Definition
Like osteoarthritis, rheumatoid arthritis (RA) is a disease that leads to inflammation, swelling and pain in the joints. Unlike osteoarthritis, it also tends to affect other parts of the body.
Rheumatoid arthritis is an autoimmune disease, which means that it arises because the body’s immune system attacks normal tissues in the body.
Women are more prone to RA than men are; this has led to the perception that it is a disease that only affects younger women. In fact, it is the second most common musculoskeletal disorder (after osteoarthritis) in older people and it is possible to have both conditions. Interestingly, people who develop RA later in life are more likely to have complete remission with treatment.
Symptoms of RA include
- symmetrical inflammation of joints (the fingers and hands, wrists, feet, elbows and ankles are often affected first)
- pain and stiffness in the morning or after a period of inactivity
- fatigue appearing later in the day
- mild fever
- swelling of the lymph nodes
- inflammation in blood vessels, the membranes surrounding the lungs or the heart, or the eyes
To confirm the diagnosis, a doctor will usually send a patient for x-rays and a blood test to check for an antibody called rheumatoid factor or other signs of inflammation. Sometimes, he or she will draw a sample of fluid from the affected joint and send that for laboratory analysis.
Treatment
People with RA need both exercise and adequate rest. Even if you have active arthritis, it is important to do at least some walking. It is also important to follow a healthy, balanced diet. Your doctor will prescribe a program for you and may suggest you see a dietitian, occupational therapist or physiotherapist to help you make any necessary lifestyle changes.
There are many drugs available for the treatment of RA, and the appropriate therapy for your condition will depend on the stage and extent of the disease. Some of the agents used are:
- over-the-counter agents such as aspirin or ibuprofen, which reduce both pain and inflammation
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- disease-modifying antirheumatic drugs (DMARDs), such as methotrexate and sulfasalazine
- corticosteroids, immunosuppressants and newer “biologic” therapies, which fight the overactivation of the immune system
Your doctor will advise you which of these is best for you.