What Joints Does Rheumatoid Arthritis Affect

Rheumatoid Arthritis Vs Osteoarthritis

Many people confuse rheumatoid arthritis with osteoarthritis due to their similar symptoms, but the two diseases are caused by different factors.

What is Osteoarthritis?

Whereas rheumatoid arthritis is an autoimmune disease that causes joint malfunction due to inflammation, osteoarthritis is a mechanical disease brought on by the destruction of joints through wear and tear.

Osteoarthritis is the most common form of arthritis, with approximately 27 million Americans over the age of 25 having been diagnosed with it. Osteoarthritis is also most commonly seen in people middle-aged to elderly and is the top cause of disability in those age groups, though it can also appear in younger people who have sustained joint injuries.

With osteoarthritis, the cartilage, joint lining, ligaments, and bone are all affected by deterioration and inflammation. When the cartilage begins to break down due to stress or changes in the body, the surrounding bones slowly get bigger and begin to fail.

Osteoarthritis is a slowly progressing disease and occurs in the joints of the hand, spine, hips, knees, and toes. Furthermore, risk factors of this disease most often stem from lifestyle or biological causes, such as:

Osteoarthritis sometimes occurs alongside rheumatoid arthritis or other disease, such as gout.

Whats New In Arthritis Research

Progress is so fast in some areas of arthritis research today that the media often report new findings before the medical journal with the information reaches your doctorâs office. As a result, you need to know how to evaluate reports on new arthritis research.

Arthritis researchers are looking at four broad areas of research. These include causes, treatments, education and prevention.

Researchers are learning more about certain conditions. For example in osteoarthritis, researchers are looking for signs of early destruction of cartilage and ways to rebuild it. For rheumatoid arthritis and other types that involve inflammation, researchers are trying to understand the steps that lead to inflammation and how it can be slowed or stopped. An initial study suggests that fibromyalgia affects more older people than originally thought and often may be overlooked in this group. Your doctor can tell you about other new research findings. If you would like to take part in arthritis research, ask your doctor for a referral to a study in your area.

Many people help make arthritis research possible. The federal government through its National Institutes of Health is the largest supporter of arthritis research. Drug companies do the most research on new medications.

What Are The Signs And Symptoms Of Ra

With RA, there are times when symptoms get worse, known as flares, and times when symptoms get better, known as remission.

Signs and symptoms of RA include:

• Pain or aching in more than one joint
• Stiffness in more than one joint
• Tenderness and swelling in more than one joint
• The same symptoms on both sides of the body

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How Does Rheumatoid Arthritis Affect Heart Health

Chronic inflammation from Rheumatoid Arthritis may affect the areas of the body besides the joints. This can also lead to lung, heart, and eye problems.

Proteins called cytokines are linked with the growth and activity of the other immune system cells. All these proteins are responsible for how RA attacks the joints and damages the blood vessels in cardiovascular disease.

What Increases The Risk Of Developing Arthritis In The Toe

Risk factors for toe arthritis include being overweight, age, family history, and even wearing high-heeled shoes!

• Genes: The anatomy of your foot is dependent on genetics, and if youve got flat feet or excessive pronation , you are at a higher risk for OA. The risk is heightened by the additional weight and pressure put on the big toe.
• Previous toe injuries: If your toe has been broken or sprained in the past, there is a greater risk for toe arthritis because the cartilage in the joint may be damaged.
• Age: Age is a risk factor for arthritis, and most cases are diagnosed after age 30.
• Work: If your job requires a lot of squatting or stress on the toe joint, it could increase the risk.
• Other health problems: Other inflammatory conditions like RA, gout, or lupus can play a role.

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Ra Symptoms In Your Joints

RA almost always affects your joints. It may take a few weeks or months for the first signs to show. The inflammation it causes often leads to these three hallmark symptoms:

• Pain.Inflammation inside a joint makes it hurt whether youâre moving it or not. Over time, it causes damage and pain.
• Swelling. Fluid in the joint makes it puffy and tender.
• Tenderness. It hurts when you move or push on a joint.

Other RA symptoms include:

• Stiffness. The joint is harder to use and doesnât move as well as it should. Itâs especially common in the morning. Although many people with other forms of arthritis have stiff joints in the morning, it takes people with rheumatoid arthritis more than an hour before their joints feel loose.
• Redness and warmth. The joints may be warmer and have color changes related to the inflammation.

Rheumatoid Arthritis Can Impact A Large Number Of Other Organs

RA can significantly affect a number of other organs as it progresses, especially if the disease is not controlled with medications, including:

• The Eyes Episcleritis, an inflammation of the episclera a tissue in the white part of the eye can occur.
• The Lungs Lungs can show scarring or develop interstitial lung disease, which can cause difficulty breathing, breathlessness, or a mild cough. Usually this is seen as the disease progresses, but it can show up in some early-stage patients, says Mannon.
• The Skin Some patients may develop blisters or nodules under the skin that are caused by inflamed blood vessels. Rashes and skin ulcers can erupt as well.
• The Mouth People with RA are twice as likely to have gum disease as those without RA. Research suggests that underlying gum disease may be a trigger for developing RA, and that getting treated for gum disease can improve joint symptoms.
• The HeartHeart failure is twice as common in people with RA, and theyre also 50 percent more likely to have a heart attack.
• The Kidneys RA can also damage the kidneys, especially when RA is not well controlled.

