.
The autoimmune nature of RA means that your entire body is affected by inflammation, not just your joints. In fact, you might not realize you are dealing with arthritis in the early stages of the disease. Initial signs of RA can include muscle aches, low-grade fever, and loss of appetite—symptoms that could easily be mistaken for the flu.
Joint pain, swelling, and stiffness become the main symptoms as RA progresses. Joints in the hand and fingers are commonly affected. Your joints might feel warm to the touch because of inflammation. Everyday activities such as dressing yourself, walking, or opening jars and containers become difficult to manage as your condition progresses.
RA affects symmetrical joints. In other words, you'll experience symptoms on both sides of your body, such as both knees, at the same time.
Progression of the Disease
The pain and inflammation associated with RA can become disabling and cause damage to other areas of your body as the disease progresses. For example:
- The cartilage that cushions your joints can begin to wear away.
- The attack by your immune system can also compromise the health and function of the ligaments and tendons that hold your joints together.
- Some people develop hard lumps under the skin of their fingers, spine, heels or elbows. These lumps, called rheumatoid nodules, are usually found on pressure points throughout the body.
Rheumatoid nodules may or may not be painful, depending on their location. However, they can interfere with physical function and might cause you to be self-conscious about your appearance.
Most people with RA experience flare-ups—times when symptoms worsen—that may calm down with the help of lifestyle modification and medication. Even if you suffer form a progressive form of the disease, you might not have extreme pain all the time.
As RA progresses, you may feel sad, withdrawn, and depressed. Depression is common among people with chronic illness, and should be discussed with your doctor. Anti-depressant medication and support groups may be appropriate methods to helping you feel less down-in-the-dumps.
Aggressive treatment is the key to the management of RA. Begin treatment early to minimize inflammation, maintain range of motion in your joints, and to reduce pain. Two types of medication are commonly prescribed to control RA: anti-inflammatory drugs and disease-modifying or biologic agent medications. Your doctor may prescribe one or both classes of medication.
Anti-inflammatory medications reduce the system-wide inflammation and localized swelling. Disease-modifying and biologic drugs slow the progression of the disease and promote remission by stopping the attacks by your immune system. By suppressing your immune system, you can save your body from deformity and disability. However, there are also side effects. Your immune system is not as strong when you take disease-modifying drugs and you are more susceptible to other illnesses, such as the common cold and flu.
The earlier you get into treatment, the better chance you have for slowing the progression of RA. Arthritis Today reports that newly diagnosed patients with joint pain in their hands were able to stave off full-blown RA for more than a year steroid injections (Arthritis Today, 2009).
Lifestyle and Support
Drug therapy plays a major role in controlling the progression of RA. However, lifestyle adjustments can also make your life more comfortable and easier to manage. Daily exercise may sound counter-intuitive when your joints hurt, but it can be effective in reducing fatigue and maintaining joint flexibility and range of motion. Discuss exercise options with your doctor to determine what type of activity is right for you.
See our slideshow, 8 Essential Everyday Exercises to Manage Pain to learn more.
Diet may also fend off symptoms in some people. Omega-3 fatty acids, found in certain kids of fish, walnuts, and flaxseed products, may reduce inflammation throughout the body. Foods rich in antioxidant vitamins C, E, and A may also keep your body safe from oxidative stress, damage at the basic cellular level.
Learn the importance of food when treating RA.
Seek out a support group with whom you can share your thoughts, feelings, and fears about the progressive nature of RA. Chronic arthritis may be something you deal with throughout your life, but it does not need to take over your life.