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What’s rheumatoid arthritis?
Rheumatoid arthritis (RA) is an autoimmune disease that can cause joint pain and damage throughout your body.
The joint damage that RA causes usually happens on both sides of the body.
So, if a joint is affected in one of your arms or legs, the same joint in the other arm or leg will probably be affected, too. This is one way that doctors distinguish RA from other forms of arthritis, such as osteoarthritis (OA).
Treatments work best when RA is diagnosed early, so it’s important to learn the signs. Read on to learn everything you want to know about RA, from types and symptoms to home remedies, diets, and other treatments.
RA is a chronic disease marked by symptoms of inflammation and pain in the joints. These symptoms and signs occur during periods known as flares or exacerbations. Other times are known as periods of remission — this is when symptoms disappear completely.
While RA symptoms can affect several organs in the body, the joint symptoms of RA include:
Symptoms can vary from mild to severe. It’s important not to ignore your symptoms, even if they come and go. Knowing the early signs of RA will help you and your healthcare provider better treat and manage it.
Diagnosing RA can take time and may require multiple lab tests to confirm clinical examination findings. Your healthcare provider will use several tools to diagnose RA.
First, they’ll ask about your symptoms and medical history. They’ll also perform a physical exam of your joints. This will include:
- looking for swelling and redness
- examining joint function and range of motion
- touching the affected joints to check for warmth and tenderness
- testing your reflexes and muscle strength
If they suspect RA, they’ll most likely refer you to a specialist called a rheumatologist.
Since no single test can confirm a diagnosis of RA, your healthcare provider or rheumatologist may use several different types of tests.
They may test your blood for certain substances like antibodies, or check the level of certain substances like
Tests not only show if joint damage has occurred but also how severe the damage is.
A complete evaluation and monitoring of other organ systems might be recommended for some people with RA, too.
There are several types of blood tests that help your healthcare provider or rheumatologist determine whether you have RA. These tests include:
- Rheumatoid factor test. The RF blood test checks for a protein called rheumatoid factor. High levels of rheumatoid factor are associated with autoimmune diseases, especially RA.
- Anticitrullinated protein antibody test (anti-CCP). This test looks for an antibody that’s associated with RA. People who have this antibody usually have the disease. However, not everyone with RA tests positive for this antibody. The anti-CCP Ab is more specific for RA than the RF test
- Antinuclear antibody test. The antinuclear antibody panel tests your immune system to see if it’s producing antibodies. Your body may make antibodies as a response to many different types of conditions, including RA.
- Erythrocyte sedimentation rate. The ESR test helps determine the degree of inflammation in your body. The result tells your doctor whether inflammation is present. However, it doesn’t indicate the cause of the inflammation.
- C-reactive protein test. A severe infection or significant inflammation anywhere in your body can trigger your liver to make C-reactive protein. High levels of this inflammatory marker are associated with RA.
There’s no cure for RA, but there are treatments that can help you manage it.
Rheumatoid arthritis (RA) can keep both patients and physicians on their toes as they figure out the best ways to treat the symptoms and slow the progression of the condition.
Recently, advances in treatment strategies have resulted in ever-improving outcomes and quality of life for those with rheumatoid arthritis. Treat to Target Rheumatoid Arthritis is a treatment philosophy that rheumatologists use to effectively manage this disease.
The treat-to-target approach has resulted in fewer symptoms and higher remission rates for those with RA. The treatment strategy involves:
- setting a specific testing goal that signals either remission or low disease state
- testing acute phase reactants and performing monthly monitoring to assess progress of treatment and management plan
- switching medication regimen promptly if progress isn’t made.
Treatments for RA help to manage the pain and control the inflammatory response which can in many cases result in remission. Decreasing the inflammation can also help to prevent further joint and organ damage.
Treatments may include:
Your healthcare provider will work with you to determine the best treatment plan for your medical needs.
For many people, these treatments help them live an active life and reduce the risk of long-term complications.
