What Are The Early Signs Of Rheumatoid Arthritis
Early signs of rheumatoid arthritis include tenderness or pain in small joints like those in your fingers or toes. Or you might notice pain in a larger joint like your knee or shoulder. These early signs of RA are like an alarm clock set to vibrate. It might not always been enough to get your attention. But the early signs are important because the sooner youre diagnosed with RA, the sooner your treatment can begin. And prompt treatment may mean you are less likely to have permanent, painful joint damage.
Can Rheumatoid Arthritis Go Away
No, rheumatoid arthritis doesnt go away. Its a condition youll have for the rest of your life. But you may have periods where you dont notice symptoms. These times of feeling better may come and go.
That said, the damage RA causes in your joints is here to stay. If you dont see a provider for RA treatment, the disease can cause permanent damage to your cartilage and, eventually, your joints. RA can also harm organs like your lung and heart.
A note from Cleveland Clinic
If you have rheumatoid arthritis, you may feel like youre on a lifelong roller coaster of pain and fatigue. Its important to share these feelings and your symptoms with your healthcare provider. Along with X-rays and blood tests, what you say about your quality of life will help inform your treatment. Your healthcare provider will assess your symptoms and recommend the right treatment plan for your needs. Most people can manage rheumatoid arthritis and still do the activities they care about.
Last reviewed by a Cleveland Clinic medical professional on 02/18/2022.
Talking To Your Doctor About A Medication Switch
If youre in chronic pain, your rheumatologist wants to know. Its not okay to just feel fine or live with it for several good reasons.
I dont want my patients to be living in pain, says Leah Alon , MD, a rheumatologist in New York City. Chronic pain is related to depression and acute pain is related to anxiety. Pain also impacts your relationships, your ability to care for your family, and your ability to find and maintain a job.
If your medication isnt working well enough and RA inflammation persists, it can cause permanent damage to the joints. Once you get damage to the joint, there is no way back, says Dr. Alon. You can prevent further damage, but you cant correct the damage that was already done.
Whats more, since untreated RA can cause systemic or all-over inflammation, it can have a negative impact on many parts of your body, including skin, lungs, heart, nerves, and kidneys.
If youre anxious about trying a new medication or are afraid you cant afford it, dont hesitate to let your rheumatologist know. We want to understand all of your concerns surrounding your medication so we can help guide you and make recommendations, says Dr. Schulman.
When it comes to considering a treatment change, its always a we make together.
Here are a few questions you can ask your rheumatologist if youre considering a treatment change:
The good news is that there are more medications than ever to treat RA and manage pain.
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What Are The Risk Factors For Ra
Researchers have studied a number of genetic and environmental factors to determine if they change persons risk of developing RA.
Characteristics that increase risk
- Age. RA can begin at any age, but the likelihood increases with age. The onset of RA is highest among adults in their sixties.
- Sex. New cases of RA are typically two-to-three times higher in women than men.
- Genetics/inherited traits. People born with specific genes are more likely to develop RA. These genes, called HLA class II genotypes, can also make your arthritis worse. The risk of RA may be highest when people with these genes are exposed to environmental factors like smoking or when a person is obese.
- Smoking. Multiple studies show that cigarette smoking increases a persons risk of developing RA and can make the disease worse.
- History of live births. Women who have never given birth may be at greater risk of developing RA.
- Early Life Exposures. Some early life exposures may increase risk of developing RA in adulthood. For example, one study found that children whose mothers smoked had double the risk of developing RA as adults. Children of lower income parents are at increased risk of developing RA as adults.
- Obesity. Being obese can increase the risk of developing RA. Studies examining the role of obesity also found that the more overweight a person was, the higher his or her risk of developing RA became.
Characteristics that can decrease risk
Will Changing My Diet Help My Rheumatoid Arthritis
When combined with the treatments and medications your provider recommends, changes in diet may help reduce inflammation and other symptoms of RA. But it wont cure you. You can talk with your doctor about adding good fats and minimizing bad fats, salt and processed carbohydrates. No herbal or nutritional supplements, like collagen, can cure rheumatoid arthritis. These dietary changes are safer and most successful when monitored by your rheumatologist.
But there are lifestyle changes you can make that may help relieve your symptoms. Your rheumatologist may recommend weight loss to reduce stress on inflamed joints.
People with rheumatoid arthritis also have a higher risk of coronary artery disease. High blood cholesterol can respond to changes in diet. A nutritionist can recommend specific foods to eat or avoid to reach a desirable cholesterol level.
