Description

Unlike osteoarthritis, rheumatoid arthritis is an inflammatory, not degenerative, disease. It first appears as an inflammation in a joint's synovium, the membrane that lines and lubricates the joint. Once inflamed, the membrane thickens and become sore and swollen-which in turn may limit the affected joint's movement. In time, this inflammation spreads to other parts of the affected joint, causing even more stiffness and pain. Eventually, the inflammation can spread to organs, such as the heart, lungs, and eyes. Its ability to spread throughout the body makes rheumatoid arthritis a systemic disease-a disease that affects the entire body.

Inflammation is not a harmful state, per se. It's actually your body's normal response to infections and injuries, caused when your white cells battle an invading organism. Typically, the inflammation subsides after the infection is wiped out. However, with rheumatoid arthritis, the autoimmune system seems to fight the body instead of protecting it.

While the disease can strike at any time, it usually occurs between the ages 20 and 50. It affects approximately three times as many women as men.

Unlike illnesses that have a set progression of symptoms, rheumatoid arthritis is unpredictable. What symptoms appear, how often they appear, and what joints and organs are affected vary widely, depending on the individual. In some sufferers, rheumatoid arthritis will flare up occasionally, only to be followed by periods of normal health. Others experience recurring attacks without returning to a state of full wellness in between. Many experience a slow and steady increase in the severity of their symptoms over time.

Some people with rheumatoid arthritis develop small lumps under the skin near the elbow, ears, or nose, or on the back of the scalp, over the knee, or under the toes. Called rheumatoid nodules, these painless and non-problematic bumps range from the size of a pea to the size of a Ping-Pong ball.

While medical experts have not identified a single cause for rheumatoid arthritis, possibilities include heredity, viral or bacterial infection, and emotional stress.

Signs and Symptoms

Pain, swelling, redness, and warmth in the affected joint-most commonly affects the smaller joints of your hands and feet, but elbows, knees, and ankles can be affected

Usually affects joints symmetrically (both hands, for example)

Overall stiffness and achiness, especially after periods of stillness, such as sleeping or long plane rides

Symptoms are worse in the early morning and lessen as the day progresses. General malaise/weakness

Anemia

Pain usually occurs during rest and movement

Conventional Medical Treatment

A series of blood tests, along with a thorough physical exam and medical history, can confirm whether you have rheumatoid arthritis. X-rays may also be helpful. Strategies for treating rheumatoid arthritis differ, depending on whether it is active or in remission. During a flare-up, a combination of rest, heat, and medication is prescribed. Anti-inflammatory drugsaspirin, in particular are the first line of treatment and may ease symptoms. There are several other medications used to treat rheumatoid arthritis. Your doctor may prescribe gold salts, penicellamine, methotrexate, azathioprine, or anti-malarials, depending on how your symptoms progress. Corticosteroids can temporarily relieve pain and inflammation, but they are usually reserved for those with more serious disease.

Physical therapy plays a major role in the treatment of rheumatoid arthritis. It is most effective when swelling and inflammation of the joint are suppressed with medications. Physical therapy can reduce deformity and restore function.

In severe cases, surgical removal of affected joint lining can prevent damage to other joint structures and cartilage. Another surgical procedure fuses the painful, uncushioned bones together but is only performed on the wrist, feet, ankles, and thumbs because it restricts motion. Tendon transfer is another surgical option for repairing damaged tendons and ligaments it is performed most frequently on the hands. Another option is arthroplasty, or joint replacement, which is usually performed on knees, hips, and shoulders.