Rheumatoid arthritis
What is rheumatoid arthritis?
Arthritis is a general term that is used to describe inflammation (pain and swelling) of the joints in the body. Rheumatoid arthritis (RA) is a type of chronic arthritis that occurs in varying joints such as the hands, wrists or knees and will appear in the joints on both sides of the body at the same time. This appearance of the inflammation on both sides of the body (such as both knees, or both wrists) is one way of identifying RA from other types of arthritis (there are more than 150 different types of arthritis). In addition to affecting the joints, RA is known to affect organs of the body including the skin, eyes, lungs, heart, blood and kidneys.
Unlike osteoarthritis, rheumatoid arthritis is an inflammatory disease that can affect people of all ages. It usually starts slowly and often begins in small joints, such as in the fingers. It may begin in just one joint, but will eventually affect several joints, often simultaneously. Also, there are often other symptoms, such as fatigue, having fevers, losing weight, and vague aches and pains. Some people may suffer from only one attack of this disease in their lives. In others, the disease may be long-term and progressive and in some it may progress rapidly.
Rheumatoid arthritis is 3 times more common in women than men and usually begins in people aged from 20-50 years. However, young children and the elderly can also develop the condition.
The cause of rheumatoid arthritis is not fully understood. However, it is thought to be caused by a combination of genetic, environmental and hormonal factors.
What are the symptoms of rheumatoid arthritis?
- General feeling of ill-health.
- Pain in the affected joints.
- Warm, swollen joints.
- Stiffness, which restricts movement, especially early in the morning or following periods of rest.
How is rheumatoid arthritis diagnosed?
There are a number of different ways to diagnose rheumatoid arthritis, with diagnosis usually decided by considering a combination of the following:
- the specific location of the painful joints and whether they affect both sides of the body (called symmetry);
- the presence of stiffness and pain in the joints in the morning;
- the presence of bumps and nodules under the skin (called rheumatoid nodules);
- results of X-rays that show inflammation or damage to the joints; and
- positive results of a blood test for RA to identify the rheumatoid factor in the blood, however, this is not a conclusive test as the rheumatoid factor may be present in people who do not have rheumatoid arthritis.
What you can do
- Consult a doctor to find out what type of arthritis you have.
- Rest the joint until the pain subsides, then resume normal activities to prevent stiffness.
- Keep the joint warm at night and in cold weather.
- Take simple painkillers (after checking with your doctor).
- Gentle exercise, such as swimming in heated swimming pools, can be of help.
- If you are overweight, losing weight can help reduce some of the strain on your joints.
However, a balance of rest and exercise is important. When there is a worsening of the joint inflammation, rest is indicated and you may need to use a walking cane or joint splints. When the inflammation decreases, gentle exercise is needed to maintain mobility in the joint and to strengthen the surrounding muscles.
What your doctor can do for you
- Take X-rays and do other tests, including blood tests, to determine the type of arthritis and assess disease activity.
- Prescribe anti-inflammatory medicine, strong painkillers or special medicines; however, you need to have regular check-ups with your doctor to ensure that there are no problematic side-effects.
- Recommend physiotherapy to relieve pain and stiffness, improve joint movements and strengthen muscles.
- Recommend heat or cold packs.
- Recommend occupational therapy to help if you have been disabled in any way by the condition and are finding it hard to cope with daily activities and tasks.
- Recommend surgery to reduce pain, correct deformities and improve function of the affected joints.
Although there is not yet a cure for rheumatoid arthritis, with the help of your doctor, you can manage it by taking steps to decrease the pain and inflammation of the condition. Current evidence suggests that early aggressive treatment of rheumatoid arthritis may improve the long-term outcome.
Last Reviewed: 28 July 2009