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Transcutaneous Electrical Nerve Stimulation
This form of therapy uses low-voltage electric currents to stimulate nerves and interfere with pain pathways. TENS is usually used for stubborn, chronic pain and not as a first-line treatment for RA, Ali says. One of the benefits of this treatment is the low occurrence of side effects. If youre interested in trying TENS for pain relief, talk with your physical therapist. If you have a pacemaker, a heart problem, or epilepsy or youre pregnant get your doctors approval first before trying TENS.
Hand Surgery For Ra May Become Less Common
Physicians expect that recent improvements in medications for rheumatoid arthritis will reduce the need for corrective surgeries in the hand.3 The sooner steps are taken to prevent joint damage the better the chances for avoiding hand surgery.
There is no known cure for rheumatoid arthritis, but symptoms in the hand and wrist can be managed with home and medical care andin some casessurgery.
Read more about Rheumatoid Arthritis Treatment
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How Common Is Ra Back Pain
When back pain is RA related, inflammation in the cervical spine is usually the cause.
RA primarily affects peripheral jointssuch as in the hands, feet, and kneesbut the cervical spine is the second most common region that’s affected.
The spine is affected when RA progresses. In other words, inflammation in the back and spine may indicate a more advanced disease. However, the damage can be seen on X-rays as early as two years after diagnosis.
A 2015 report suggests that more than 80% of people with RA have some cervical spine involvement.
Although pain in the lumbar spine, or low back, is not commonly a part of RA, it’s associated with RA. This means that if you have RA, it’s common to also have low back pain.
A 2013 study reported that up to 65.5% of people with RA may experience low back pain. The researchers also noted that people with RA who had low back pain reported lower quality of life and had an increased risk for depression.
A 2017 report in the German medical journal Zeitschrift für Rheumatologie also found that low back pain in those with RA led to a higher degree of disability.
How To Handle Rheumatoid Arthritis Pain
While you may not be able to avoid the pain that comes with rheumatoid arthritis , you can take action to limit it. Start with these eight ideas:
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Rheumatoid Arthritis Pain Management
While the overall goal of rheumatoid arthritis therapy is to prevent disease progression and further joint damage, pain management is a necessary daily practice for patients, in order to maximize their quality of life. Chronic pain can adversely affect a patients ability to work, participate in physical and social activities, and can generally interrupt day-to-day life.
Despite medications and aggressive forms of treatment, many rheumatoid arthritis patients experience ongoing pain and stiffness. The reality is, it may never completely go away. But there are specific things patients can do to manage pain and limit its impact on their lives.
What Medications Treat Rheumatoid Arthritis
Early treatment with certain drugs can improve your long-term outcome. Combinations of drugs may be more effective than, and appear to be as safe as, single-drug therapy.
There are many medications to decrease joint pain, swelling and inflammation, and to prevent or slow down the disease. Medications that treat rheumatoid arthritis include:
Non-steroidal anti-inflammatory drugs
- Golimumab .
- Tocilizumab .
Biologics tend to work rapidly within two to six weeks. Your provider may prescribe them alone or in combination with a DMARD like methotrexate.
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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
- Weight loss
How Is Spinal Arthritis Diagnosed
Your doctor may use some or all of the following diagnostic methods to confirm spinal arthritis:
Medical history and physical exam
Blood tests for genetic markers and/or RA antibodies
X-rays of the spine to locate the arthritic joint
Joint aspiration: testing of the synovial fluid inside a joint
To pinpoint the painful joint, your doctor may numb it with an injection and check whether the pain goes away.
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Understanding Your Treatment Options
If patients have a flare-up of RA that was previously controlled, its important to promptly seek the advice of your rheumatologist to decide which treatment plan is right for you, says Dr. Schulman.
When a patient has had sustained disease activity over weeks or more, that indicates that the current regimen is failing and a different medication should be considered, says Dr. Goodman.
The medication your doctor recommends whether its a new therapy or a higher dose or in addition to something youre already taking is very individualized. Every single patient is different, says Dr. Schulman.
The treatment options to consider will depend on the progression of the disease, severity of flare, comorbidities, and a patients personal preferences.
However, there is one common factor: Treatment choices are always a balance between risks and benefits, notes Dr. Goodman.
Heres a closer look at some treatment change options that you and your rheumatologist may discuss:
A short course of anti-inflammatories to treat the inflammatory response.
An increase in dosage of your current medication. Sometimes adjusting doses and optimizing the ongoing therapy can be sufficient, says Dr. Goodman.
A change in the route of administration for example, changing from pills to injections for better absorption, says Dr. Schulman.
