Conquering the Pain Of Rheumatoid Arthritis
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Rheumatoid arthritis (RA) is an autoimmune disease, which means that your own immune system attacks your body and causes inflammation. RA is an ongoing condition that mostly affects joints, but it also can damage other body systems. For example, RA may cause inflammation in your lungs, heart muscle, blood vessels, and eyes.
If RA is not well-controlled over years, it puts you at greater risk of hardening of the arteries, stroke, and cancer. It also increases your risk of getting some cancers and lymphomas. An estimated 1.3 million Americans have RA, according to the Arthritis Foundation.
RA is not the same as osteoarthritis, although both cause joint pain. These two types of arthritis have different causes and effects throughout a person’s life.
Causes And Risk Factors
There is no known cause or risk factor for RA. Some doctors think it may be triggered by infection, but that hasn’t been proven.
What doctors and scientists have observed is that RA:
- Occurs most often in people during their 20s through 50s
- Is 1.5 times more likely in women than in men
- Tends to be the same in women as in men
- Generally doesn’t occur (or flare up) in women who are pregnant
Symptoms
The most debilitating effects of RA are typically joint pain and swelling. The hands and wrists are commonly affected, and usually on both sides. Joint pain may also occur in the knees, ankles, feet, shoulders, and neck. Many people even develop significant joint damage that can’t be reversed.
Below are common symptoms of RA:
- Joint pain
- Stiffness that lasts for several hours, requiring you to get up earlier than usual to ease into movement
- Fatigue, which can lead to inactivity and deconditioning of muscles
- Inability to bend or straighten some joints as the disease progresses
- Weight loss from loss of appetite, or weight gain from inactivity
- Difficulty sleeping if in pain
- Dry mouth
- Eye discharge, dryness, itching
Later signs of the disease are chest pain when you breathe, and hard, unsightly lumps of tissue beneath the skin that typically show up on the hands and elbows.
Diagnosis
It is recommended that anyone who has persistent joint pain and swelling should see a doctor for evaluation. To diagnose RA, you doctor will typically:
- Ask you about symptoms
- Perform a physical exam, including looking at your joints for signs of swelling or tenderness
- Order X-rays to help confirm RA or rule out other causes of joint pain
- Order blood tests to rule out other conditions or identify antibodies that can precede onset of RA symptoms
Treatment
Treatment options for RA have improved dramatically in recent years. Years ago, there wasn't much. Everything changed for the better when biologics such as Enbrel® (1998), Remicade® (1993), and Humira® (2003) became available.
Early diagnosis helps you to get appropriate treatment as early as possible. This limits permanent damage to joints and organs. Biologics target specific parts of the immune system that drive inflammation. One limitation is that, currently, there are no markers in the blood that allow doctors to match the correct drug to what’s driving the inflammation.
Further, sometimes people think they are doing well enough to stop their medications. This isn’t a good idea without medical advice. By the time people return, worsening joint damage can occur. If you need or want to taper off, ask your doctor for advice first.
Outlook
There are currently about 15 to 20 medication options for the treatment of RA. Most people will respond to something and will be much better off than when they started. Research to develop new drugs and treatments is ongoing. Talk with your doctor about a treatment that might be right for you.
Currently, RA cannot be cured. If RA is poorly controlled over years, it can shorten a person’s lifespan by six or seven years. You can improve your odds by taking the right medicine for you and staying physically active. Walking, swimming, and biking are good examples. Maintaining a healthy weight that doesn’t put stress on your joints is also advisable. Generally, there is hope that you'll have the ability to stay active, work, and have a better quality of life.
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Source: Centers for Disease Control and Prevention; Healthline