There are many types of medication for RA. Some of these medications help to reduce the pain and inflammation of RA. Some help to reduce flares and limit the damage that RA does to your joints.
The following over-the-counter medications help reduce the pain and inflammation during RA flares:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
The following drugs work to slow the damage that RA can cause to your body:
- Disease-modifying antirheumatic drugs (DMARDs). DMARDs work by blocking your body’s immune system response. This helps to slow down the progression of RA.
- Biologics. These new generation biologic DMARDs provide a targetedresponse to inflammation rather than blocking your body’s entire immune system response. They may be an effective treatment for people who don’t respond to more traditional DMARDs.
- Janus kinase (JAK) inhibitors. These are a new subcategory of DMARDs that block certain immune responses. These are drugs that your healthcare provider may use to help prevent inflammation and stop damage to your joints when DMARDs and biologic DMARDs don’t work for you.
Certain home remedies and lifestyle adjustments may help to improve your quality of life when living with RA. This includes exercise, rest, and assistive devices.
Low-impact exercises can help to improve the range of motion in your joints and increase your mobility. Exercise can also strengthen muscles, which can help to relieve some of the pressure from your joints.
You may also want to try gentle yoga which can help you regain strength and flexibility.
Get enough rest
Apply heat or cold
Ice packs or cold compresses can help to reduce inflammation and pain. They may also be effective against muscle spasms.
You can alternate cold with hot treatments such as warm showers and hot compresses. This may help to reduce stiffness.
Try assistive devices
Certain devices such as splints and braces can hold your joints in a resting position. This may help to reduce inflammation.
Canes and crutches can help you maintain mobility, even during flares. You can also install household devices, such as grab bars and handrails in bathrooms and along staircases.
Shop home remedies
Your healthcare provider or dietitian may recommend an anti-inflammatory diet to help with your symptoms. This type of diet includes foods that have lots of omega-3 fatty acids.
Foods high in omega-3 fatty acids include:
- fatty fish like salmon, tuna, herring, and mackerel
- chia seeds
- flax seeds
- berries, such as blueberries, cranberries, goji berries, and strawberries
- dark chocolate
- kidney beans
Eating lots of fiber is also important. According to some researchers, fiber may help reduce inflammatory responses which may decrease C-reactive protein levels. Choose whole grain foods, fresh vegetables, and fresh fruit. Strawberries may be particularly beneficial.
Foods containing flavonoids can also help to counter inflammation in the body. They include:
- soy products, such as tofu and miso
- green tea
What you don’t eat is just as important as what you do eat. Make sure to avoid trigger foods. These include processed carbohydrates and saturated or trans fats.
Avoiding trigger foods and choosing the right foods in trying to follow an anti-inflammatory diet may help you manage your RA.
There are several different types of RA. Knowing which type you have may help your healthcare provider provide the best type of treatment for you.
Types of RA include:
- Seropositive RA. If you have seropositive RA, you have a positive rheumatoid factor blood test result. This means you have the antibodies that cause your immune system to attack joints.
- Seronegative RA. If you have a negative RF blood test result and a negative anti-CCP result, but you still have RA symptoms, you may have seronegative RA. You may eventually develop antibodies, changing your diagnosis to seropositive RA.
- Juvenile idiopathic arthritis (JIA). Juvenile idiopathic arthritis refers to RA in children ages 17 years old and younger. The condition was previously known as juvenile rheumatoid arthritis (JRA). The symptoms are the same as those of other types of RA, but they may also include eye inflammation and issues with physical development.
Seropositive RA is the most common type of RA. This type of arthritis may run in families. Seropositive RA may come with more severe symptoms than seronegative RA.
Presenting symptoms of seropositive RA can include:
- morning stiffness lasting 30 minutes or longer
- swelling and pain in multiple joints
- swelling and pain in symmetrical joints
- rheumatoid nodules
- weight loss
RA isn’t always confined to the joints. Some people with seropositive RA can experience inflammation in the eyes, salivary glands, nerves, kidneys, lungs, heart, skin, and blood vessels.
