Rheumatoid arthritis (RA) occurs as a result of the immune system causing inflammation of the lining of joints and surrounding structures.
About rheumatoid arthritis
Arthritis means inflammation of the joints. Rheumatoid arthritis (RA) is an autoimmune disease. This means that the white cells and antibody proteins in your blood that usually fight infections enter your joints and cause inflammation. This causes heat, swelling and excess fluid to be produced.
Eventually, this may lead to thinning of the cartilage that covers the ends of your bones, and may cause the bone to be worn away. Rheumatoid Arthritis may also cause inflammation of the sheaths around your tendons. Rarely, the condition can affect other parts of your body, such as your lungs.
Rheumatoid Arthritis affects more than 350,000 people in the UK and can start at any age.
Symptoms of rheumatoid arthritis
You may notice discomfort initially in a few joints such as your fingers, knuckles, wrists or the balls of your feet. Typically RA is a ‘symmetrical’ arthritis – this means it affects both wrists or both hands in the same way. For most people, RA develops quite slowly at first. Other people find the condition comes on quickly and painfully, making it difficult to carry out daily activities. Symptoms include:
- stiff and painful fingers when it rains or when the weather changes
- pain and swelling around the joint, making it tender and warm
- stiffness in the morning, or if you sit for a long time
- poor grip strength
- tiredness, making you feel irritable and depressed
- rheumatoid nodules – fleshy lumps that usually appear on your hands, feet and elbows
RA affects everyone differently. You may find that your symptoms come and go with little pain, swelling or inflammation in between the flare-ups. Flare-ups can last for a few days to a couple of months. You probably won’t be able to predict when they will occur.
Causes of rheumatoid arthritis
The exact reasons why you may develop RA aren’t fully understood at present. There are a number of things that seem to be involved. Women are nearly three times more likely to get RA than men. Symptoms tend to improve during pregnancy, suggesting that hormones and the immune system may be involved. It’s possible that RA is triggered by an infection or virus, but there isn’t any evidence to prove this.
Having certain genes makes it more likely that you will get RA, and the disease runs in some families. Lifestyle factors may also increase your risk, for example, if you smoke or are obese.
Diagnosis of rheumatoid arthritis
If you think you may you have RA, even if your symptoms are mild, see us. It’s important to start treatment as early as possible, especially if you have had symptoms for more than three months. Treatment focuses on reducing inflammation to limit the damage to your joints. If left untreated, RA may lead to serious disability.
Our doctor will ask about your symptoms and examine you. He or she may also ask you about your medical history. There’s no single test that can diagnose RA but our doctor may refer you for one or more of the following.
- A blood test for a marker called rheumatoid factor, present in eight in ten people with RA.
- X-ray, ultrasound or magnetic resonance imaging (MRI) to look for changes in your joints.
Treatment of rheumatoid arthritis
There are things you can do to help ease the symptoms of RA.
- Find a balance between exercise and rest. It’s important to exercise to stop your joints from becoming weak and stiff but don’t do too much. Swimming is excellent because it strengthens your muscles and joints without putting any strain on them.
- Losing excess weight will reduce the pressure on your joints.
- Use a splint on the affected joint and rest it during a flare-up.
- Painkillers may help to relieve pain and stiffness.
- Non-steroidal anti-inflammatory drugs (NSAIDs) reduce symptoms of inflammation, relieving pain and swelling.
- Anti-inflammatory injection in to a specific joint can help to reduce inflammation
- Shockwave therapy
- Platelet rich plasma therapy
As medical treatments have improved it’s now less likely that you will need surgery to treat RA. However, if you have severely damaged joints and medicines haven’t helped, your doctor may recommend one of the following operations to reduce pain and discomfort.
- A hip or knee replacement.
- Synovectomy to remove the lining of an inflamed joint.
- Removal or repair of severely inflamed tendons.
- Surgery to fuse a joint to make it more stable.
Living with rheumatoid arthritis
You may find Rheumatoid Arthritis upsetting and frustrating at times. It’s important to tell your doctor how it’s affecting your life so you get the most suitable treatment. You may need to make changes to your daily life but there are people who can help to make this easier.
There is some evidence to suggest that if you have an inflammatory condition such as rheumatoid arthritis, you may be at a greater risk of heart disease. Therefore, it’s important to take steps to minimise your risk of developing this, for example by reducing the amount of saturated fat in your diet and taking regular exercise. Our doctor can give you more advice and information.