Stopping your current medication and switching to an alternative treatment, including:
Watch Our Video About What Rheumatoid Arthritis Is
Rheumatoid arthritis is a condition that can cause pain, swelling and stiffness in joints.
It is what is known as an auto-immune condition. This means that the immune system, which is the bodys natural self-defence system, gets confused and starts to attack your bodys healthy tissues. In rheumatoid arthritis, the main way it does this is with inflammation in your joints.
Rheumatoid arthritis affects around 400,000 adults aged 16 and over in the UK. It can affect anyone of any age. It can get worse quickly, so early diagnosis and intensive treatment are important. The sooner you start treatment, the more effective its likely to be.
To understand how rheumatoid arthritis develops, it helps to understand how a normal joint works.
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Exercise Can Ease Rheumatoid Arthritis Pain
Rheumatoid arthritis can cause pain and stiffness that makes moving the last thing you want to do.
But staying active is important. Not only is it beneficial for your general health it’s also a way to strengthen your joints, improve your range of motion, and give you the opportunity to take part in the activities you enjoy.
For people with RA, it’s best to take a cautious and strategic approach when starting an exercise program. An individualized program ideally developed with the help of a physical therapist can help you protect vulnerable joints while strengthening surrounding muscles. A well-rounded exercise program should include each of these elements:
Aerobic conditioning. Exercise that increases your heart rate and breathing rate has many benefits, including lowering your chances of developing conditions such as diabetes, stroke, and heart disease. It’s especially important for people with rheumatoid arthritis because they are more prone to developing heart disease than people without RA. When choosing aerobic activities, people with rheumatoid arthritis should consider low-impact exercises such as swimming, bicycle riding, and walking.
Stretching and flexibility exercises. Joints damaged by rheumatoid arthritis don’t move with the same ease or to the same degree as healthy joints. That makes activities that lengthen and strengthen the muscles surrounding your joints, such as stretching exercises, tai chi, and yoga, especially important for people with RA.
Whats The Age Of Onset For Rheumatoid Arthritis
RA usually starts to develop between the ages of 30 and 60. But anyone can develop rheumatoid arthritis. In children and young adults usually between the ages of 16 and 40 its called young-onset rheumatoid arthritis . In people who develop symptoms after they turn 60, its called later-onset rheumatoid arthritis .
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Use Hot And Cold Therapy
Heat and cold treatments can help relieve arthritis pain and inflammation.
- Heat treatments can include taking a long, warm shower or bath in the morning to help ease stiffness and using an electric blanket or moist heating pad to reduce discomfort overnight.
- Cold treatments can help relieve joint pain, swelling, and inflammation. Wrap a gel ice pack or a bag of frozen vegetables in a towel and apply it to painful joints for quick relief. Never apply ice directly to the skin.
- Capsaicin, which comes from chili peppers, is a component of some topical ointments and creams that you can buy over the counter. These products provide warmth that can soothe joint pain.
What Are The Symptoms Of Rheumatoid Arthritis
Rheumatoid arthritis affects everyone differently. In some people, joint symptoms develop over several years. In other people, rheumatoid arthritis symptoms progress rapidly. Many people have time with symptoms and then time with no symptoms .
Symptoms of rheumatoid arthritis include:
- Pain, swelling, stiffness and tenderness in more than one joint.
- Stiffness, especially in the morning or after sitting for long periods.
- Pain and stiffness in the same joints on both sides of your body.
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Tips For Rheumatoid Arthritis Pain Management
Other than the pain itself, rheumatoid arthritis can cause many other problems and disruptions in life. There are some things you can do to stay healthy and reduce your pain. These are in addition to your regular treatments.
Here are some tips to help you with your rheumatoid arthritis pain management and coping with the disease:
Dont smoke: Smoking can have serious health consequences on rheumatoid arthritis patients. Smoking causes inflammation, which can complicate these disease and cause more pain.
Be conscious of your use of joints: Try reducing the stress on your joints by being conscious of your daily activities. Picking up items and turning door handles can add pressure to your joints causing them to feel sore. Look for ways to adjust your daily habits and limit the aggressive use of your joints.
Talk to your doctor and rheumatologist: If you still feel pain despite treatment, or you notice new pain, be sure to communicate with your physician and your rheumatologist. There may be additional pain relieving options available.
Seek emotional support: Deal with any stress or trauma you may feel by joining a support group of other rheumatoid arthritis patients. Professional counseling may also help improve your mood and help you to remain positive.
If you continue to experience chronic pain, there are several options for you to try. Talk to your rheumatologist about rheumatoid arthritis pain management options that are right for your individual case.