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Joint Damage Pain Deformities Loss Of Function: Late

It is important for people with these symptoms to be diagnosed as soon as possible, because if RA isnt diagnosed and treated early the synovial lining can become so inflamed that it damages and erodes the cartilage this makes bone loss more likely.

Moving joints becomes more difficult, and flare-ups can occur with greater frequency. These joint changes are called erosions, and they can lead to deformities of the bone, such as crooked fingers, says Daniel Solomon, MD, MPH, chief of the section of clinical sciences in the division of rheumatology at Brigham and Womens Hospital in Boston. In severe cases, bones may eventually fuse together. All of this further contributes to pain and loss of function.

How Arthritis In The Hands Is Treated

If youre diagnosed with an inflammatory form of arthritis, you have more treatment options than someone with OA. While nonsteroidal anti-inflammatory drugs can help manage the pain of both types of arthritis, the development of disease-modifying antirheumatic drugs and biologics has vastly improved the prognosis of those with inflammatory forms of arthritis by reducing inflammation and preventing further joint damage.

Cortisone injections can be useful for those with OA and conditions such as RA, though theyre usually used in patients whose inflammatory arthritis is limited to just one or two joints, Dr. Byram says. Injections of hyaluronic acid can be helpful for those with OA , but these are better for managing pain in larger joints like the knees rather than the hands.

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Research On Rheumatoid Arthritis

In the last decade, much research has been conducted to increase our understanding of the immune system and what makes it malfunction. There have also been new therapies developed to help treat the disease. Some of the topics of intense research include:

What are the genetic factors that predispose people to develop rheumatoid arthritis?

Some white blood cells, commonly known as T cells, are important in maintaining a healthy and properly functioning immune system. However, scientists have discovered a variationcalled single nucleotide polymorphism in a gene that controls T cells. When the SNP gene variation is present, T cells attempt to correct abnormalities in joints too quickly, causing the inflammation and tissue damage associated with RA. The discovery of SNP may help determine peoples risk for getting RA and might help explain why autoimmune diseases run in families.

At conception, twins have an identical set of genes. So why would only one twin develop RA?

How Is Rheumatoid Arthritis Diagnosed

Diagnosing RA may be difficult in the early stages. This is because symptoms may be very mild, and signs of the disease may not be seen on X-rays or in blood tests. Your healthcare provider will take your medical history and give you a physical exam. Tests may also be done, such as:

• X-ray. This test uses a small amount of radiation to create images of internal tissues, bones, and organs onto film.
• Joint aspiration. For this test, a small fluid sample is taken from a swollen joint. It is done to look for signs of infection or gout.
• Nodule biopsy. Tiny tissue samples are taken to look at under a microscope. This helps to check for cancer or other abnormal cells.
• Blood tests. These tests are done to find certain antibodies, called rheumatoid factor, cyclic citrullinated antibody, and other signs of RA.
• Ultrasound or MRI. These imaging tests can look for bone damage and inflammation.

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How Ra Hand Pain Is Diagnosed

Theres no one test to diagnose RA and in its early stages, signs and symptoms can mimic those of many other diseases.

But early diagnosis of rheumatoid arthritis is important for the best outcome. We are learning that we need to control inflammation much more aggressively upfront as joint damage can ensue early on, says Dr. Albayda. Hence, there has been a shift in treatment paradigms to catching patients early and instituting treat-to-target control.

To help determine whether you have RA in your hand or wrist, a health care provider will examine your hands and fingers for such symptoms as:

• Joint instability

They will also ask questions about other symptoms that tend to go along with RA, such as fatigue, flu-like symptoms, fever, and disrupted sleep.

A health care provider may order imaging tests to check for certain characteristics of RA, such as narrowing of the joint space or erosions of the bone. They will run blood tests to look for antibodies that may be found in people with RA as well as elevated levels of markers of inflammation in the blood.

Here is more information about tests used for diagnosing rheumatoid arthritis and criteria used for diagnosing rheumatoid arthritis.

What Are The Diagnostic Criteria For Rheumatoid Arthritis

Diagnostic criteria are a set of signs, symptoms and test results your provider looks for before telling you that youve got rheumatoid arthritis. Theyre based on years of research and clinical practice. Some people with RA dont have all the criteria. Generally, though, the diagnostic criteria for rheumatoid arthritis include:

• Inflammatory arthritis in two or more large joints .
• Inflammatory arthritis in smaller joints.
• Positive biomarker tests like rheumatoid factor or CCP antibodies.
• Elevated levels of CRP or an elevated sed rate.
• Your symptoms have lasted more than six weeks.

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Why Are Rest And Exercise Important For Ra

You need to be active, but you also have to pace yourself. During flare-ups, when inflammation gets worse, itâs best to rest your joints. Using a cane or joint splints can help.

