Rheumatoid arthritis (RA) is a “rheumatic disease”, that can affect the organs and systems of the whole body. It is a serious, long-term, and progressive condition, but one in which there are often periods in which the disease does not cause any symptoms. Fortunately, modern treatment can prolong these symptoms-free periods and slow the disease process.
Rheumatoid arthritis is an autoimmune condition, in which the body’s defense mechanism attacks its own tissues. It affects about three times more women than men. It can strike at any stage of life, but it usually becomes apparent between ages 40 and 60.
In RA, joints lubricated by synovial fluid become inflamed – and a large number of the joints in your body, including the facet joints of the vertebrae, are synovial. This inflammation leads to a reduction in mobility and damage to bones and cartilage. In the spine, the cervical (neck) vertebrae are most commonly affected by this condition.
The symptoms of RA tend to come and go, often being inactive for months or even years. This makes the condition difficult to diagnose early. The hands and wrists are often the first to be affected, leading over time to severe deformities.
The disease often affects the cervical vertebrae, leading to pain at the base of the neck as the vertebrae become unable to support the weight of the skull, and so slip bit, leading to deformities and the serious risk of spinal cord compression at the base of the skull.
Compression in other areas of the spine may first become apparent if your gait starts to change. You may also experience weakness and problems in keeping your balance. When the condition is active, there is muscle and joint stiffness, frequently accompanied by tiredness, a raised temperature, and a loss of appetite.
RA can also affect other organs and systems of the body, such as the lungs, kidneys, heart, liver (“Felty’s syndrome), and the eyes (“Sjogren’s syndrome), which often become dry and inflamed.
What Causes Rheumatoid Arthritis?
Nobody knows for sure. What is clear is that a family history of RA predisposes to it, and there is strong evidence that cigarette smoking, stress, and obesity are all risk factors.
It is thought that, especially when risk factors are present, a viral or bacterial infection may trigger an autoimmune response in which your body’s defensive immune system starts to target your body’s own tissues.
Figuring Out What’s Wrong
A doctor may first suspect RA after looking at your joints to see whether they are swollen, twisted in any way, or tender; stiffness (characteristically in the morning) and decreasing mobility are also key indicators. The relative numbers of small and large joints affected are an important part of the diagnosis. Blood samples are also taken. In about 80 percent of people who have RA, an antibody – that is, a protein that destroys material identified as foreign – called “rheumatic factor” is found, but some people who have this antibody in their blood do no have RA.
Fixing Rheumatoid Arthritis
The earlier a diagnosis is made and treatment can start the better in order to reduce the risk of irreversible joint damage.
The pain of RA can be relieved by oral medication, physiotherapy or injection.