Rheumatoid arthritis is an autoimmune disease that is characterized by chronic inflammation of the joints. Commonly affected joints are found in the wrists, hands, and knees. It is an autoimmune disorder, meaning rheumatoid arthritis is caused by the immune system attacking its own body’s tissues resulting in painful swelling. Unlike osteoarthritis that causes wear-and-tear damage, rheumatoid arthritis damages the joint tissue. This damage may result in chronic pain, lack of balance, or deformities.
While rheumatoid arthritis primarily affects joint tissue, it may also affect the skin, lungs, eyes, heart, or blood vessels.
Signs and Symptoms
People with rheumatoid arthritis may experience the following symptoms:
- Painful or aching joints.
- Stiff joints, especially after inactivity.
- Swollen, warm, or tender joints.
- Symmetrical symptoms (such as in both knees).
- Fatigue.
- Weakness.
- Weight loss.
- Fever.
Symptoms may come and go. People often experience periods of worsening symptoms, known as flares, and then experience periods where the pain and swelling get better, known as relative remission.
Causes and Risk Factors
Rheumatoid arthritis happens when the immune system attacks its own cells. While the exact causes of this process remain unclear, there are factors that can make some people more likely to develop the disease. Environmental and genetic risk factors include:
- Genetics: Certain genes and inherited traits increase the risk of developing rheumatoid arthritis. Leukocyte antigen (HLA) class II genotypes may also worsen the disease.
- Sex: Women are generally two-to-three times more likely to develop rheumatoid arthritis.
- Age: While rheumatoid arthritis may occur at any age, the risk increases with age and the onset is most common in adults 60 years or older.
- Smoking: Smoking cigarettes may increase risk and worsen the disease.
- No history of births: Women who have not given birth may be more likely to develop the disease.
- Obesity: People who are overweight have an increased risk of developing the disease, with the risk increasing with more weight.
- Early life exposures: Children with mothers who smoked or parents of lower income have an increased risk of developing the disease as adults.
Diagnosis
Doctors who specialize in caring for rheumatoid arthritis, known as rheumatologists, diagnose the disease by reviewing symptoms and performing physical examinations. The doctor may check joints for swelling, warmth, and redness. Muscle strength and reflexes may also be evaluated. Imaging tests such as X-rays, ultrasound tests, and MRI tests may be used to diagnose and track the disease’s progression. Blood tests may be ordered to determine whether patients have a high erythrocyte sedimentation rate or C-reactive protein that may be associated with inflammation. Other blood tests may look for anti-cyclic citrullinated peptide antibodies. Early diagnosis and effective treatments can reduce join damage.
Complications
Rheumatoid arthritis affects people in many physical and social ways. It may cause problems in the following areas:
- Premature heart disease: Because people with rheumatoid arthritis are at an increased risk of chronic heart diseases treatment often focuses on losing weight and quitting smoking.
- Employment: Rheumatoid arthritis may make it difficult for people to work. Work loss is common with jobs that are physically strenuous.
- Obesity: Obese people with rheumatoid arthritis are more likely to have high cholesterol, high blood pressure, and developing chronic conditions. Medical treatment may not be as effective in obese patients.
Treatment
Medications can reduce pain, swelling, and inflammation of the joints. Medications that ease pain, swelling, and stiffness include:
- Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, aspirin, or naproxen.
- Corticosteroids, including prednisone.
- Narcotic pain relievers.
Treatment for rheumatoid arthritis also commonly includes medications that slow disease progression and prevent deformity in joints. These medications are known as disease-modifying-antirheumatic drugs (DMARDs). Biological response modifiers may be used for second-line treatment.
ProficientRx can help healthcare providers dispense these rheumatoid arthritis medications through an on-site pharmacy. On-site dispensing provides freedom and convenience for providers and patients.
Self-Management Strategies
Treatment may also involve self-management strategies to improve quality of life, including:
- Physical activity: Consistent physical exercise such as walking, biking, or swimming can help improve quality of life and reduce the chances of developing other diseases such as diabetes, heart disease, and depression.
- Weight management: Because obesity increases problems associated with rheumatoid arthritis, weight loss and weight management are important.
- Quit smoking: Cigarette smoking can worsen the disease and lead to other medical problems. Smoking may also make physical activity more difficult.