The exact cause of RA isn’t known. However, certain factors seem to play a role in increasing the risk of developing RA or triggering its onset.
Factors that may increase your risk for RA include:
- being a woman
- having a family history of RA
Factors that may trigger onset of RA involve:
- exposure to certain types of bacteria, such as those associated with periodontal disease
- having a history of viral infections, such as the Epstein-Barr virus, which causes mononucleosis
- trauma or injury, such as bone breakage or fracture, dislocation of a joint, and ligament damage
- smoking cigarettes
- having obesity
The cause may not be known but there are several risks and triggers.
Arthritis in the hands may start as a low-level burning sensation that you feel at the end of the day. Eventually, you may experience pain that isn’t necessarily from using your hands. This pain can get quite severe if you don’t treat it.
You may also feel:
If the cartilage in your joints wears away, you may notice some deformities in your hands. You may also have a grinding feeling in the joints of your hands, fingers, and large joints, if the cartilage deteriorates completely.
As the disease progresses, fluid-filled sacs or synovial cysts typically develop in the wrists, knees, elbows, ankles and around the small joints of the hands. These cysts aren’t without complications and tendon rupture can occur in some cases.
You may also develop knobby growths, called bone spurs, in the affected joints. Over time, bone spurs can make it harder for you to use your hands.
If you have RA in your hands, your healthcare provider will work with you on exercises that can help you retain movement and function.
Exercises, along with other types of treatment, can help reduce inflammation and stave off progression of the disease.
RA may be most visible in your hands and feet, particularly as the disease progresses and especially if you don’t currently have a treatment plan.
Swelling of fingers, wrists, knees, ankles, and toes are common. Damage to ligaments and swelling in the feet can cause a person with RA to have trouble walking.
If you don’t get treatment for RA, you may develop severe deformities in your hands and feet. Deformities of the hands and fingers may cause a curved, claw-like appearance.
Your toes can also take on a claw-like look, sometimes bending upward and sometimes curling under the ball of the foot.
You may also notice ulcers, bunions, and calluses on your feet.
Lumps, called rheumatoid nodules, can appear anywhere on your body where joints are inflamed. These can range in size from very small to the size of a walnut or larger, and they can occur in clusters.
Like RA, people with osteoarthritis (OA) can experience painful and stiff joints that make moving around difficult.
People with OA may have joint swelling after extended activity, but OA doesn’t cause any significant inflammatory reaction that typically results in redness of the affected joints.
Unlike RA, OA isn’t an autoimmune disease. It’s related to the natural wear and tear of the joints as you age, or it can develop as a result of trauma.
OA is most often seen in older adults. However, it can sometimes be seen in younger adults who overuse a particular joint — such as tennis players and other athletes — or those who’ve experienced a severe injury.
RA is an autoimmune disease. The joint damage from RA isn’t caused by normal wear and tear. It’s caused by your body attacking itself.
Rheumatoid arthritis isn’t considered a hereditary disease, yet it does appear to run in families. This may be due to environmental causes, genetic causes, or a combination of both.
If you have family members who have or have had RA, talk to your healthcare provider, especially if you have any symptoms of persistent joint pain, swelling, and stiffness unrelated to overuse or trauma.
Having a family history of RA increases your risk of getting the disease, and early diagnosis can make a big difference in how effective treatment will be.
RA is a chronic disease that doesn’t currently have a cure. That said, most people with RA don’t have constant symptoms. Instead, they have flare-ups followed by relatively symptom-free periods called remissions.
The course of the disease varies from person to person, and symptoms can range from mild to severe.
Though symptoms may stop for extended periods, joint problems caused by RA will usually get worse over time. That’s why early treatment is so important to help delay serious joint damage.
If you’re experiencing any symptoms or have concerns about RA, talk to your healthcare provider.