Rheumatoid arthritis (RA) affects more than 2 million people in the United States alone. RA is a systemic autoimmune disease which can manifest itself in multiple joints of the body. It is most often accompanied by swelling, stiffness, deformity and pain. RA is distinguished from osteoarthritis, and other forms of arthritis, due to its symmetrical features, or its tendency to occur equally on both sides of the body.
RA is more common in adult females, yet it can affect men and children. Features of RA include inflammation that often affects the wrist and finger joints. It can also produce tender, swollen and/or warm joints, firm bumps under the skin (known as rheumatoid nodules), symmetrical pattern of affected joints – meaning if one hand or knee is involved the other one will also be involved, as well as fatigue, pain, stiffness, loss of function and occasional fevers.
The immune system and rheumatoid arthritis
Each type of arthritis involves a different part of the joint tissue. In people with RA, the immune system acts as if the joints are a foreign matter in the body. It then begins to target the synovial membrane, or the lining, that covers the joints. As the membrane becomes inflamed, this ‘synovitis’ causes enzymes to be released. These enzymes act as an erosive and cause a chronic inflammatory process within the joint lining. Over time the joint lining begins to thicken and swell causing damage to the joint surface. Rheumatoid arthritis can also affect the lining of the heart and lungs.
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How long will you have rheumatoid arthritis?
For some people, RA may last for only a few months or a couple of years. It can then go away without leaving behind any noticeable damage. Other people can have a more moderate form of the disease which is marked with times when their symptoms flare up and periods when they are in remission. Still others have a severe form of RA and the disease is active most of the time. This severe form of RA often leads to serious damage of the joints. While there is no cure for RA, researchers are working hard to find better ways to treat the disease.
Current treatment strategies which help most people lead productive and active lives include:
Rest and exercise: People with RA are advised to rest when the disease is active and to exercise when the disease is not active.
Joint care: Some people find that wearing a splint, especially on the wrists and hands, reduces pain and swelling. A medical professional can help a person choose a splint that fits properly. Other ways to care for the joints and reduce stress is to use self-help devices such as zipper pullers, long-handled shoe horns, grabbers and other assistive devices.
Diet: While there is no evidence that shows that any specific food or nutrient helps rheumatoid arthritis, with the exception of a few specific oils, having a nutritious diet and consuming adequate protein and calcium is important.
Medications: Most people who have RA will take medications. Some medications are used to reduce inflammation, others are used for pain relief and still others are used to try to slow the course of the disease.
Surgery: If medications are not preventing or slowing down joint damage, there are several types of surgeries which can benefit RA patients who have severe joint damage such as tendon repair, total joint replacement and removal of the joint lining.
What causes rheumatoid arthritis?
Science is still investigating what causes a person’s immune system to fight against itself in RA. While there is still much to learn, researches have begun to see that genetics may be one factor. For instance as many as 60% to 70% of RA patients with European ancestry carry the HLA-DR4 gene – compared with 30% in the general population. While this is an important discovery, it does indicate that there is more than one gene involved in RA.
Many scientists believe that people who have the genetic makeup of RA must have something occur in their environment to trigger the disease to process – possibly a bacterial or viral infection. Another area under investigation is why women are more likely to develop RA than men. Scientists are currently studying a variety of hormonal factors such as contraceptive use, hormonal changes and hormone deficiencies to see how they are linked to RA.
Even though science hasn’t answered all the many questions surrounding RA, work continues. If you would like to learn more about RA and the research that is underway, visit The Arthritis Foundation.