When the inflammation eases, itâs a good idea to exercise. Itâll keep your joints flexible and strengthen the muscles that surround them. Low-impact activities, like brisk walking or swimming, and gentle stretching can help. You may want to work with a physical therapist at first.

Stiffness In The Joints

In addition to pain, this disease causes stiffness in the affected joints. You may have difficulty getting out of bed or walking in the morning because of stiff and painful ankles, knees, or feet. This stiffness is usually worse in the mornings and can last for 45 minutes or more.

RA can also trigger swelling in the affected joints. Long-term inflammation can cause you to feel physically exhausted.

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What Are The Types Of Arthritis

The term arthritis refers to over 100 conditions which can impact the joints. However, the most commonly observed forms of arthritis can be narrowed down to two:

• Osteoarthritis The most common form of arthritis is osteoarthritis, also known as degenerative or wear and tear arthritis. This form of the disease occurs over time, as the joint gradually begins to break down due to age or injury. It most commonly affects the knees, hands, and hips.
• Rheumatoid Arthritis RA is an autoimmune disease in which the bodys own immune system mistakenly attacks healthy cells of the joints. This leads to painful inflammation in the tissue that lines joints and is most commonly observed in the knees, hands, and wrists.

Soothe With Ice And Heat

Cold therapy can provide relief for inflamed joints in the wrist. Cold constricts the blood vessels in the muscles, which decreases blood flow to the joint area to help reduce swelling and inflammation. Heat therapy warms the skin and the joints, which causes blood vessels to dilate, and sends more oxygen and nutrients to the joints and muscles. Try both and see which makes you feel best.

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Symptoms Of Ra Include Some Or All Of The Following:

• Swollen, tender, or warm joints
• Symmetric swollen joints , such as in both your right and left wrists
• Swollen joints in the wrist and finger joints closest to the hand
• Other swollen joints such as the neck, shoulders, elbows, hips, knees, ankles, and feet
• Feeling tired and having low energy
• Pain and stiffness that lasts for more than 30 minutes in the morning or after a long rest
• Symptoms that last for many years

What Are The Four Stages Of Rheumatoid Arthritis

• Stage 1: In early stage rheumatoid arthritis, the tissue around your joint is inflamed. You may have some pain and stiffness. If your provider ordered X-rays, they wouldnt see destructive changes in your bones.
• Stage 2: The inflammation has begun to damage the cartilage in your joints. You might notice stiffness and a decreased range of motion.
• Stage 3: The inflammation is so severe that it damages your bones. Youll have more pain, stiffness and even less range of motion than in stage 2, and you may start to see physical changes.
• Stage 4: In this stage, the inflammation stops but your joints keep getting worse. Youll have severe pain, swelling, stiffness and loss of mobility.

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Isometric Exercises For Better Arthritis Health

Isometric exercises are strength-training workouts in which the muscles contract, but the body doesnt move. Isometrics involves tensing a muscle, then relaxing it. This type of training is especially useful if the usual weight lifting causes your joints to hurt.

Some advantages of isometrics include:

• No need for additional equipment
• The body is activating nearly all of its available motor units
• Increased strength
• Improved flexibility

Isometric exercises are beneficial because they can help you stay strong and healthy. While these exercises are less likely to hurt your joints than traditional weight training, if they do make your joints hurt, ask a trainer to show you another type of isometric exercise.

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Exercising The Ankle Joints

Keeping the ankle joints mobile throughout the day can improve flexibility and range of motion in the area.

Exercises can be designed to ensure the ankles stay mobile but without adding too much strain and causing further damage.

Strengthening the muscles around the joints can also reduce further damage by providing extra support.

People can try specific exercises that stretch and strengthen the ankle joints to reduce pain, stiffness, and swelling, including:

• exercises to strengthen the foot and ankle muscles to relieve pressure on the joints
• stretches to alleviate stiffness in the tissue surrounding the ankles

Physical therapists can create exercises plans that they tailor for the individual. People will need to find out what exercises are best for their needs.

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How Rheumatoid Arthritis Affects You Over Time

When you deal with inflammation for a long time without any treatment, it can damage the cartilage of your bones. The cartilage is elastic-like tissue that covers bones and joints. When the effects of rheumatoid arthritis go unchecked, the normal joint spacing between bones becomes smaller. In addition to causing pain in the joints, the shrinking of this space can also lead to loose and unstable joints that you may have trouble controlling voluntarily.

The most common areas of the body affected by rheumatoid arthritis include the ankles, elbows, feet, hands, knees, and wrists. The disease is symmetrical, which means it typically affects both the right and left body part at the same time. It is also important to realize that rheumatoid arthritis can affect respiratory, cardiovascular, or other body systems. This makes it a systemic disease, which means that it affects your entire body.

Joint deformity is another common issue with untreated rheumatoid arthritis.

Unfortunately, damage to the joints is not reversible. This is the reason we recommend early diagnosis and aggressive treatment at UHC Rheumatology. While this disease is incurable, it is possible to treat it and manage the symptoms.