Rheumatoid Arthritis
What is rheumatoid arthritis?
Rheumatoid arthritis is a disease that causes pain, stiffness, swelling, and sometimes joint deformity. It occurs most commonly in the fingers, wrists, elbows, shoulders, jaw, hips, knees, and toes. It usually affects the same joint on both sides of the body (for example, both knees).
Rheumatoid arthritis often appears first in early adulthood or middle age. However, sometimes it does not occur until the later years. There may be one single attack, but more often the condition is persistent. The disease cannot be cured, but medicine can reduce the degree of joint inflammation and damage.
Rheumatoid arthritis affects 1 in every 100 Americans. It is three times more common in women than in men.
How does it occur?
Rheumatoid arthritis is thought to be an autoimmune disease. This means that the body's defenses against infection attack the body's own tissue. In rheumatoid arthritis, the result is that the lining of a joint becomes inflamed, causing swelling, stiffness, and deformity.
Heredity may make some people more likely than others to have rheumatoid arthritis.
What are the symptoms?
The symptoms may include:
- joint pain and stiffness, particularly morning stiffness
- red, warm, or swollen joints
- joint deformity
- mild fever, tiredness
- loss of appetite
- anemia
- small lumps or nodules under the skin.
In severe cases, there may be more widespread complications involving the circulatory system, lungs, blood vessels, and lymph glands.
How is it diagnosed?
Your health care provider will review your medical history and examine you. He or she may order blood tests and x-rays to confirm the diagnosis and measure the extent of the disease.
How is it treated?
The goal of treatment is to keep the joints working properly by reducing inflammation, relieving the pain and stiffness, and stopping or slowing down joint damage.
Many drugs are used for the long-term relief of rheumatoid arthritis. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, and naproxen, can help with both short-term and long-term relief of pain and inflammation. Disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, are also used. Treatment with DMARDs has to be watched carefully by your provider to avoid side effects. Corticosteroids are effective in treating rheumatoid arthritis, but may cause side effects. They can be taken by mouth or injected into a joint. Other drugs given by injection, known as TNF-blockers, can also be very effective. (These drugs are injected under the skin or infused into a vein).
Physical therapy helps restore use of affected joints and muscles. Occupational therapy teaches you how to overcome the disability and manage everyday tasks.
You may wear splints to rest inflamed joints and to prevent them from becoming deformed.
Sometimes severely damaged hips and knees are surgically replaced.
How can I take care of myself?
No one yet knows how to prevent rheumatoid arthritis. However, you can relieve the symptoms and help prevent the permanent joint deformity that can result from flare-ups by following these guidelines:
- Take the medicine your health care provider recommends for controlling your arthritis.
- Rest your joints when they are warm, swollen, or painful.
- Follow the advice given by your health care provider or a physical therapist on how you can best keep the affected joints mobile.
- Ask an occupational therapist ways you can cope with everyday tasks.
- Try to keep a positive outlook. It will make it easier for you to cope.
- Keep your body healthy by eating a healthy, varied, low-fat diet.
- Follow any other recommendations made by your health care provider for controlling your arthritis.
- Report all changes in your condition, including signs of infections, to your doctor or nurse.
Reviewed by David A. Fox, MD, Professor of Internal Medicine, Rheumatolgoy Division, University of Michigan Health System, April 2005
Developed by Ann Carter, MD, for McKesson Health Solutions LLC.
Published by McKesson Health Solutions LLC.
Last modified: 2004-11-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
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