​​Rheumatoid Arthritis: Symptoms, Causes, & Treatment

What is rheumatoid arthritis? 

Rheumatoid arthritis, or RA, is a type of autoimmune arthritis that affects more than 1.3 million Americans in the world today. If you or a loved one has recently been diagnosed with rheumatoid arthritis, it’s natural to experience feelings of anxiety, frustration—even grief. But information is your first line of defense. The more you know about RA and how to manage it, the better equipped you will be to cope with this disease. 

What are the signs and symptoms of rheumatoid arthritis? 

The most common signs and symptoms of RA include: 

• Tender, warm, swollen joints 
• Joint stiffness in the morning and after periods of inactivity 
• Fatigue, fever, and loss of appetite 
• Dry eyes and mouth 
• Firm lumps beneath the skin, known as rheumatoid nodules 

RA symptoms have a tendency to change or progress over time, affecting the smaller joints first before spreading to the wrists, knees, ankles, elbows, hips and shoulders. Typically, symptoms will occur in the same joints on both sides of the body. Because there are many diseases that are commonly mistaken for RA, it’s important to get a correct diagnosis from your doctor in order to avoid unnecessary testing.

How is rheumatoid arthritis diagnosed? 

In its early stages, rheumatoid arthritis can be difficult to diagnose because the early signs and symptoms mimic those of many other diseases. There is no one blood test or physical finding that can confirm a RA diagnosis. Instead, your healthcare provider will perform a physical exam and ask you about your signs and symptoms. He or she may check your joints for swelling, redness and warmth, as well as check your reflexes and muscle strength.

How is rheumatoid arthritis treated? 

Treatments for RA usually aim to lower inflammation and swelling, ease painful symptoms, and prevent long-term joint damage. Treatment varies from patient to patient, so it is important to consult with your doctor to see what will work best for you, though most patients use a combination of medication, therapy, and possibly even surgery. 

Medications 

NSAIDs 

Nonsteroidal anti-inflammatory drugs (NSAIDs) help to relieve pain and reduce inflammation. You can buy certain NSAIDs over-the-counter, such as Advil, Motrin IB, and Aleve, while stronger NSAIDs are available via prescription. Side effects may include stomach irritation, heart problems and kidney damage.

Steroids 

Steroids help to reduce inflammation and pain, while slowing joint damage. However, steroids can cause bone thinning, weight gain, as well as diabetes, and should not be prescribed for long term use. 

DMARDs 

Disease-modifying antirheumatic drugs (DMARDs) can slow the progression of RA, while saving the joints from permanent damage. Common DMARDs include methotrexate (Rheumatrex, Trexall, Otrexup, Rasuvo), leflunomide (Arava), hydroxychloroquine (Plaquenil) and sulfasalazine (Azulfidine).

Biologic agents 

Biologic agents are a newer class of DMARDs that target parts of the immune system that trigger inflammation that causes joint and tissue damage. Common examples include abatacept (Orencia), adalimumab (Humira), anakinra (Kineret), certolizumab pegol (Cimzia), etanercept (Enbrel), golimumab (Simponi), infliximab (Remicade), rituximab (Rituxan), and tocilizumab (Actemra).

Therapy 

Physical or occupational therapy can help with the painful symptoms of RA by introducing you to new exercises to help keep your joints flexible.

Surgery 

You and your doctor may consider surgery to repair your damaged joints if medications fail to prevent or slow the damage. Surgery may also help restore your ability to use the joint, reduce pain, and improve function. 

Lifestyle remedies 

Rest and exercise 

There will be times when your RA is more active than others, and it will be important to rest during these times in order to decrease swelling, pain, and fatigue. However, exercise can help strengthen your muscles and increase joint flexibility. For those living with RA, you can try low-impact exercises such as swimming and stretching. A few tips: 

• Exercise consistently to achieve meaningful results 
• Choose comfortable accessories to properly fitting shoes or a slip-resistant yoga mat to reduce your risk of injury 
• Be open to a variety of exercise to accommodate stiffness or pain in certain areas on certain days 

Joint care 

Wearing a splint when your RA is active may help to reduce pain swelling. Additionally, there are a number of self-help devices that can continue to protect your joints, ranging from zipper pulls and long-handled shoe horns to adaptive toothbrushes and devices to help you get on and off chairs. 

Stress & mental health management 

A RA diagnosis may ignite feelings of fear, anger, and frustration. Techniques like meditation, deep breathing, or other relaxation techniques, in addition to regular exercise, can help manage this stress. In addition to talking to friends and family, you can consider adding a mental health expert to your care team, or joining an online support group. 

Healthy diet 

A healthy diet is an important part of caring for your RA, and maintaining at a lower weight can alleviate joint stress. 

Although there’s no cure for rheumatoid arthritis, there are many effective treatments available for managing your symptoms like joint pain and inflammation, as well as treatments for slowing the progression of the disease. Early diagnosis and treatment can help your prognosis, so talk to you healthcare provider today if you are suffering from joint pain or swelling.  

Sources:

• Rheumatoid arthritis. (2021, May 18). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648. 
• Rheumatoid Arthritis: What is it, Causes, Symptoms and Treatment. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4924-rheumatoid-arthritis.